The Front Cover image at the beginning of these essays was extracted from a German medical journal published in 1944 by one Dr. Liebegott. It is the single best representation of the progress of one form of “stress disease” I have ever seen and it was republished in Hans Selye’s 1950, 1025 page tome on the subject of “stress”. These post-mortem autopsy slides of adrenal glands demonstrate, from the left to right, a normal unstressed adrenal gland, followed by an adrenal gland from a man who suffered from high blood pressure, and next another slice from another man suffering from high blood pressure, and finally, on the far right, the mere shell of an exhausted adrenal gland. The gland slices were stained for fat, as cholesterol (a fat) is the primary chemical building block for all 18 life sustaining adrenal “steroid” hormones produced by the outer shell of the adrenal gland in the 4 layers of that “cortex”. The center two slices demonstrate excessive synthesis of the stress hormone “cortisol” and their swollen, enlarged condition consistent with excessive production of that hormone (and others) known to increase blood pressure, just as the final slice demonstrates an exhausted gland incapable of producing this vitally important hormone. This image demonstrates the progression of the “stress disease” of high blood pressure and its fatal conclusion in “adrenal fatigue/collapse”, and no doubt death.
After a 42 year clinical psychiatry practice and livelong study of chemistry, biology, neuroscience, general medicine, and psychiatry, I have have come to the painful conclusion that 9 out of ten physicians prescribing anti-depressant medications have no idea how they work or how to use them properly, thanks to Big Pharma and our lack of competent medical education. Why am I writing this now? I spent much of yesterday with a friend, who I have not seen in a while, and who has been taking “Zoloft”, 200 mgm/d. for some time now. When I asked him to rate his mood on a ten point scale, with 10 being the happiest ever, he replied that he was at a 2. In my long experience, before retiring from practice in 2012, the “normal” response was most often 7 or 8. I suspect this is the number a reader of this piece, who is not depressed, will come up with. I explained to this friend that, although I was not his treating physician, my experience had taught me that almost never did one anti-depressant alone ever cure depression and that I long ago learned from experience that two drugs were necessary for a “cure”.
How could this be, since the Big Pharma “detail” marketing agents sent to doctor’s offices every day, and bearing sample of their latest brand name drug, always suggest physicians use their drug exclusively when treating any medical condition, including clinical depression? And, today, 1/3 entering college freshmen and 1/4 adult American women are already taking these drugs! We Americans currently take 4.3 billion prescriptions a year! How could we physicians be so wrong, so misled, and how could my friend still be so depressed?
To answer this question, we must understand two things: (1) drug companies market only one drug for a given condition at a time, so only one anti-depressant at a time; and (2) clinical depression is the result of inadequate levels of TWO neurotransmitter chemicals in the mood center of the brain, not just one. Selective serotonin reuptake inhibiting anti-depressant drugs like Zoloft, only increase the levels of “serotonin” in our brains, and, more importantly but rarely known by prescribing physicians, that increase in serotonin actually LOWERS the already depleted levels of the second brain chemical necessary for normal mood: dopamine. Ironically, only one currently available antidepressant is known to increase dopamine levels in our brains (the same stuff released by nicotine and cocaine!) and that drug, brand name “Wellbutrin SR or XL”, inhibits the release of serotonin! So, using either class of antidepressant alone actually further decreases the levels of the very chemicals necessary to maintain normal mood! THEY MUST BE USED TOGETHER, in tandem, and in just the right weight ratios. This information was first published in my book, Stress R Us, last year, and available as a FREE PDF on the MAHB website in their “library” out at Stanford, or as a PB/Kindle on Amazon Books.
As my knowledge of this fact stems only from treating 25,000 patients and writing 1,000,000 Rx, and has never been “proven” in a placebo controlled, double blind research study and published in a medical journal, it has not been widely distributed to my former colleagues. And, for that, I apologize. The many young physicians in training I had the great pleasure to mentor over my 42 year career were properly informed and could see the results in one patient after another in my office during their time with me and my patients.
If the reader could have been with me yesterday and have seen the utterly depowered and unmotivated (dopamine is the “motivation” chemical in our brains) this poor fellow was with his 200 mgm of Zoloft daily, you would understand the importance of this essay to anyone taking a single antidepressant and the importance of balancing two antidepressants, with two very different mechanisms of action, in the effective treatment of clinical depression. I believe antidepressants are among the most prescribed of the 4.3 billion drug prescriptions we are taking every year, so I hope you can appreciate the importance of this information and the tragedy of our medical education systems and drug marketing scenarios. Very often, by prescribing only one class of antidepressant, either SSRI or dopaminergic, releasing serotonin OR dopamine in the depressed brain, we have been generating a whole range of “side-effects” and often making our patients worse! I only wish I could find a way to get this extensive “case study” information out to a wider audience than the few folks who read my comments in the NYT or on a few other websites or public seminars. And, as for my friend, all I can do now, after explaining this information to him, is pray for his very survival and yours.
I recently commented on our local WPR (Wisconsin Public Radio) three times a day e-magazine on an article celebrating the Sports dept. of one of the UW system campuses including video gaming among the college’s “sports”. My comment read like this. We have become a nation of stress addicts and violence is one of the prime forms. The neuro-chemicals released in the stress response in all of its many forms (aka “arousal”, “anxiety”, “fear”, “rage”, sexual arousal, asserting “dominance” in a status contest, etc.) are identical and include (nor) epinephrine, dopamine, endorphins, serotonin, cortisol, and others. If you’ve read anything lately about “addiction”, you’ve seen dopamine implicated in the addictive process. Let’s face it, dopamine and the endorphins in particular are often referred to as the “feel good” neuro-transmitters and they drive repetitions of what ever behavior releases them, or “addiction”.
My WPR comment suggested that in our stress addicted modern society and “hurry-up” lifestyles we have become addicted to the very violence-stress that “gamers” find so attractive. However, just try to find a recent movie, or TV show, or “sporting” event that is not filled with physical and/or gun violence. And then we wonder why the recent upswing in public gun violence sprees! The military unabashedly uses violent video games to train our soldiers of violent combat and an honest war veteran may be willing to tell you that he/she misses the “high” of combat missing back home. I hear we’re recruiting more drone pilots as well. Not to worry, it’s just another video game.
I guess self-reflection has too few biochemical “feel good” rewards for us, now that we’re stress addicts and must constantly find the next “high” from participating in or watching a football “game”, a hockey “game”, a war or “crime” movie, a “professional” wrestling match, an MMA “contest”, or one of the hundred other forms of violent behaviors or “games” that renew our lagging feel good neurotransmitters/brain chemicals. We have become addicted to our “HURRY-UP” life style and are quickly “bored” or even depressed unless we’re getting our next “fix”.
The problem with our stress addicted lifestyle is that “cortisol” also is released in the chronic stress response and medical research is strongly suggesting/proving that cortisol is responsible for causing ALL of our top ten killing “diseases of civilization”, none of which are to be found in contemporary traditional living Hunter-Gatherer clans/bands. We have 99.9% of the same genes as they do, so it must be the environment and lifestyle we have manufactured that is making us so sick and killing us. 55% of all American adults and 80% of us over 50 yo have at least one chronic medical condition requiring regular medical attention. 1/3 of entering college freshmen is ALREADY on anti-depressants and 1/4 adult American women are too!
So, it’s safe to conclude that our stress addicted lifestyles in our hyper-stressful man-made physical world is actually killing us in a shower of feel-good brain chemicals. I guess that revelation was just too much for the narrow mined censors at WPR! Oh, well, don’t say I didn’t warn you!
This is the title of my recently published Forum Paper on the NPG (Negative Population Growth) website. This is another effort to get the word out to the general public, as my medical colleagues have generally responded to my theory with this: It just can’t be that simple! Let me be as concise as possible and without all the medicalese that mostly is intended to mystify the general public, who made up most of my 25,000 patients during a 42 year medical career during which I wrote 1,000,000 Rx.
So, what is Population Density Stress? It is an umbrella term for the cause of our over-active stress response and all the “diseases of civilization” that can be traced to the resulting chronically elevated blood “cortisol” levels. It is composed of 4 elements: (1) crowding among large groups of total strangers, (2) bombardment by “stressors” thoughtlessly built into our modern physical environments, (3) alienation from the stress regulating rhythms of nature, and (4) the loss of our long evolved “clan/band” social structures. My apologies if this just sounds “too simple”. Over the 42 years of my medical psychiatry practice, I had one overlying job: to get the the bottom of what was causing my patients’ “anxiety” and clinical depression. When I started practice in 1974, after 3 years of psychiatric training and patient treatment under supervision, we only had a handful of anti-anxiety and anti-depressant agents, other than the well known calming and worry relieving effects of alcoholic beverages widely used in the 1950’s and throughout the 20th and earlier centuries, but with all the health damaging side-effects. Today, 1/3 of entering college freshmen are already taking antidepressants and 1/4 adult American women, some used for anxiety and the rest for clinical depression. Over my 42 year career, I watched in alarm as the rates of anxiety and depression increased year after year.
So, I began to search for the basic causes of this epidemic of anxiety and depression in American society and to refine our treatments, as the number of patent medicines to treat these potentially life threatening disorders exploded, as it still is. Alcoholism is also a growing problem, at least here in Wisconsin, and an increasing component of the “diseases of despair” that are shortening our lifespans for the first time in 100 years. Everywhere I looked, I found over production of the stress hormones: cortisol, (nor)adrenaline, endorphins, serotonin, and others. But wait a darned minute! These were also the chemicals being increased in our brains with the anti-depressants! So, a picture began to emerge of something driving this overproduction of stress hormones and our brains becoming exhausted in the race to keep up, which was forcing physicians to increase their prescribing of anti-anxiety and anti-depressant medicines, to the joy of stock holders of Big Pharma company stocks, but at great expense to the suffering public and our insurance companies. To my surprise, however, i seemed to be the only physician I knew who was observing this epidemic of mental illness and the explosion of mood and anxiety altering drugs. Psychiatry and medical science in general, I was to discover, suffer from what Arthur Koestler called “reductionism”: an inability to step back and look at the big picture surrounding a problem.
During my training at Wisconsin, I had the honor of being mentored by one of the founding fathers of a new approach to treating mental illnesses: Family Therapy. Our family therapy seminar was led by Carl Whitaker and during one of our sessions, as he was given to doing, he passed out a paper published in 1962 in the February issue of Scientific American written by John B. Calhoun, an NIMH animal population researcher who had been studying the reproductive behavior of rats. Dr. Calhoun titled his article “Population Density and Social Pathology”, as he had discovered that patterns of behavior changes could be seen when rodents were raised in an enclosed space ( a sort of chicken coop for rodents) and allowed to reproduce at liberty and with none of the natural controls found in wild populations. At the maximum, there were 2,200 animals in a 10′ by 10′ enclosure! Whereas, in his 1/4 ac. backyard enclosure only 200 animals ever could be counted, as they separated into family units who defended their individual territories and thus prevented overpopulation, not unlike the Native American tribes in the US before our European ancestors arrived. Those 500 spread out “Indian” tribes held 2M individuals at the time of our ancestor’s arrival, but we are now 323M. Hmmmmmm?
When I retired in 2012, I was sorting through my papers and ran across Calhoun’s paper. I began researching population dynamics, as a small group of population biologists had been doing for 70 years, and discovered that one researcher had suggested that the stress response studied by Hans Selye in Montreal could be a population controller as designed by Mother Nature. He was the Scottish animal biologist V.C. Wynne-Edwards and had made this suggestion in his 1962 Animal Dispersion in relation to Social Behavior and he was seeing the same swollen adrenal glands (that produce the stress hormones (nor) adrenaline, cortisol, and endorphins) in his low ranking birds as Selye had seen in his experimental stressed rats. In 1971, the British psychologist Jeffrey Gray published his The Psychology of Fear and Stress and in it he also suggested that Selye’s “General Adaptation Syndrome” (swollen adrenal glands overproducing cortisol, shrunken thymus gland, and gastric ulcers) might be thought of a population regulation mechanism.
I don’t know exactly when the light went off in my head, but it did, and then I ran across the work of Jack Christian in Baltimore, who repeated Calhoun’s mouse/rat crowding experiments and measured the cortisol levels as crowding increased. By the way, i should point out at this juncture that not long after these rodents reached maximum population numbers, their entire population went extinct. Calhoun and another researcher here at Wisconsin believed that the crowding became so disruptive to pup rearing that mothers could no long protect their offspring and no more could be raised to reproductive age, but Christian thought the high cortisol levels were turning off reproduction. Why not both? So, I began to wonder if this same process was not happening in our crowded modern populations and it had been raising its ugly head in the increasing anxiety and depression of my patients all through my 42 years!
I am now convinced that this is exactly what we’re seeing in our modern human populations! Thus, my theory of “population density stress”. All of our top ten killing “diseases of civilization” are increasing, although our extensive and fabulously expensive medical care “industry” is ever better at keeping us alive with all its wonderful but expensive new technologies. Were it not for all this medical intervention, we’d be a tiny fraction of our current numbers. If you don’t “believe” in vaccinations against communicable diseases, consider the Ebola outbreak, or AIDS, or the 146,000 deaths so far from measles. How many friends and family members do you know who’ve had heart surgery, or take insulin, or have had joint replacements, cataract surgery, etc.? And, I haven’t mentioned that elevated cortisol levels suppress our immune system by killing off the same T-lymphocytes that Selye’s rodents couldn’t make in their shrunken thymus glands. HIV does its greatest damage by killing off these very same T-lymphocytes. Beginning to see a big picture here or have I just confused you? Sorry, but I’ve been trying to put this in terms anyone with a HS biology class could understand (maybe with a little help from a dictionary or the www).
This little essay is attempting to present the basic raw bones of my theory of “population density stress”, but, if you really want to dig into it further, you’ll have to Google “Stress R Us” for a free PDF in the e-library at the MAHB website out at Stanford, or get a PB/Kindle copy from Amazon Books. In any case, Good Luck, and a long and happy life!
As a retired clinical psychiatrist and stress researcher, I tend to look behind the surface of all human behavior and at the deep “limbic” survival emotions driving our behavior. For instance, Our Mad King Donald has a Mixed Personality Disorder due to his sudden abandonment by his dear mother when he was only 2 yo, due to her hemorrhaging following the delivery of her 5th child, Donald’s younger brother. She was hospitalized for a lengthy period and then forced to convalesce at home. Who took over her mothering of toddler Donald is unknown to me and not described in any biographical info I’ve run across. This massive narcissistic injury can explain Our Mad King’s desperate unending search for narcissistic “supplies” (loving admiration from all around him), as well as his “thin skin” or “rejection sensitivity” so well known by those of us with psychological training/experience in folks suffering from Borderline Personality Disorder. But here’s the real problem. A 2 yo who is suddenly abandoned by his caretaking parent will inevitably blame himself and spend the rest of his life expelling the the resultant self-loathing through the ego defence mechanism known as “projection”. Without this emotional escape valve, the building pressure of self-loathing might well lead to self-destruction. Perhaps you haven’t notice but every angry accusation that Our Mad King fires off at his surround of enemies is actually a window into his own self regard, his own rage at himself, which dates back to his abandonment. Online commenters often accuse Our Mad King of behaving in immature ways, estimating his emotional age at far younger than his chronological age, but never do they get it young enough: 2 yo. Our Mad King is permanently “conflicted” at a developmental age 2, and his behavior is age appropriate.
So, Our Mad King is driven by a never ending need for narcissistic renewal through his grandiosity, which has caused him to set about to create his own version of America and counter to the “deep state”, which is the Federal and State Governments that you and I know and answer to. A 2 yo has limitless grandiosity and everything happening in his/her world is caused by him/her, thus his loss of his mother’s love must be his fault. Only a Kingly reign in his grand vision of Trumpworld will do for Our Mad King, which ironically places the true governments in the “deep state”, some dark conspiracy trying to overthrow our Mad King’s MAGAWORLD, which I have come to call “Trumpistan” for comic relief.
The MSM has only touched rarely on the true nature of Our Mad King’s efforts to create a parallel government staffed by Loyalists, and any sign of disloyalty must be dealt with severely and immediately, thus he is surrounded by sycophants. This arrangement is occasionally referred to as a “cult”, which is quite accurate, given the large portion of MAGAMEN and WOMEN who worship their powerful King as loyal citizens must. The MAGAMEN have been seething in a state of rebellion for many years, and they finally got their chance to express their rebel sentiments against government of any sort with the candidacy of the Rebel-in-Chief offering his alternative government.
The “Deep State” is a fantasied distortion of the functioning Federal and State Governments, and the GOP is onboard for fear of being primaried by their MAGAMEN and WOMEN back home, as his angst is the best expression of their long pent-up frustration with all the rules, taxes, endless wars, culture change, and multiple disruptions in their way of life. Our Mad King is their best possible expression of their frustrations, and the normal day to day functioning of the Federal and State governments. Yes, my friends, there has been a “coup”, and our Mad King Donald in leading the charge. The ultimate outcome is yet to be determined, but one thing is certain. Our Mad King’s deep wounding at 2 yo can never be undone and it will continue to determine his behavior to the end of years. God help us!
The late neurophysiologist and NIMH researcher Paul MacLean coined this term to describe the neuroanatomical structures featured in this 1798 hand colored lithograph from an atlas of brain slices done from the unusual perspective of bottom up. Note the hippocampi, the two seahorse like structures facing eachother from deep in the two Temporal Lobes of the “emotional brain”. They are topped with amygdalas, the two almond shaped “heads” of the seahorses. Who cares, you may be saying? Here’s why these structures are so important.
The hippocampal gyrus is the body of the seahorse and houses our short-term memory and is central to our moods. Nearly 500,000 new brain cells are born in the basal layer of this structure daily, especially in young folks, but quite possibly all through life. The chronic stress hormone “cortisol” is known to prevent these new brain cells from being born and migrating out to repair even distant areas of our brains. Remember “Alzheimer’s Disease”? It is the loss of recent memory or “dementia”. So, if our over-active stress response is overproducing cortisol in our adrenal glands, and that cortisol can pass through the blood into the brain, then, Hmmmmmm. This structure is smaller in folks who suffer from PTSD, which is one well known form of over-active stress response and is associated with memory and mood problems.
As for the amydalas, they are known to contain 18 bundles of cells known as “nuclei” and they initiate “survival” behaviors when triggered by certain well defined external signals: sudden loud noise, stranger’s face(s), hunger, sexual signals, aggressive acts, and others less well defined so far, but perhaps most importantly the “fight or flight or freeze” response that is the core element of the “stress response”. So, when we bundle together or “connect the dots” of a stress filled man-made physical environment, the toxic effects of our over-active stress response, and our rapidly increasing “diseases of civilization”, a clear picture of why we are so sick and getting sicker begins to emerge from the constant competing clutter of our profit seeking media: Population Density Stress Is Killing Us NOW, through all of these “diseases of civilization”, none of which are to be found in contemporary traditional living hunter-Gatherer clans/bands. Since we are one of two most genetically identical mammals known, with 99.9% the same genes, then the dramatic differences in the Hunter-Gatherer and our “modern” urban Western man-made world becomes obvious: it’s the environment stupid (to borrow a metaphor from the Clinton campaigns). More later or in my book, “Stress R Us”, mentioned above.
Population density stress is killing us NOW through all of our “diseases of civilization” (heart attack and stroke, cancers, lung diseases, kidney diseases, “the diseases of despair” (addiction, overdose, suicide, gun violence), obesity and diabetes, infertility, accidents, wars, civil unrest, etc.), none of which are to be found in contemporary traditional living Hunter-Gatherer clans/bands. In the long history of crowded animal research over the past 70 years, the population curves of animals confined to limited spaces have always followed the same trajectories: they rise exponentially until they level out and plateau, only to soon thereafter cease all successful reproduction.
The infertility rate in the US has risen 100% in the past 34 yrs. and sperm counts in the West have fallen 59% over the past 38 yrs. These rates are consistent in crowded urban populations worldwide. We are currently 3,000 time more populous than our ancestors prior to the agricultural revolution and already exceeding our sustainability limits for future generations and in a ever more polluted world. None of our watchdog governmental organizations are sounding an alarm and we even have a Mad King who does not believe in science or “climate change”. The recently replaced governor of Wisconsin and his GOP dominated legislature passed a law banning the term “climate change” from all state government publications. The IPCC says otherwise, but does not have the courage to identify human overpopulation and over-consumption as central causes.
The details of this theory of an imminent species ending scenario is explained in great detail in the free PDF e-book, “Stress R Us”, available in the e-library on the MAHB website at Stanford, or as a PB/Kindle on Amazon Books. I would be willing to entertain any and all questions/criticisms, but I must warn the reader that you will have great difficulty dismissing the 100 famous experts cited in the book out of hand. Good Luck!