The Fort Lauderdale Airport Violence

On January 9, 2017, the US House of Representatives stood in a moment of silence following the Ft Lauderdale Airport shootings. (

I concur with the thoughts and concerns for the families of those who were killed or for those who were injured, either physically or emotionally, or both. Words do not reverse the pain and the losses.

But let’s take an ‘etiological’ look. So far, all the dominate evidence seems to point to a shooter who was acting in response to dreadfully malevolent psychiatric spirits, over which he had no rational veto.  Therefore, it seems this shooting is from a psychiatrically allied event.

As for the US House standing in respect to the victims: yes, it is nice…it honored the victims…. which as a community is very needed and crucial, and very fitting to the collective craving we need to assemble a means to resolve and endure the event. But did they realize they stood up in response to a psychiatric event?

I doubt most of them thought of it that way. I will loudly apologize if I am wrong.

The reason I ask is because I need to add to this event our country’s statistics of 44,192 suicides per year. That’s 121 per day. (  This circadian carnage does not capture the countless daily domestic assaults, mental cruelty acts, reckless or inebriation based motor accidents, or other acts of violence which equivalently stem from inadequately treated mental illnesses.

I wonder if the authorities in Alaska would have addressed the shooter with more concern for public safety if he had spoken of a core political/religious fanaticism that would have been graded as dangerous, as opposed to a mental illness, which, shall we say, was not categorized as frightful and uncontrollably destructive? Is being mentally ill without a political component more of a community nuisance than a community danger? Do agencies choose to move the person elsewhere so the problem will belong to another agency? Or was the decision to release him and return the gun yet another case of the typical, all-too-common, errors in judging future dangers?

We must discuss the notion of violence and mental illness. The clear and immense majority of mental illnesses do not threaten others in the manner of a Ft Lauderdale like shooting. Rather it is the opposite, and those who suffer a mental illness tend to harm themselves more than others. The etiology of a mental illness is a drifting mixture of bad genetic/toxic biological exposures and processes interspersed with psychosocial stressors.

But there are some troubling realities. For example, a non-mentally ill victim of domestic abuse may develop a mental illness in response to the actions of other people’s mental illnesses – the victim may need medications to relieve some of the pain, but the real treatment is cognitive and behavioral therapy; this may at times also require geographical separation that is financially or legally impossible. It gets very complex and sticky.

Mental illness eats at our society in horrific, massive, and often non-public ways. At times, it finds venues for those whose thinking is distorted by mental illness to find expression and solace in political/religious extremism.

The inside core is mental illness. The outside scaffolding is extremism that, to the person, feels nutritious and wholesome.

The US House of Representatives should daily stand up to think about the so many whose lives, and deaths, are controlled by mental illness.  They would never sit down if they memorialized every suffering event produced by mental illness.

We, too, should stand up. Yes, stand up, and use the augmented height to look beyond our usual landscapes, and see the world a bit more to what it really is.



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Is the MTHFR enzyme the next Prozac? Not exactly…

Note: Many thanks to Catherine Passariello, Ph.D., for being a co-author. Follow her as she speaks about genetic testing and psychopharmacology at  – a podcast interview.

Fifty percent or more of depressed people fail to respond to their first trial of an antidepressant, and the percentage only decreases as numbers of antidepressant trials increase.

Failure can occur even with a correct diagnosis and good medications. But now a genetic mutation may help explain why this is so.

This can all be a bit technical, so read it slowly. Maybe even read it twice. It is not thorny or impossible to understand.

It is now accepted that inadequate folic acid intake or a deficiency in its conversion is associated with high homocysteine levels and an inadequate monoamine production. This effectively is a lessening of norepinephrine, dopamine, and serotonin levels Knowing this information makes for a significant paradigm shift in understanding biological depression. It moves the traditional focus away from primarily blocking the re-update of neurohormonal entities to now actually increasing hormone production. This is done by reducing homocysteine levels. And this, in turn, is partially done by an enzyme which converts folic acid into its active form.

That enzyme is the MTHFR – the initials stand for MethyleneTetraHydroFolateReductase. It converts folic acid, which is vitamin B9, into l-methylfolate. Unconverted (the fancy term is ‘not reduced’) folic acid is not active, but l-methylfolate is quite active. This active form induces a cascade of biochemical actions affecting many of our body systems.  We now know that many people have a ‘sluggish’ enzyme insofar as being able to make that folic acid conversion.

The question exists about taking extra regular B9 to override the compromised MTHFR.  No, it does not, but taking more B9 may help if there is a primary B9 deficiency.

MTHFR was discovered in 2003 as part of the Human Genome Project. The MTHFR gene produces the MTHFR enzyme, which changes dietary folic acid (also known as 5,10- MethyleneTetraHydroFolate, into 5-MTHF; this is also called l-methylfolate.  The problem lies in that there is a single point variation (C677T) of the MTHFR gene that directly effects how well the enzyme works: the gene can either have the C or the T variant.  We all inherit two copies of every gene, one from our biological mother and one from our biological father, each copy is called an allele. Two C copies (C/C) makes for a normally functioning enzyme, two T copies (T/T) for a severely reduced functioning enzyme, and a mixed combination (T/C) is for a less diminished function enzyme. So, if a T/T or T/C form exists, the enzyme owner could suffer.  The T/T or T/C forms are still compatible with life; they can, however, result in a host of biological limitations.  About 40% of people have the C/C,  40% have the C/T, and this leaves 20% with a T/T variation.

Getting past the hurdle of a less than optimal MTHFR improves a host of biochemical events, often including a reduction of depression. Indeed, the relation of depression to elevated homocysteine has been referred to as the Homocysteine Theory of Depression.

This is the biochemical cascade: the 5-MTHF is necessary to convert homocysteine (an amino acid) into methionine (another amino acid). Methionine later changes into SAMe (s-adenosylmethionine) which supports the immune system, helps with anti-inflammation, and makes and breakdowns neurotransmitters. It also helps to grow and maintain cells. Your doctor will say that SAMe is a methyl donor, and that the SAMe donated methyl group goes directly into the production of norepinephrine, dopamine, serotonin and melatonin.

Without SAMe, which comes from methionine, which in turn comes from the breakdown of homocysteine because of the l-methylfolate, the neurotransmitters will be produced in short supply.

Here is a quick summary of the downstream effects of a poorly functioning MTHFR enzyme:

  1. When homocysteine is not sufficiently broken down into methionine, there is a build-up of homocysteine in the system, a condition termed as hyperhomocysteinenemia. This is associated with cardiac and vascular problems, inflammation, some cancers, IBS, possible pregnancy issues, migraines, and even some dementias.
  2. Low SAMe leads to a decrease in its products which is associated with depression. Taking extra SAMe offers mixed results as an antidepressant.

Too much homocysteine is toxic. It can interfere with the synthesis and repair of DNA and worsen inflammatory responses.  An oxidized homocysteine can also stimulate the NMDA (N-methyl-D-aspartate) receptor which will let calcium enter a cell. This then releases a substance known as proteases, and the process can result in cell death and hasten dementia. Homocysteine can also damage cells that line arteries and contribute to the atherosclerotic processes.

Life-style can also increase homocysteine levels, such as smoking, obesity, some medications, insufficient exercise, and psychosocial stresses. Excessive alcohol use and poor diet may cause a multiple B vitamin depletions. Exercise distributes the homocysteine more evenly throughout the body. Some lipid lowering medications, as well as lithium, methotrexate, birth control pills, L-dopa, and some anticonvulsants also increase homocysteine levels.

All this is fascinating. For a long time, the strategy to address this gamut of problems was simply to add folic acid. But too often this did not work well enough. The reason was the  sluggish MTHFR enzyme.  With a sluggish enzyme, the ingested folic acid never became ‘active.’

Fortunately, l-methylfolate formulations now exist that can bypass the sluggish enzyme. It would seem that getting around the sluggish MTHFR would therefore solve so many problems. The effect of these l-methylfolate formulations can sometimes be positively dramatic.

But, and medicine is replete with the ‘buts’, the real-time practice of medicine is not always so uncomplicated as is the draw to this charismatic concept.  Each case needs a rigorous consideration because other processes can cause these same medical problems.

Many folks remember when the antidepressant Prozac had the reputation that it could fix so many things.  In time, however, Prozac’s ranking was re-measured in step with its reality – it was good but not magic.  The same is happening for the MTHFR. Too many people speak of it as the present-day Prozac. It’s not.  But it is a great new tool.

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What happened? The downside of growing up.

‘Tis the season.

For all it’s a New Year.

Some of us celebrate a freedom after a war – Chanukah.

Others celebrate a birthday – Christ.

The United States celebrates a living democracy.

But equally, for all of us, it’s another time – not a first time – to think about who we are and what is important to our lives.

Here’s what I am thinking about: I have never reconciled the need for war. Especially if it is born of singular religious or political convictions. Please don’t tell me to change, or fear me, because I connect to God or live differently than you. I hold you dangerous only if you first hold me dangerous. How can a common God allow one set of humans to be less worthy of life than others? Surely God knows we all relate to Him in many ways. My son vigorously and eloquently teaches me that there are many roads to God.

In the purity of those roads is also a purity of all life. Would it not be better to blend our views and not punish if we elect one road to God than another? Is there a sense that one path gets us a seat closer to God than another road? I’m certain that every religion can find practitioners in other religions who are charitable, caring people, with family and community love, and who work honest jobs. It would be nice to see people realize that we all seek the same endpoint.  I would like to see people this year think about how the differences between us came about and who perpetuates them to continue. Why do we compete for something that needs no competition?

Disappointingly, every religion or political group has its extremists who tolerate violence to reach their end-points. Do they do the violence for themselves or for God? We need to carefully study that question. The best life work is usually done by the noiseless, unsung teacher. Let’s all think about and proportion those in life who loved us, who taught us, who scared us, who hurt us, or who misguided us for their own gains.

Chanukah’s toy is a small square top called a dreidel. Each of the dreidel’s four sides is inscribed with a Hebrew letter—nun, gimel, he, shin. They mean “A great miracle happened there”

Nothing grows from knowing I have killed in war. It is not a sign of a progressive human civilization. But, and it is so painful to have so say ‘but,’ it is part of the current human experience that thus far we have no developed skills to often remove danger by other humans but for with violence. War breaks or exhausts the violence, which then seeds a peace. What an all too common, laughable and wretched decorum and etiquette.

There are many roads to God.  These roads do not last if blood and retribution is used in the pavement.

The how-to prophecy comes with children playing together. They don’t know of political or religious differences – they only know curiosity, healthy competitions and games teaching respect and self-confidence, and that their Muslim friend’s mother can cook tasty and interesting, but different, foods.

Listen to the kids. What joy.  Nun, gimel, he, shin. But let’s change it to ‘A great miracle happened today.”

And as an aside, how interesting it is that Chanukah and Christmas are now both festivals of lights?

What happened? Why are we all so similar until we grow up?





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Can’t Overlook Those Who Hired The Illegal Immigrants…

The election rhetoric prompted lurid rabblerousing about illegal immigrants.

Let’s give it a dose of a clearer thought.

Crime and drug using rates did not skyrocket because of immigrants. Indeed, drug use went up because many American’s were not timid about or fearful of trying drugs.  Have no market and there will be no sales.

Our drug abuse impasse belongs to us; the drug dealers, entrepreneurially, merely continue to take advantage of the marketplace.  Don’t blame others for our weaknesses. Effective drug treatment programs mandate user responsibility for their substance abuse. Don’t blame the pusher; question the users and their worlds’ about assorted malfunctions which fail to give them life expedients and skills that do not require drug use. 

As for the jobs issues, don’t blame the immigrants. They saw a market willing to pay them. They manipulated an economic opportunity to be paid, quite often off the books, by doing work others would not do at that payrate. For them it was a step up from their prior worlds. The majority came here to better themselves.

Equally blame the employers who hired them; they chose to give away American jobs to the least costly. Like any cost sensitive firm, they want their products produced at a lesser cost.

Pulling illegal immigrants into our workforce would be less if American companies got the same job done if they would give realistic wages to the local citizen workers.

Consider, however, that our tomatoes will surely cost more if the pickers got health insurance, retirement funds, etc.

We need to accept our portion of the onus and culpability in about these happenings. We have an unconditional duty to overhaul their etiologies.  Just to make noise refurbishes nothing.

The election and its grandiloquence kept logic and personal accountability off the playing field. It indisputably tried to pass the blame to others.

And such reasoning, again,  keeps us away from the true nucleus.


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The Breast Is Going Dry

So it was said:

Once the earth was flat. Some believed this even into the 17th century. 

Once the sun and universe went around the earth. This is called geocentrism – that the earth is the center of the universe. Copernicus, Kepler, Galilei and others ultimately convinced the scientist and the lay person that our earth is quite miniscule compared to the universe, and yes, it goes around the sun – we are heliocentric.   

Each of these realizations inflicted a major and agonizingly psychological blow to our self-defined station in the universe. But to early thinkers, when they looked around them, geocentrism seemed accurate. Nonetheless, science was right; people were wrong, and they had to accept it as such.  

Amazingly, in 2012, nearly 25% of Americans answered that the earth goes around the sun. (ABC News) 

Once the world was seen as incredibly big, always able to repair damages, to reestablish its balance and environment, and to restore itself so it could sustain us. We take, take, take, like money from a tangibly large parent who always manages to feed us.  

Now we know that the earth is living just as does every animal and plant. The earth is not the place on which we live – it is a lifeform with which we live.  

Harm the earth and we harm ourselves. Like a good parent, it wants to sustain us.  Like a good child, we must help the parent survive.  

But it seems so big. Can our tiny selves and actions truly harm it?  Yes, it is smarter than any single one of us. But as a crowd of millions of little acts…the image explains itself.  Consider one parent with one taxing child compared to one parent with a dozen demanding children.  

Also amazingly are the many who doubt global warming; they are egocentric.  

We are earth’s children. We need to sacrifice for our parent. Denying the science is an insistence that people do not want to be responsible for their lifelines. With an earth paling and ailing, we must fix those ingredients from us that add to the infliction. We must also learn if we can alter the larger natural forces. It won’t hurt if the earth is less sick because of our efforts. 

The label is less important than the theme. Global warming is global damage. The fact a struggle exists to prove global damage is real rings of the past analogous battles in history. It also shows the current delaying and denying processes linked to egos fighting not to lose their egocentrism.  

Once there was a giving, warm breast with limitless milk flows.  But dear me, look! The breast is drying.  

Once there was no global damage. Then there was. And then life as we and the earth want it to be had to change. 

How to do good change? Have a child do an earth healthy act with you. Then do it again. And again. And again, and forever.

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Break the stigma by making them not to be afraid to ask to be touched. Break the stigma by not being afraid to touch them.

Last night I attended a meeting dealing with mental health stigma. Lots of young adults, teachers, young filmmakers, clergy, a few of we professionals, but also families of the afflicted.  They all worked to extricate ourselves and our communities from the all too common fear or embarrassment of mental illness. Their messages rang out with pain and hope!  Good for them –  brave folks speaking about what can no longer be hidden. The take home missives were to feel safe in being honest and learning how to ask for help.

I left re-connected to an ever so palpable sensitivity. It is for the suffering of the family of the affected. This expands it so a family is defined more than by blood. It is our collective spirit. What we saw and felt that night made us cry within ourselves, to be sure, but also to cry as a community. What we saw is not of a them or me; it is of us.

The event’s primary sponsor’s ended with a preview, a stirring documentary, about their son who, burdened with a history of horrid schizophrenia, three years ago to the day took his own life.  Many of us felt compelled to hug the young man’s mother from our own struggles to soothe her.

Many of those who went to her had also lost family by suicide. Many, like me, who had not so suffered, just needed to outwardly touch her and try, oh so much to try, to give her a fix of peace. Inwardly we feared life because what happened to her could happen to us. It is tendering of love to her, a reality to us, and anger at what we as a community and profession missed that might have saved those people. In all our touching was born again the certainty that in the human reality comes pain to us, but our touching can unfathomably cultivate new strength from those memories.

I went back stage to find the young man’s father. He stood in the wings, looking at a bright but vacant stage. “Thank you, “I said, touching his shoulders from behind, “thank you…”  I needed to honor his bravery, to allow him time alone, and somehow shape in him that from his pain another life may be saved.

All that is well and good, but it left me pondering how inside this good man, how hard it must be, how solitary, with feelings so contemplative and poignant, to make sense out of his life.

I wanted to say the same to all who lost lives for all the wrong reasons.

What energy and purification that night brought to we who did not have mental illness but nonetheless suffered its upshots.  Imagine the power given to a suffering person who is asked to join us. A first-step ticket from fear and isolation to membership and love!

Break the stigma by making them not afraid to ask to be touched.

Break the stigma by not being afraid to touch them.

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The Grope

There are two rudimentary notions of a grope: (1) to feel about with the hands, or (2) to search blindly or uncertainly. Both want to seize an object or answer.

Slang, however, has it as touching for one’s personal pleasure in a purely oppressive manner.

One can grope for votes or money. One can grope to solve a challenging question. Or one can grope for sexual pleasure.

But what lies within the sexual grope?

Groping is a common an occurrence in life, as many know. Sometimes it is part of a developing relationship, but the behavior must immediately stop if requested. The souring issue is that sexual groping is tremendously unaccepted in ways different than groping for votes because the respect for another person’s sexual personal space is an underpinning of our society.  Sexual groping violates that keystone. 

Why not just ask someone to be a sexual partner? Some might fear the wanted partner would say no. Perhaps the requester lacks the social skills to appropriately elevate a relationship into what is sexually comfortable for both people.  Groping assumes the ‘receiving’ partner prefers not to be groped. The wanted cohort may say “stop that, don’t do that not now or ever!” When the groper won’t stop groping, the ‘grope’ goes into disrespect. Which leaves scars. Ask most women how they respond to groping – a very, very large number have experienced it – and many try to dismiss it as a wretched fact of life. But sometimes it is hidden more than dismissed.

The ‘grope’ skips the mutual relationship part. One subset of gropers feel an uncomfortably strong sexual drive, and these folks’ psychosocial skills are so impaired that touching is needed for some ego gratification regardless of ramifications. But there is another subset of gropers who do not have these psychological impairments. They grope from egotism; they choose not to use the usual ladder of building a relationship. It is as if the relationship building process is not required of them in the process of achieving sexual satisfaction.  A quality often inhabits this second subset that the groped should be honored that they were chosen to be groped. This later groping is entirely selfish, which could, as details appear, eventually reflect an equally finicky psychopathology in someone who just happens to have assemblies of money, dominance, or other social positions.

Woefully, and which adds much confusion to the strength of a simple narrative, is that some folks don’t mind being groped if it means they can experience a special contact with an icon. Such is the footing of the groupie.  This possibility then makes a final determination of the real history of the groping event so problematic until there is detailed understanding of everyone’s motivations,  for only then can we finalize an accurate report of who did what to whom and with which inducements or permissions.

The variety and levels of motivations to grope or not are similar to the separation between those who truly cannot make a healthy relationship to those who have the psychosocial skills to create the healthy and mutual relationship but choose not to. 

Yes, yes, it is burdened with layers and complications.  But equally yes is that the vast majority of groped women are true victims. The sad fact is that so many of them strip it of reactive emotions and re-mold it as another cost of womanhood.






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