(+++) DEPRESSION BEATERS

The Whole Brain: The Microbiome Solution to Heal Depression, Anxiety, and Mental Fog without Prescription Drugs. By Raphael Kellman, M.D. Da Capo. $27.

Craig & Fred: A Marine, a Stray Dog, and How They Rescued Each Other—Young Readers’ Edition. By Craig Grossi with Kelly Shetron. Harper. $16.99.

     The increasing awareness of the importance of properly balanced gut bacteria for the overall health of the human body has led, predictably, to a proliferation of charlatans, absolutists, marketers of “perfect” digestive products, and genuinely thoughtful holistic or naturopathic physicians with a focus on the health of the microbiome – the body-pervading collection of trillions of microorganisms living within each of us humans. Even when dealing with the most sincere of these microbiome focusers – and there is little doubt that Raphael Kellman is sincere – it can be helpful to remember that other, equally sincere healthcare practitioners, medical and otherwise, have different beliefs about the best route to overall physical and mental health, and that there is not even a consensus about whether there is any single “best” approach. The complexity of the human body would argue that there is not. But the desire of advocates such as Kellman is to argue that, yes, there is one single route to health and well-being, and it can be presented in basic form in a book such as The Whole Brain, then implemented on one’s own or, even better, by becoming one of Kellman’s patients in New York City. Readers would do well to pay attention to Kellman’s arguments while realizing that they are one set of analyses of types of physical and mental difficulty and one set of recommendations on how to feel better. With that understood, there is nothing wrong with trying Kellman’s ideas, or anyone else’s, and settling on what works for you, either as a single approach or as a combinatorial one. Kellman’s angle on health includes some typical warnings about  traditional Western medicine: “The current way that thyroid function is measured by conventional doctors is often inadequate. You can easily have thyroid lab results that say ‘No problem!’ and still actually have a thyroid problem.” Comments like this are typically designed to create skepticism in readers so they will be less inclined to question the author’s approach and more inclined to dismiss what their current doctors say. Kellman also offers some unexceptionable comments on items that can cause chronic inflammation and intestinal imbalance, including sugar, artificial sweeteners, processed grains, gluten, dairy, the dairy substitute soy, industrial chemicals in personal-care products and in “conventionally farmed foods,” and of course stress. It becomes easy to see, quite early in The Whole Brain, where Kellman will end up when he finishes his descriptive sections and moves to prescriptive ones: he is going to call for everyone to consume probiotics, healthful fats, and lots of things labeled “organic” (and priced accordingly). And this is exactly where Kellman goes. Products from cow’s milk are unacceptable – eat only ones made from goat’s or sheep’s milk. If you use oils, they should be avocado or coconut or organic ghee, although he does include butter with the comment that “ghee is better.” Brown rice, millet and quinoa are the only acceptable “grains and near-grains.” Lots of vegetables are all right, but not iceberg lettuce. Also, no canola or cottonseed oil, no corn, no dried or canned fruits, no juices, no peanuts or peanut butter, no processed or packaged foods, and no soy “except soy lecithin and organic fermented soy.” Also, no sugars or sweeteners of any kind except a specific brand called Lakanto that many people find bitter or at best mildly sweet. Kellman’s ultimate point, like that of so many self-proclaimed naturopathic or holistic practitioners, is that health requires a massive change in the typical American diet, a change not only in what is eaten but also in what one enjoys eating – you must train yourself to like different things in order to promote your overall health, no matter how much time that takes and how much stress a massive dietary overhaul provokes. Pretty much every diet, of every type, says this same thing, and pretty much every diet, of every type, fails because of the emphasis on making significant mental and psychological adjustments to food types (and portions), as if doing so is no big deal because the proponents of the diets have done so themselves (or say they have). Kellman, like many nutrition-oriented advocates, also strongly favors supplementation involving, individually or in combination, items including berberine, wormwood, caprylic acid, slippery elm, gamma oryzanol, butyrate, various digestive enzymes, and so on. Kellman recommends supplements for many purposes – Saccharomyces boulardii for cognitive decline, for example, to “help to reduce the ammonia levels that contribute to brain dysfunction.” He also includes multiple weeks of dietary suggestions, plus recipes that assume people have loads of time available to spend finding the right ingredients and getting things done in the kitchen. Kellman appears to be quite sincere in his advocacy, and while the absolutist nature of his gut-only focus is overdone, there is no question that gastrointestinal issues lie at the foundation of some pains, problems and health issues, including “depression, anxiety and mental fog” in some people. Readers who believe their clinical picture fits the rather broadly drawn one that Kellman says can be helped by dietary changes may certainly find the suggestions in The Whole Brain to be worth trying. If they seem to help – even if that is because of the placebo effect – these approaches are worth continuing. But do not be lured by the belief that these ideas and no others hold the key to health. That sort of notion, no matter how it is dressed up and no matter how well-meaning it may be, is nonsense.

     If you really are looking for a near-panacea for depression and other mental, psychological and social ills, you could do a lot worse than getting a pet. Again and again, in circumstance after circumstance, responsive pets that offer unconditional love and acceptance and impose activity and interactivity regimens of their own through their need for care have been shown to relieve stress, anxiety, depression, even physical pain. Dogs are champions at this, but plenty of other animals work for some people in some circumstances: cats, rabbits, horses, pigs, and various reptiles all have at least some success stories. So, on one level, Craig & Fred, now available in an edition for young readers, is nothing special. On many other levels, though, it is very special indeed. It is the story of a mutt found wandering around Afghanistan when a contingent of Marines was stationed there, of how the mutt – that would be Fred – became part of the Marines’ lives and especially part of the life of Craig Grossi, and of how the two became inseparable both in Afghanistan and (after considerable struggle with paperwork and human relations) in the United States. There is nothing particularly new in the notion that people who adopt dogs say the dogs really saved them, not the other way around. But there is special meaning to that notion, and special pathos to it, in Grossi’s case. Grossi suffers a traumatic brain injury in a Taliban attack, and after being taken to the Battlefield Recovery Center at Camp Leatherneck, he is seized by vomiting and passes out. And then, he writes, “I woke up thinking of one thing: Fred.” And it seems that Fred is thinking of Grossi, too, in some way, because the man caring for Fred while Grossi is in the field says the dog “was not happy while you were away,” would not eat his favorite food, spent his time moping, and even refused to play soccer. Grossi goes to find him, and when he does, “I watched for a minute, tears brimming. The weight of responsibility I felt for Fred came rushing back to me, but it didn’t feel like a burden this time. Instead, it was my mission.” Then Fred sees him and, as Grossi writes, “I was assaulted with love.” Thanks to all sorts of help from all sorts of people, Fred is cleared to go to the United States – this is no small matter – and eventually, after further deployment and violence and heartache, Grossi returns as well. And this is only halfway through the book. The rest of it is likely to be less interesting to young readers, although parents may want to read it for a largely unsentimental and straightforward story of military personnel adapting to a return to civilian life. That is what happens in the second half of the book: Grossi finds out all he does not know and needs to learn about returning to the United States, and finds out all Fred does not know and needs to learn to be a dog living somewhere outside a war zone. It turns out that Fred is young, less than a year old, and smart as well. The combination makes him trainable, which is a good thing, since he has some serious fears: curbside sewer drains terrify him, for example, and Grossi’s father, caring for Fred before Grossi’s return, has to pick the dog up and carry him past them. Fred also has aggressive tendencies, taking them out on Grossi’s girlfriend’s small dog and at one point on Grossi himself – leading to a “dominance” wrestling match that Grossi wins, with the result that Fred “never bit again.” At one point, Grossi writes, “When we came home together, Fred was a source of light.” And that is a good description of the positive, upbeat, anti-depressive capabilities that so many dogs seem to possess so naturally. The later part of Craig & Fred, a road trip that involves meeting various humans who interact with Fred as well as Grossi, is pleasant enough and homey enough to counterbalance the intensity and viciousness of the book’s earlier sections. It is, however, less interesting to read. But its warmth, and the way it shows how dogs really can rescue the people who seem to rescue them, reinforce the feel-good message of the entire book. It is a message that should inspire readers of any age to deep gratitude to Grossi and those who serve as he did – the vast majority of them without the benefit of a Fred in their lives.