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I asked the question which is ever-present at Safe Harbor: Was he given a thorough examination by a competent practitioner who knew to look for the underlying cause(s) of his behavior? The answer: "Not really."

So before the son was shipped off, I suggested the parents try that first. A few days later, I spoke with the mother and the clouds of gloom were gone. They had taken their son to the favorite family practitioner, a crackerjack nutritionist. She had found the young man had three severe deficiencies, hormonally and nutritionally. The son was greatly relieved to find he wasn't just "crazy" and was eager to cooperate with a treatment program.

This concept of doing a full searching exam on anyone with mental symptoms is THE most ignored step in mental health treatment. When Safe Harbor did a study of the Los Angeles County Department of Mental Health, we found that NONE of the more than 100,000 outpatients received exams unless a medical emergency was present.

Even in private psychiatric practice, failure to do full exams is a legendary area of neglect and has been so for decades, even though psychiatric journals clearly show the vital importance of it.

If you add on top of that the fact that even when exams ARE done, orthodox doctors almost never look for food allergies, toxic conditions, nutritional imbalances, and a host of other things that complementary practitioner have found can cause mental disturbances - you begin to see the level of failed diagnosis and misdiagnosis that goes on in the field of mental health.

It appears to be an amazingly hard lesson to learn, but learn it we must or the suffering of countless individuals - and their families - will continue.

Simply send us an email to SafeHarborProj@aol.com, saying you wish to be on the SafeHarbor2 list.

Of course, feel free to pass this information along to anyone looking for or needing a holistic mental health support group.

Naturopathic physician Melissa Metcalfe (www.naturalsolutions.com), a graduate of Bastyr University with experience in treating mental disorders, will speak at the Safe Harbor office on natural mental health treatments.

We will have a support group meeting from 7 PM to 8 PM and the talk and a question-and-answer period will last from 8 PM to 9 PM. The talk is free and all are invited.

The lecture will be Wednesday, January 8, 2003, at the Safe Harbor office at 1718 Colorado Blvd. in the Eagle Rock section of Los Angeles.

Admission is free and all are invited. We ask that you call the Safe Harbor office or email to let us know you are coming: (323) 257-7338 or SafeHarborProj@aol.com. 

When the body is under bacterial attack, the immune system responds by producing antibodies that attack the infection. If the invading bacteria mimic normal healthy tissue, could the antibodies mistakenly attack healthy tissue? This hypothesis has been offered by some researchers to explain PANDAS. One way to assess or measure this problem, is by specialized blood tests.

(As we see in an article below, a similar "friendly fire" hypothesis has been offered by at least one researcher in connection with anorexia.)

The relationship between strep infections, rheumatic fever, and chorea (a group of disorders involving involuntary movement and lack of coordination) dates back to Sydenham's description back in the 17th century. It was observed in the 1950's that some children, months after a bout of rheumatic fever, developed a movement disorder known as Sydenham's chorea or "St. Vitus Dance" (rapid, aimless, involuntary movements of the muscles of the limbs, face, and trunk). These children were found to have elevated levels of antibodies to this type of streptococcal infection.

Current findings of researchers active in investigating PANDAS were presented at the American Association of Child and Adolescent Psychiatry conference in Oct. 2002. Here are some brief excerpts of conference coverage:

"Postinfectious autoimmune disorders in response to Streptococcus infections were confirmed in the 1950s. Rheumatic fever (RF) was the prototype disorder and Sydenham chorea (SC) was identified, not only as a criteria for the diagnosis of RF but also as a stand-alone manifestation of the potential for a central nervous system autoimmune response. SC can have a mix of both motor and psychiatric manifestations, including hyperactivity, mood lability and, in severe cases, psychosis. Behavioral symptoms often precede the motor manifestations and can include obsessive-compulsive features. On average, SC lasts about 6 months...

"Swedo and colleagues first proposed that some cases of childhood-onset obsessive-compulsive disorder (OCD) might be, like SC, a post-strep disorder of immune character. They coined the acronym PANDAS to identify the occurrence of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. This is a disorder of prepubertal children with sudden and dramatic onset of OCD post-streptococcal infection.

"Dr. Susan Swedo, from the Pediatric Developmental and Neuropsychiatry branch of the National Institute of Mental Health (NIMH), presented that these children have a remarkably episodic course with remitting and relapsing OCD symptom severity. Her criteria for a PANDAS presentation also require the presence of associated neurologic problems. These are usually 'choreiform' (resembling chorea) movements, which, by definition, are not full-blown SC. In fact, these are often subtle movements. They do not interfere with voluntary motor control and may only be elicited with careful observation of the extended hand/fingers. Such movements were present in 25 of 26 children seen during an exacerbation of their OCD symptoms in the early studies at NIMH...

"Dr. Swedo reported that there was an initial sense by clinicians that a larger spectrum of psychiatric disorders (e.g., attention deficit/hyperactivity disorder, autism, anorexia nervosa) might also be placed under the PANDAS rubric. However, she feels strongly that this subgroup classification should be reserved, at this time, for OCD and tic disorders."

"Dr. Harry Hill, Infectious Disease specialist and Streptococcus researcher at the University of Utah School of Medicine, reported that the current "rapid" streptococcal screens used in most clinics are perfectly acceptable for proving the presence of the Streptococcus if positive. However, if the rapid screen is negative, this is not a true indication of the absence of infection. A full plate culture needs to be done."

"Finally, the question of how much of "typical" OCD may have its genesis in postinfectious etiology is a tantalizing one. Given the interest of psychiatry and child psychiatry in finding clear etiologies for many disorders, the possibilities of viral and bacterial contributions to currently poorly understood disorders and their exacerbations make the evolving PANDAS story a model for all clinicians to watch."

Paraphrased from Frequently Asked Questions on the NIMH website:

Q. Is there a test for PANDAS?

A. No. PANDAS is a clinical diagnosis, which means that there are no lab tests that can diagnose PANDAS. Clinicians use 5 diagnostic criteria for the diagnosis of PANDAS:

1. Presence of Obsessive-compulsive disorder and/or a tic disorder
2. Onset of symptoms in childhood
3. Episodic course of symptom severity
4. Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of Scarlet Fever)
5. Association with neurological abnormalities (motoric hyperactivity, tics).

Q. What does an elevated anti-streptococcal antibody titer mean? Is this bad for my child?

A. An elevated anti-strep titer [concentration in a sample] means the child has had a strep infection sometime within the past few months, and his body created antibodies to fight the strep bacteria. This is a normal, healthy response. "Positive" antibody titers may persist for many months after the infection goes away.

Q. Will Penicillin treat PANDAS?

A. No. In PANDAS, it appears that antibodies produced by the body in response to the strep infection are the cause of the problem, not the bacteria themselves. Therefore one could not expect antibiotics such as penicillin to treat the symptoms of PANDAS.

The NIMH is researching plasma exchange and antibiotic prophylaxis (preventive use of antibiotics) as two possible treatment regimens for PANDAS.  

"The three primary biochemical classifications of bipolar disorder are the following:

"A. Undermethylation: This condition is innate & is characterized by low levels of serotonin, dopamine, and norepinephrine, high whole blood histamine and elevated absolute basophils. This population has a high incidence of seasonal allergies, OCD tendencies, perfectionism, high libido, sparse body hair, and several other characteristics. They usually respond well to methionine, SAMe, calcium, magnesium, omega-3 essential oils (DHA & EPA), B-6, inositol, and vitamins A, C, and E. They should avoid supplements containing folic acid. In severe cases involving psychosis, the dominant symptom is usually delusional thinking rather than hallucinations. They tend to speak very little & may sit motionless for extended periods. They may appear outwardly calm, but suffer from extreme internal anxiety.

"B. Overmethylation: This condition is the biochemical opposite of undermethylation. It is characterized by elevated levels of serotonin, dopamine, and norepinephrine, low whole blood histamine, and low absolute basophils. This population is characterized by the following typical symptoms: Absence of seasonal, inhalent allergies, but a multitude of chemical or food sensitivities, high anxiety which is evident to all, low libido, obsessions but not compulsions, tendency for paranoia and auditory hallucinations, underachievement as a child, heavy body hair, hyperactivity, "nervous" legs, and grandiosity. They usually respond well to folic acid, B-12, niacinamide, DMAE, choline, manganese, zinc, omega-3 essential oils (DHA and EPA) and vitamins C and E, but should avoid supplements of methionine, SAMe, inositol, TMG and DMG.

"C. Pyrrole Disorder: This condition, also called pyroluria, is a genetic stress disorder associated with severe mood swings, high anxiety, and depression. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Pyrolurics are devastated by stresses including physical injury emotional trauma, illness, sleep deprivation, etc. Symptoms include sensitivity to light and loud noises, tendency to skip breakfast, dry skin, abnormal fat distribution, rage episodes, little or no dream recall, reading disorders, underachievement, histrionic behaviors, and severe anxiety. They usually respond quickly to supplements of zinc, B-6, Primrose Oil, and augmenting nutrients."

"Dealing with acute cases can be extremely challenging to manage in an out-patient setting, including for a physician willing to explore alternative treatments. At times a hospital environment is necessary largely because of the controlled environment (and not necessarily because of the drugs).

"Having said this, it is possible to attempt controlling an acute manic episode if you have the proper support from family, friends, and physician (24 hour on-call care is vital). If not, I would not attempt such an intervention.

"I have found that there are a few simple approaches to try to help control acute cases:

1. Tryptophan - 8000mg - 14,0000mg per day. This has been studied for treating mania and I have used it as well with success in some cases
2. Melatonin - 10mg twice daily (or more)
3. Benedryl - 50mg IM and repeated every 2 hours as needed

"In every case, I have also used tailored intravenous nutritional support. This area I have found to be vital in the treatment program and the protocol I use varies upon the case."  

"An amazing body of work, a great inspiration and a vital message that has the potential to transform an entire area of health care" was the verdict of the judges who award 'the Oscars' of the complementary and alternative medicine (CAM) world, sponsored by Britain's leading CAM supplier, the Nutri Centre.

Based on her own continuing recovery from mental and physical ill health, Amanda founded the Food and Mood Project in conjunction with Mind, the mental health charity in 1998, and is delighted to receive both the recognition of the CAM Award and the £1,000 prize money.

"There has been a huge interest in 'food and mood' right from the start of the Project nearly five years ago. It's been a lot of hard work but I know that the Food and Mood Project has made a real difference to the lives of a lot of people", said Amanda Geary, Food and Mood Project Founder.

During 2002 the Food and Mood Project conducted a national 'food and mood survey' of 200 people which received national media coverage, co-presented a groundbreaking Food and Mood conference and provided workshops, information and advice to hundreds of individuals with mental or emotional health problems (many of whom, due to long-term illness are on low incomes).

Publications include The Food and Mood Handbook, the Food and Mood Self-help Report, and an informative website (www.foodandmood.org) that hosts a 'Food and Mood' email group and features a list of nutritional therapists in England who are able to provide professional support to individuals.

"There are so many possibilities for taking this work forward, but more research and expanding the Food and Mood Project website both feature in the strategic plan. It's now a question of managing the growth so that it's sustainable and continues to serve the needs of the individuals the Project intends to help," said Amanda.

For more information contact the Food and Mood Project on 01273 478108 or email: info@foodandmood.org. 

Regarding the complementary use of nutritional supplements and psychotropic medications, many psychiatric patients seem to be unable to discontinue medications without incurring withdrawal side effects and many want to stay on medication believing, sometimes rightly, that recurrence of psychiatric symptoms are prevented.

In my practice when I evaluate someone taking psych meds, I initially usually do not change any medication dosages and proceed to do the testing and then design treatments that make medications unnecessary. In the meantime I quickly focus on mitigating neuronal injury in two ways, antioxidants therapies and phospholipid/essential fatty acid therapies. The former is a no-brainer as oxidative stress, especially when toxic substances are in contact with cells, is always an issue. For instance, vitamin E is probably the most important and I immediately prescribe it in the dosage ranges of 800 IU to 1600 IU a day.

See:
Am J Psychiatry.1991 Feb;148(2):279.
Vitamin E in the treatment of tardive dyskinesia.
Elkashef AM, Ruskin PE, Bacher N, Barrett D. Department of Psychiatry, Baltimore VA Medical Center, MD.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1987837

"Eight subjects with persistent tardive dyskinesia were treated with vitamin E and placebo in a randomized, double-blind crossover study. Their mean score on the Abnormal Involuntary Movement Scale (AIMS) was significantly lower after treatment with vitamin E than after placebo administration."

I am assuming that if vitamin E can assist is in reversing TD then it probably could help prevent any neurological injury. Of course, it works best if combined with other antioxidants, such as vitamin C, CoQ10, a source of zinc and selenium etc.

The other factor in preventing neuronal injury that is often overlooked, is essential fatty acids and phospholipids. These would be expected to work as:

1. They are high-energy, basic structural and functional elements of all biological membranes, such as cells, blood corpuscles, lipoproteins, and surfactants.
2. They are indispensable for cellular differentiation, proliferation, and regeneration.
3. They maintain and promote the biological activity of many membrane-bound proteins and receptors.
4. They play decisive roles in the activity and activation of numerous membrane-located enzymes, such as sodium - potassium - ATPase, adenylate cyclase, and lipoprotein lipase. They are important for the transport of molecules through membranes.
5. They control membrane-dependent metabolic processes between the intracellular and intercellular space.
6. The polyunsaturated fatty acids contained in them, such as linoleic acid, are precursors of the cytoprotective prostaglandins and other eicosenoids.
7. As choline and fatty acid donors, they have an influence in certain neurological processes (probably due to enhancement of neuroplasticity).
8. They emulsify fat in the gastrointestinal tract.
9. They are important emulsifiers in the bile.
10. They codetermine erythrocyte and platelet aggregation.
11. They influence immunological reactions on the cellular level.

(from Cerv, G and Paltauf, F.(editors): Phospholipids: Characterization, Metabolism And Novel Biological Applications. AOCS Press, Champaign, Ill., 1995, pp.209-227 (Chapter 19, Gundermann, K.F., author).

After some early reports on the benefits of phosphatidyl choline, later studies were surprisingly disappointing.

See:
(J Clin Psychiatry 1990 Apr;51(4):149-53, A crossover study of lecithin treatment of tardive dyskinesia. Gelenberg AJ, Dorer DJ, Wojcik JD, Falk WE, Brotman AW, Leahy L. Department of Psychiatry, University of Arizona College of Medicine, Tucson 85724.)

The problem here, as always, is "magic bullet" thinking, the search for the one intervention that works. If these researchers were interested in generating acetylcholine to downregulate dopamine, it would have been nice to supply pantethine (activated vitamin B5) so that the choline could actually be acetylated. Also, if these researchers were more interested in the structural (not neurotransmitter precursor) effects of phospholipids, it would have been nice to study the far more important phospholipid in the brain, phosphatidyl serine (PS), not phosphatidyl choline (PC). Despite the extensive evidence that PS prevents memory loss, I can not find references regarding TD or neuronal protection using PS. The other two main phospholipids, inositol and ethanolamine likewise have not been studied either that I can find, despite some promise of inositol for depression, panic disorder and OCD.

See:
J Clin Psychopharmacol 2001 Jun;21(3):335-338, Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. Palatnik A, Frolov K, Fux M, Benjamin J. Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel.

The reason that phospholipids may not help as much with neuronal protection as might be expected may be that the polyunsaturated fatty acids of these soy-derived phospholipids are mostly omega 6, not omega 3. Especially in light of the omega 3 studies in depression, I have therefore prescribed lots of distilled salmon oil along with the phospholipids (PC and PS), as fatty acids are readily exchanged in phospholipid molecules and the omega 3s are thus incorporated into cell membranes via PS and PC. Also, as I have now reviewed hundreds of essential fatty acid analyses on patients, it seems important to also add flax oil to discourage the elongase and other enzymes from converting any additional omega 6 oils that are already in abundance with PC and PS supplementation. So the protocol (subject to genotype variations) that should protect all psych patients on meds and is unlikely to hurt anyone is:

1. Antioxidants galore as above
2. Phosphatidyl serine 200 mg. twice a day
3. Purified soy lecithin 1000 mg. twice a day (higher doses can be used in non-dopamine deficient patients, e.g., catecholamine deficiency, Parkinsons)
4. Flax oil - 2000 mg. twice a day
5. Distilled fish oil - 2000 mg. twice a day

I hope this helps for those with questions about what nutrients they can take to help protect them from the long term side effects of psych meds. This protocol is also helpful for those who are no longer on psych meds but may still be suffering from the previous injury due to them. Also, in kids or for those who cannot swallow pills well, these capsules can be opened up, the contents mixed and massaged into the skin. Phospholipids are also used in transdermal delivery of drugs and carry all the oils rapidly into the body.  

In 1977, Barbara Reed, then chief probation officer in a municipal court, reported to a US Senate Select Committee on nutrition and human needs on her experience with 318 offenders. Of 252 offenders who required attention to their diet and vitamin needs, not a single one was back in court for offences if they had remained on an appropriate diet accompanied by vitamin supplementation. Reed ended her report by saying, "Never before has the court had such a tool for working with the many ill people who find themselves in court. We wonder what the results would be if this method of treatment could be applied to all those sentenced to jail."

Lonsdale reported the case of an individual who committed a petty crime for which he was found guilty and sent to jail. This was in spite of the fact that diet and supplementary vitamins had corrected a complex set of biochemical changes that confirmed that he had been a sick man at the time that the crime was committed. He had felt unwell for years, and had noted his tendency to "blind rages" after intake of alcohol and his constant tendency to become angered easily. The biochemical abnormalities had disappeared after his nutritional rehabilitation. A double-blind trial with thiamine disulfide was shown to be more effective in alcoholics than the usual and customary treatment that they received in a residential and correctional institution.

Americans consume more than 400 million cups of coffee every 24 hours, representing 50 tons of caffeine. Although this drug is responsible for a large amount of functional illness, including mood swings and irritability, it is frequently overlooked as a cause of illness. We can assume that an irritable criminal might be more capable of a "hot" crime. Could the ingestion of soda have played a part in the O.J. fiasco? Meetings of Alcoholics Anonymous are punctuated with the availability of ad lib coffee, which may promote a continuation of craving for alcohol; it certainly promotes craving for nicotine. Statistics of this nature emphasize the fact that little thought is given to biology as an underlying cause of the menace that haunts our contemporary society.  

Body defenses against low blood sugar cause some very different symptoms in different people. Usually, this is about 3+ hours after eating a sugary processed meal.

One symptom that is not uncommon in women is an anxiety attack, or even fainting. Men sometimes might experience these symptoms, but not as often. An anxiety attack caused by a hypoglycemia episode while driving might result in a phobia of driving, or if driving in a tunnel, a phobia about that, or if on a bridge, a phobia about that. In practice, I've seen all three of these phobias generated by hypoglycemic episodes!

Men have another common symptom. The combination of testosterone and adrenalin may trigger "undifferentiated" anger in a man. He will have a "rational" reason for the anger, but bystanders can't understand how he got so angry for "no real reason." Men who change personality dramatically while drinking are of this type. There is a Personality Test called the MMPI that shows this type clearly as "pseudoschizophrenic".

I once helped to save a marriage by simply advising the husband to eat a handful of peanuts and raisins every two hours after lunch. (He was her boss, and at 3 PM, she couldn't do anything right according to him - his lunch included a candy bar and a soda!!)

Anyone who has a sugar handling problem might be well advised to carry a bag of peanuts and raisins around, and make sure that they eat a handful every two hours or so. (Ratio of about 5 peanuts to 1 raisin). The raisins will provide glucose within a relatively short time, and the peanuts will provide protein and fats that can be converted into glucose over a longer time. This was what I usually advised hypoglycemic sensitive persons to do, and it works well. Really sensitive persons should know to eat 6-8 small meals every day. A meal might be a hard-boiled egg, or half an apple, etc.  

In a study reported in December 2002, Serguei Fetissov of the Karolinska Institute in Stockholm found that three-quarters of the anorexic and bulimic women studied carry blood antibodies targeted against appetite centres in the brain. Just 16% of those without eating disorders had such antibodies.

The antibodies may block the response of nerves to hormones that control hunger, Fetissov says, and so contribute to eating problems. If so, diagnosis could be improved on the basis of the presence of the antibodies.

Neuroscientist James McNamara of Duke University Medical Center in Durham, North Carolina, and others have said that some cases of epilepsy and of the sleep disorder narcolepsy might also be attributed to wrongly aimed antibodies. "My suspicion is that a subset of many common nervous-system disorders could be auto-immune in nature," he says.

Recent studies have suggested that some people carry a genetic susceptibility to anorexia. This could, for example, encourage the immune system to turn on its own tissues.

Alternatively, Fetissov speculates that prolonged or acute stress in anorexics might stimulate the immune attack. One of the misdirected antibodies detected by the team is aimed at adrenocorticotropic hormone, which is released in response to stress.

But the team has yet to show whether the suspect antibodies actually cause the eating disorders, or are simply a symptom of them.  

After a normal youth, I had my first manic episode at the age of 16. Later, after I was out on my own, the manic episodes began again. I believe that when I was still living with my parents they helped me by making me go to bed and get regular sleep.

I was diagnosed by my doctor as being schizophrenic. Eventually, I was put on lithium and I felt somewhat well on it because the manic episodes seemed to stop.

Then, after the birth of my first daughter, I began having manic episodes again. My confidence in the lithium was lowered because the medicine that was supposed to be protecting me from manic episodes now seemed to cause them! I kept taking the medicine but felt I had a lack of alternatives.

In the year 2000 I began to get halfway to a recovery because I started taking natural food supplements. I discovered this after reading Dr. Rath's book, Why Animals Don't Get Heart Attacks But People Do. For instance, the book mentions people taking diuretics (water pills), and then losing vitamins and minerals they need to prevent heart attacks as a result of the pills. But I did keep taking the lithium, and the food supplements made it easier to do so.

In 2002 I stopped taking the lithium. Everything felt better and I was able to get goose bumps from listening to music, something which I did not feel at all during 5 years of taking lithium. I did have to start taking it again later, after I began to have manic episodes when I had to stay up at night caring for my sick daughter.

But soon after, I read an article about Omega-3 fatty acids being very important to people with bipolar disorder. With that I started taking 3 grams of fish oil a day. Having that new fuel to my brain, I found I did not get a manic episode at all!

After this, I stopped taking lithium again in April, 2002. I kept confident that I would not get manic at all.

My second child was expected in June, and I was sure I would not get manic at all and that I would be able to feel every emotion that should be felt by a father who loves his children.

In May I had my first visit with a homeopathic doctor which was very successful. He believed my story about fish oils, and even put me on flax oil, an even better source of fatty acids. I felt for the first time that I was being taken seriously by a doctor. He also prescribed Carcino Sinum 100k twice a week, two granules. A week after I started taking this things started to go a lot better because I didn't care about things so seriously the way I did before. It was a very good and natural feeling.

I told my psychiatrist I had finally stopped taking the lithium. He said he had to respect my choice although he did not understand!

Then in June, our second child was born. There was no trouble at all with the birth as far as my having manic episodes! I was really beginning to enjoy it! My wife even noticed that we had less disputes and that everything with me seemed to go easier!

Now it is autumn of 2002. Normally I can get in trouble in autumn, but this year the trouble stays away and I still feel as normal as I did in the summer when the baby was born! I am now taking the homeopathic substance Carcino Sinum 200k every week, and soon it will be Carcino Sinum MK every two weeks. It is simply great how I feel and behave. I sleep well - and that is the most important thing for somebody who is affected with mental health trouble. I am so happy I took this step. My brain is reaching its full power again and on normal fuel!

The reasons I could stop the lithium are two-fold. First, the Omega-3 fatty acids (1 gram, 3 times a day), which take away one of the causes of bipolar disorder. This was taken along with an amino acid complex and vitamin B-complex, 100 mg, taken in the evening before bed. Then I followed this with a good multi-vitamin with amino acids in the morning. The Omega-3 fatty acids just feel like the right fuel for my brain.

The second reason is that I visited a homeopathic doctor who prescribed something that made it easier for me to just "let things be the way they are."

In the end, I have gotten back my emotions without taking lithium at all.

For those seeking further information, the author can be contacted via his site at: www.hhff.info  

"Many published activist accounts refer to feelings of encouragement and confidence emerging from experiences of collective action," says Dr Drury. "But it is not always clear how and why such empowerment occurs, so we aimed to explain what factors within a collective action event contribute most to such feelings."

The study involved in-depth interviews with nearly 40 activists from a variety of backgrounds, in which over 160 experiences of collective action were described.

"The main factors contributing to a sense of empowerment were the realization of the collective identity, the sense of movement potential, unity and mutual support within a crowd," says Dr Drury.

"However, what was also interesting was the centrality of emotion in the accounts. Empowering events were almost without exception described as joyous occasions. Participants experienced a deep sense of happiness and even euphoria in being involved in protest events. Simply recounting the events in the interview itself brought a smile to the faces of the interviewees."

Psychologists have become increasingly interested in the role of positive experiences and emotions not just in making people feel good but also in promoting psychological and physical health. Uplifting experiences are associated with a variety of indicators of well-being, such as speed of physiological recovery; ability to cope with physical stressors; and the reduction of pain, anxiety and depression.  

Although primarily aimed at women, with special chapters on hormones and female anatomy, most of the book applies to either gender so male readers will benefit as well.

The reader gets a truly rare, well-documented glimpse of the journey of a father, educated in the medical model of psychiatry and the "need" for drugs, as his research and observations slowly but clearly demonstrate to him that bipolar disorder is not a vague "mental illness of unknown etiology" but has definite, treatable causes, including nutritional imbalances, fatty acid deficiencies, and Lyme Disease. Moyer tells of his enlightening experience through trying the TrueHope supplements (www.truehope.com) on his son and finding a light at the end of the tunnel.

The book is available at www.bipolarodyssey.com.