tag:blogger.com,1999:blog-6561748834204284315.post1400629922303582116..comments2024-03-23T08:25:22.526-04:00Comments on ED Bites: "Brain disorder"Carrie Arnoldhttp://www.blogger.com/profile/02569839838912988783noreply@blogger.comBlogger42125tag:blogger.com,1999:blog-6561748834204284315.post-43476544526260960032023-05-23T07:08:27.674-04:002023-05-23T07:08:27.674-04:00i like it.areenadesigni like it.<a href="https://areenadesign.com/" rel="nofollow">areenadesign</a> GGhttps://www.blogger.com/profile/14969306107464567853noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-45464156978090066202011-01-31T13:25:22.724-05:002011-01-31T13:25:22.724-05:00eating disorders are 'simply' genetic HPA ...eating disorders are 'simply' genetic HPA axis misfirings present all through life, but adapted by ones environment when malnutrition is triggered, be it a diet or just bad food choices...<br /><br />fixing eating disorders means fixing malnutrition.<br /><br />you can 'argue' its a brain disease or disorder vs not being, but the brain doesnt change until the genetic switch is fluipped and that doesnt occur until malnutrition is present. from there, recovering from malnutrition will lead one to develop and repair habits that have been 'tag alongs' in the ED like rituals, obsessions, and sociabilityAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-29509533108939659062011-01-30T14:21:04.527-05:002011-01-30T14:21:04.527-05:00Katie- I read your blog entry- It was great! This ...Katie- I read your blog entry- It was great! This discussion has helped me much also. Bouncing ideas around with other recovery-minded people is a good and healthy thing.<br /><br />In the end, I'm still partial to "disorder" over "illness" in my process towards understanding myself- as a germaphobe, "illness" doesn't sit well with me- as a lover of math and all things orderly, "disorder" works for me because it says I've got something I can WORK with- I can line this thing up and try to re-order the things in my head! I can try to make order out of this frustrating disorder- and that's what I'm trying to do. :)hmnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-54644352154530837652011-01-30T06:21:36.151-05:002011-01-30T06:21:36.151-05:00Carrie - I just wanted to say, I hope you're o...Carrie - I just wanted to say, I hope you're okay with what happened to your comments section here, and thank you! <br /><br />Thanks to everyone else to commented too, I found it so helpful in clarifying my thoughts. So much so that I couldn't resist waffling on a bit more on my own blog. My poor readers...Katiehttp://themilkfreeway.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-72215384445945083732011-01-30T06:04:37.398-05:002011-01-30T06:04:37.398-05:00@Jamie - don't worry that I felt attacked or i...@Jamie - don't worry that I felt attacked or insulted. I don't see debating on this blog as personal whatsoever. We are just discussing science, evidence and theories. I only mentioned my understanding of the science of starvation to emphasise the point that on the basis of knowing the science I wholly believe that AN certainly IS driven to a large extent by starvation and does therefore have a biological basis. I had low weight restricting AN for many years and I personally witnessed how re-feeding ameliorated many symptoms of my AN. But re-feeding didn't cure my anxiety or OCD. Therapy has helped with these factors that played into my AN.Cathy (UK)noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-19319861370985131132011-01-30T04:03:56.115-05:002011-01-30T04:03:56.115-05:00@Katie - I totally agree with you about the variab...@Katie - I totally agree with you about the variabilty of expression and heterogeneity of EDs - and even subtypes such as AN.<br /><br />Another point is that many people with EDs have co-morbid diagnoses (e.g. OCD, ASD, BPD, GAD). Most clinicians view co-morbidity as the norm rather than the exception. <br /><br />I only read 2-3 ED blogs on a regular basis nowadays, but in the past I followed quite a few. I did (and do) wonder, when some people discuss what they call their ED, whether what they are sometimes describing are characteristics of a co-morbid condition. There simply isn't a standard medical model to describe even AN. That is why tailor-made treatment has helped me.Cathy (UK)noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-63559855921772836872011-01-30T03:41:33.526-05:002011-01-30T03:41:33.526-05:00Jamie - it's quite alright, we like debating! ...Jamie - it's quite alright, we like debating! Hehe. I think maybe you are misunderstanding my approach to my outreach. I certainly don't tiptoe around the idea of biology in my talks to teenagers (who are all college students by the way, not people with eating disorders, although obviously some will have problems in any class), I make sure by the end of the session that they understand the effects of starvation and the research suggesting a biological basis for AN. I just don't like the term brain disorder, because as A and Cathy pointed out, that implies something along the lines of Huntingtons or Parkinsons etc, and there's no proof (yet) that anorexia is that obviously and physically located in the brain. I called my anorexia an illness - I clearly had all the traits associated with future AN development in childhood, then during each of my relapses some trauma or stress made me lose my appetite, undereat and get locked into that pattern of behaviours by the biological effects of starvation. It makes sense to me to think of the biology behind anorexia in two parts: first of all the group of (genetically determined) traits which predispose someone to the disorder, and secondly what happens to a person (biologically) when they begin to restrict their intake. It's a bit different from believing that anorexia is a specific disease process that is triggered by restriction. I was a physics rather than biology student, so Cathy and A are much better explaining that than I am.<br /><br />This is purely conjecture, but I wonder if we are discussing different illnesses. There are huge differences among people with anorexia, bulimia and BED. Some people at low weights got there by bingeing and purging, some just restrict, some have body dysmorphia, some feel it's more akin to OCD...anorexic and bulimic seem to be umbrella terms for a very diverse set of people. The only real similarity I've found between myself and all the other people with eating disorders I know is that everyone is subject to the biological effects of restriction/malnutrition. Other than that, you could barely say that any two of them had the same illness.Katiehttp://themilkfreeway.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-37152198298365610502011-01-30T03:11:23.887-05:002011-01-30T03:11:23.887-05:00Ok I admit that I am way out of my league on the s...Ok I admit that I am way out of my league on the sciency stuff here but here goes my non-clinical observations.<br /><br />First Rose, I would like to reassure you that I view all eds as a sign/symptom of a sick brain. Anorexia tends to get used as a generic term sometimes.<br /><br />My theory is faulty wiring - I have been doing a lot of watching of Dr Ramachandran on YouTube and his TED talks and it makes sense to me. I think that part of the treatment of an ed is the "normalising" of eating patterns, as well as weight restoration. I think neuroplasticity has a big part to play alongside desensitisation. I put my daughter's anorexia on the OCD scale, so therefore I feel that she had a disorder. However I am convinced that this disorder sprang from a diseased brain but, in the end, it is just words to me.<br /><br />Whether you describe the condition as a brain disease, or damage, or disorder, or condition is all immaterial to me, as a parent and a carer, because I am not a scientist or intellectually up to the more technical points being made here. However, I do loathe the stigma surrounding the whole area.<br /><br />On a personal level, I would much rather be labelled with a disease, a relatively blameless diagnosis, than a disorder, which, to me, has the connotations of it being my fault.Charlotte UKnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-85789883204469703782011-01-30T02:32:59.932-05:002011-01-30T02:32:59.932-05:00@Jamie - not 'heated' whatsoever; merely a...@Jamie - not 'heated' whatsoever; merely a debate - and perhaps me being a little over-precise and literal as usual.. <br /><br />@A:) - you describe perfectly the point I have been endeavouring to get across :) How can we state that certain mental illnesses stem from a genetically-based (primary) 'brain' disorder when this is merely hypothetical?<br /><br />There is no evidence of 'faulty' genetics in AN when compared to (e.g.) cystic fibrosis. The assumed genetic basis is derived from data from twin and family studies. But unless identical twins are reared apart, it's near impossible to clearly attribute AN to inheritance because of environmental influences. The genetic data also suggest that relatives of AN more frequently have (e.g.) depression, anxiety and ASD. The genetic basis most likely relates to inherited traits that may express in a variety of forms that influence psychological functioning or wellbeing; not a specific and isolated genetic condition.<br /><br />What we do know, however, is that semi-starvation has profound effects on the functioning of all tissues and that the brain is especially sensitive to glucose deprivation on account of an inability to metabolise fat. The changes in thinking that occur in AN may merely be normal adaptations to starvation. Blood levels of many hormones and nutrients alter radically during chronic semi-starvation and these feedback to the brain. This is all NORMAL adaptive functioning. It is not a brain disorder. Starvation may 'strengthen' pre-existing traits so as to lock the person in the illness until their systemic physiology and metabolism are normalised.Cathy (UK)noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-16350673775894409212011-01-30T00:24:22.466-05:002011-01-30T00:24:22.466-05:00i get frustrated at the notion that there is no bi...i get frustrated at the notion that there is no biological basis for BN and BED like there is for AN. it pisses me off, to be honest. i'm not trying to start a fight. i'm just expressing my feeling on the matter. <br />i also really like Dr. Ravins definition of a brain disorder. i htink it makes sense and gives "credit" to those of us with "mental illness", a term which is so often misunderstood, even by treaters themselves.Rosehttps://www.blogger.com/profile/05663360216186611103noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-79715740967715872562011-01-29T21:52:12.281-05:002011-01-29T21:52:12.281-05:00I think we are getting confused over terminology.
...I think we are getting confused over terminology.<br /><br />No one is saying that EDs do not have a biological basis or that they are not strongly inherited, improved by stable nutrition, etc -- just that there is no evidence to suggest that it is a "disorder" of the brain.<br /><br />As Cathy so aptly stated (I agree with everything you say Cathy :P) there is really no evidence that EDs are not borne of sub-optimal functioning in the brain ( perhaps as a result of specific personality traits, genetic predispositions toward depression, anxiety, rigidy) -- in fact all the evidence supports this PREDISPOSITION.<br /><br />This is EXTREMELY different than a disorder which implies structural or functional impairment/deficit on a gross level.<br /><br />In Alheizmers disease we can visualize beta amyloid plaques and tangles and watch the development of the disease (at least in animal models). In Parkinson's disease we can visualize that destruction of the substantia nigra and we have a working model of how this affects the basal ganglia. Similarly, this can also be done in Huntingtons chorea, etc. <br /><br />My point is that these are disorders of the brain where something goes seriously wrong -- whether it is a mutated protein, gross cell death, etc and there are behavioural consequences.<br /><br />EDs are less concrete. The genetic/biological evidence that has been found suggest slight deviations from the normal population the SUBTLY influence functioning. However, some of these SAME genetic polymorphisms and differences have been found ACROSS mental illness and in non-ill family members. So can we REALLY point to biological evidence that proves a brain disorder?<br /><br />I think it is more likely that EDs are a biologically based mental illness. They have a biological basis, but their presence does not guarantee the disorder.<br /><br />It is also important to note that there is less genetic evidence for BN and BED (at least at the moment) than AN. So we cannot lump all EDs together.<br /><br />A:)A:)noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-70553961186844314782011-01-29T20:02:23.357-05:002011-01-29T20:02:23.357-05:00Very true hm, very true! :-)Very true hm, very true! :-)Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-8683795225408668152011-01-29T20:02:02.697-05:002011-01-29T20:02:02.697-05:00This comment has been removed by the author.Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-42211722758724480342011-01-29T19:23:34.067-05:002011-01-29T19:23:34.067-05:00Jamie- It's not "heated"- it's &...Jamie- It's not "heated"- it's "spirited." :)<br /><br />I love all of these different viewpoints. Each person with their particular thoughts adds more color to the canvas.hmnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-47369346513229065412011-01-29T18:40:31.060-05:002011-01-29T18:40:31.060-05:00Cathy (UK)- I think I get what you are saying. Is ...Cathy (UK)- I think I get what you are saying. Is it a "brain disorder"? If so, what's the concrete proof of that? You can see the difference in insulin in a diabetic. But disordered thoughts don't show up on a brain scan, blood test, or an x-ray.<br /><br />It's much simpler to just say "eating disorder," because those of us who struggle don't eat the same way "normal" people do. But I can honestly say it's not that I don't know how to eat- it's not like I feel like I need to eat while standing on my head, or using my toes instead of my fingers, or smearing food all over my face (as one article suggested with its photos...). It's that my thoughts towards eating are off. My thoughts towards food, weight, calories- all off, apparently. Thoughts towards many other things are quite on the spot.<br /><br />"Brain disorder" fits for me. It helps me to categorize my thinking, into rational thoughts and disordered thoughts. I am learning how to strengthen the rational side so that it can recognize disordered thinking and then keep the disordered side in check. But in order to recognize the difference, I need to acknowledge both! Yes, I have a good brain, a smart brain- and yes, I have a disordered brain.hmnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-61690576871157335622011-01-29T18:36:10.700-05:002011-01-29T18:36:10.700-05:00Cathy, as a molecular biologist myself, I have no ...Cathy, as a molecular biologist myself, I have no doubt from reading your posts that you have a thorough understanding of the biology and physiology of starvation. <br /><br />However, when I responded to a comment that you had made, it had absolutely nothing to do with either of those things. You stated that "the only advantage of describing EDs as 'brain disorders' is that it negates any sense of guilt or blame - for anyone...that it might make the sufferer, or carer feel happier."<br /><br />That is the quote that I was responding to. And in responding, it was not my aim to make you feel attacked or insulted. Just to provide another point of view.<br /><br />The rest of my post was not responding to anything that you said.<br /><br />Oh my. Things seem to have gotten a bit heated here....Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-39258205712911511252011-01-29T18:04:39.769-05:002011-01-29T18:04:39.769-05:00@Jamie: Very briefly, not the least because I have...@Jamie: Very briefly, not the least because I have been hugely 'gobby' already.... I don't dispute the biological basis of EDs whatsoever; I have a PhD in the Biomedical Sciences and understand the biochemistry and physiology of starvation very thoroughly. But: (1) I dislike the term 'disorder' in the context of the brain in certain mental illnesses - and (2) there is no clear scientific evidence that explains precisely what is happening in the brain in individuals with active EDs and a history of EDs as yet. <br /><br />My primary concern relates to the potential for stigma and misunderstanding.Cathy (UK)noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-14877794295628097342011-01-29T18:03:14.585-05:002011-01-29T18:03:14.585-05:00Katie-I think thats awesome and amazing that you d...Katie-I think thats awesome and amazing that you do outreach work. I was in no way trying to attack you, please understand.<br /><br />I do feel that the problem with easing people into the idea is that its almost like admitting that we're not that comfortable with it ourselves. I'm not saying that going in guns blazing is the answer, however, I don't think that tiptoeing around the issue and easing people in is either. That will take too long, and in the interim, too many sufferers will not be getting the proper care. Will some people be turned off initially? Yes, of course. But I think that this is an issue with a lot of causes seen throughout history-and sometimes hard choices have had to be made about when to speak up about what-and the people speaking up were not always saying things that were popular-but they were saying things that had to be said.Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-61291732136182804212011-01-29T17:45:49.530-05:002011-01-29T17:45:49.530-05:00Jamie, I think you've pretty much re-expressed...Jamie, I think you've pretty much re-expressed our own views ;) as I explained to hm, I already do outreach work, explaining the biology of eating disorders to teenagers. I wasn't arguing that we shouldn't fight, I was arguing that we shouldn't go in all guns blazing because that turns people off - it's better to ease people in when trying to change their views, so they are more open to what you have to say. I think of my past ED as a biologically based mental illness - the phrasing of brain disorder doesn't appeal to me, but the ideas behind it are largely in line with my own thinking. It's just semantics.Katiehttp://themilkfreeway.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-8817521471467302732011-01-29T17:36:32.178-05:002011-01-29T17:36:32.178-05:00Stepping back on the soapbox for one more second :...Stepping back on the soapbox for one more second :-)<br /><br />Just one more comment re: whether or not EDs are, in fact anyone's fault (I personally do not believe that they are anyone's fault, and certainly not the sufferers), but, even if they were, let me put this out there:<br /><br />Would it do any good to place blame?<br /><br />If you place things within that model, what would putting blame on a suffering, tortured, patient, who is living with an ED demon in his/her head do? Would it help?<br /><br />What would placing blame on a parent who, while possibly not perfect, while perhaps VERY not perfect do? Make the parent more hostile? Resentful of the ED'd child? <br /><br />Blame = Shame<br /><br />Its never a good idea.<br /><br />Not healthy for the parents, and won't lead to recovery for the child.<br /><br />Back off soapbox-thanks for reading :-)Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-23254571999269192482011-01-29T17:26:24.894-05:002011-01-29T17:26:24.894-05:00Now, what I am going to say next is where I branch...Now, what I am going to say next is where I branch off a bit from the biological model just a bit. I know that individuals who advocate the brain disorder model generally feel that weight restoration, stabilization of the person's nutrition, and cessation of symptoms are what is necessary to restore health. They feel that any therapist who looks for underlying or roots causes of the ED is a T that also feels that finding these causes will ultimately be what stops the behaviors and is not worth his/her salt. I couldn't agree more. I have been treated by people like that, have sat in chairs for years looking for causes while I starved to death. I also feel that individuals should not begin therapy until they are either fully weight restored (with AN or BN) or until all b/p symptoms have stopped (with BN). While a person is fully entrenched in AN or BN, they aren't able to engage in T-they are too malnourished and/or medically unstable. However, and I do think that each person should be evaluated on a case by case basis, I do think that it is beneficial for the individual to do some, what I like to call "dot connecting", which IMO is very, very different from looking for root causes. The way I see it, because right now, I am at the "connecting the dots" stage, it is something you do because it allows you to take an aerial view of your life, if you will, to view it holistically and to become a wiser, stronger person who is better able to be compassionate to both herself and to others. It is also just generally an enlightening undertaking. It allows you to see where you came from, what got you to that point, and where you are going.<br /><br />Cathy (UK), you stated:<br /> As far as I can see, the only advantage of describing EDs (the subject discussed most frequently on this blog) as 'brain disorders' is that it negates any sense of guilt or blame - for anyone. That is to say that no-one need be blamed or need feel guilty, because the individual with the ED (supposedly) has a 'brain malfunction'. That might make sufferer or carer feel happier <br /><br />I have to say, I respectfully view it very differently. In fact, I look at the situation much the way Charlotte views diabetes. I might have a genetic vulnerability to diabetes that may or may not manifest. However, if certain environmental stressors are in play (poor diet, no exercise, etc) it is much more likely to show up. Same with the ED. My own mother, in fact was extremely abusive of my weight growing up and I blamed her entirely-I completely adhered to the "root causes" model. Now I see that it simply isn't possibly. There are children from perfectly lovely families who develop AN and children from horrid families who are abusive about their weight who don't-they don't have that same genetic vulnerability. Dr. Julie O'Toole actually mentioned something on her blog on the Kartini Clinic website about two mother with munchausen by proxy who tried to induce AN in their daughters and were unable to because their daughters did not have the biological predispostion to the disease (thank goodness!).<br /><br />Katie<br />With regard to your comment that medicalizing mental illness and how calling it a brain disorder might increase stigma-I just want to say-that might be true-BUT...I think that the only way to fight that stigma is to keep saying the truth, to not be ashamed and to fight, fight, fight-for better care for current sufferers, for early detection and prevention for future sufferers, and for investigation of treatment facilities that are, frankly, appalling, and IMO doing more harm than good. (Anyone see THIN?)<br /><br />Ok, I am stepping off my soapbox because this post has become far too long. Thank you to anyone who has managed to reach the end! With that, I am off to prepare a lovely dinner :-)Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-7582093571304270662011-01-29T17:25:39.206-05:002011-01-29T17:25:39.206-05:00Thank you, Carrie for this excellent post! As some...Thank you, Carrie for this excellent post! As someone in recovery from AN, I strongly agree with everything that you said. I would also like to add a few things, and to respectfully respond to a few posts made on the board. (I'm really glad to see that this particular post created such a spirited discussion about such an important issue!).<br /><br />In terms of eating disorders being biologically based brain diseases, I, like you Carrie, have also found a great deal of comfort and relief in finding this out. Because in knowing this information, the solution became clear: full nutrition. Full nutrition is medicine for someone with an eating disorder. Is it a magic cure? No, of course not. Will someone with AN become WR and overnight will all ED thoughts and desires to engage in symptoms go away? No. But full nutrition is a START. It gives the patient, whether AN or BN a fighting chance to face the thoughts, the desires, and everything else because when the person becomes stable medically and weight-wise, their mind is clear and rational for the first time, very often, in years. They have physical strength that they haven't had for a very, very long time. And because their mind is clear, this allows them to want to continue (sometimes, not always) to nourish themselves, because suddenly, they can SEE the future, they can see their way out of depression, anxiety, isolation, whereas they could not before. If they are not able to nourish themselves on their own, this is simply an indication that the person is not truly weight restored, or just that they need more time eating their meal plan with support and maintaing their weight restored weight as their brain heals. (cont below)Unknownhttps://www.blogger.com/profile/04404008515971173826noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-34230290818466880162011-01-29T16:07:48.943-05:002011-01-29T16:07:48.943-05:00What fascinating posts everyone!
I think it's...What fascinating posts everyone!<br /><br />I think it's also important to realize that there may be a few components to this whole brain disorder thing. There's the initial genetic/environment component that means we end up with eating disorders, but there is also the changes to the brain that occur as the result of starvation which only amplify the original condition.<br /><br />I have found a lot of comfort in the idea that AN is a brain disorder and I know a lot of girls in treatment who feel the same way. Recognizing the biological basis on EDs really helps to alleviate guilt for sufferers and their parents who often feel blamed. <br /><br />Increasing our knowledge and pushing people who discuss EDs, either in private, in treatment or in the media, to include a conversation about biology can only help increase understanding and make for better treatment.Thttps://www.blogger.com/profile/02173013733681509913noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-53891978552240664932011-01-29T13:06:21.772-05:002011-01-29T13:06:21.772-05:00@Dr Ravin: Thanks for commenting on my comment. I&...@Dr Ravin: Thanks for commenting on my comment. I'd be interested to know your answer to the following questions, if that's OK:<br /><br />1. How do you view the link between the brain and the mind, and what is your opinion on Dualism? The mind is quite easy to test; however, the brain is more difficult. We can investigate metabolic activity of various regions of the brain in response to a variety of sensory cues using techniques such as fMRI, and make cross-sectional comparisons between symptomatic and asymptomatic individuals, or track longitudinal changes within the same individual over time, but can we categorically define most mental illnesses as 'brain disorders' using such techniques? Is there a clear, definable split between a 'disordered' brain and 'non-disordered' brain? <br /><br />2. Do we know that anorexia nervosa is caused by a measurable malfunction of the brain (in the sense of a clear organic abnormality) as opposed to a variation of normal functioning?<br /><br />I'd be really interested to know your views on this, if that's OK!Cathy (UK)noreply@blogger.comtag:blogger.com,1999:blog-6561748834204284315.post-49229716118021611662011-01-29T10:13:40.910-05:002011-01-29T10:13:40.910-05:00Thank you, Carrie, for posting this - I am very fl...Thank you, Carrie, for posting this - I am very flattered. Thank you to everyone who commented - I found each comment to be thoughtful and valid.<br /><br />I do want to comment on Cathy's second post regarding EDs which are triggered by abuse. While I understand why some people may be offended by the use of "brain disorder" in this context, their discomfort may stem from a misunderstanding of the term brain disorder. <br /><br />The fact that the public misunderstands a term does not mean that we should discard that term. Rather, we should educate the public.<br /><br />All psychiatric disorders are, in my opinion, brain disorders. PTSD is by definition triggered by trauma, and it is a brain disorder. Traumatic brain injuries and concussions can lead to depression and psychosis, which are brain disorders. <br /><br />As I see it, the fact that a physical or psychological trauma triggered a brain disorder does not change the fact that it is a brain disorder. Perhaps the brain was not "disordered" before the trauma, but the combination of trauma and preexisting brain wiring resulted in a brain disorder.Dr. Ravinhttp://Www.drsarahravin.comnoreply@blogger.com