Dr. Gary Kaplan on KBOO 90.7FM’s "Healthwatch"

On October 6th Dr. Gary Kaplan did a 30-minute live interview on “Healthwatch”, 90.7FM KBOO Portland, Oregon Community Radio.

Dr. David Naimon, Naturopathic Physician, Licensed Acupuncturist, Board Certified Chinese Herbalist, and host of Healthwatch, asked Dr. Kaplan to discuss the concepts in his book Total Recovery: Solving the Mystery of Chronic Pain & Depression.

Dr. Kaplan argues that we’ve been thinking about disease all wrong. He explains that chronic physical and emotional pain are two sides of the same coin. New discoveries show that disease is not the result of a single event but an accumulation of traumas. Every injury, every infection, every toxin, and every emotional blow generates the same reaction: inflammation, activated by tiny cells in the brain, called microglia. Turned on too often from too many assaults, it can have a devastating cumulative effect.

To listen to this broadcast please click on the audio link provided below.


RodaleNews.com Features Dr. Kaplan’s "3 Tips to Ease Inflammation in the Brain"

Do You Suffer From Sleep Drunkenness?

by Leah Zerbe, www.RodaleNews.com, September 3, 2014

Do you find yourself picking up the phone when your alarm clock goes off in the morning? Do you know someone who actually turns violent when they are suddenly awakened? A disorder called “sleep drunkenness,” which affects about 15 percent of the population, could be to blame, according to a study published in the journal Neurology.

The disorder may, in fact, be as prevalent as affecting one in every seven people. Sleep drunkenness disorder involves confusion or inappropriate behavior during or following arousals from sleep, either during the first part of the night or in the morning. An episode, often triggered by a forced awakening, may even cause violent behavior during sleep or amnesia of the episode. “These episodes of waking up confused have received considerably less attention than sleepwalking even though the consequences can be just as serious,” says study author Maurice M. Ohayon, MD, DSc, Ph.D., professor of psychology and behavioral science at Stanford University School of Medicine in Palo Alto, CA.

For the study, 19,136 people age 18 and older from the general U.S. population were interviewed about their sleep habits and whether they had experienced any symptoms of the disorder.

Participants were also asked about mental illness diagnoses and any medications they took. The study found that 15 percent of the group had experienced an episode in the last year, with more than half reporting more than one episode per week. In the majority of cases—84 percent—people with sleep drunkenness also had a sleep disorder, had a mental health disorder or were taking psychotropic drugs such as antidepressants.

People with depression, bipolar disorder, alcoholism, panic disorder, or post-traumatic stress disorder and anxiety were more likely to experience sleep drunkenness. But about 30 percent of people with the disorder reported taking psychotropic drugs like antidepressants. “The first question to ask is whether ‘sleep drunkenness’ is a symptom of a more serious underlying disorder,” says Gary Kaplan, DO, author of Total Recovery: Breaking the Cycle of Chronic Pain and Depression. “The condition is highly associated with mental health disorders and sleep disorders, all of which are symptoms of an inflammatory condition in the brain.”

Dr. Kaplan says physicians (inappropriately) are oriented to treat these conditions as diseases and not look for an underlying cause. “In the case of sleep apnea, also highly associated with ‘sleep drunkenness,’ inadequately treated sleep apnea causes the brain to be deprived of oxygen and results in the death of brain cells and chronic inflammation in the brain. Properly treating the sleep apnea should resolve the problem.” (A recent study even linked depression to a higher risk of Alzheimer’s disease.)

He says he’s concerned that physicians are too quick to treat the symptom and don’t take the time to properly identify the underlying cause. “The majority of people who suffer with this condition were taking antidepressants; there is a wide range of conditions for which antidepressants are prescribed, including for the treatment of sleep disorders, migraines, and other chronic pain conditions, as well as mental health issues,” he says. “I have listened to many patients who take these medications frequently complain of ‘feeling hung over in the morning,’ completely consistent with the finding in this study.”

For instance, Dr. Kaplan says one of his patients had depression and sleep disturbances consistent with sleep drunkenness, but he really had undiagnosed Lyme disease. “Treatment of the Lyme resulted in complete resolution of symptoms,” he says.

In another case, Dr. Kaplan saw a teenager with a severe depressive disorder who was taking multiple antidepressants and complaining of being “hung over” on the medication. It turned out he had undiagnosed celiac disease. “Off gluten, the depression resolved and his sleep returned to normal,” Dr. Kaplan explains. “It took around a year for him to get to fully recover because it takes time for the brain to heal.

“I treat depression and all sleep disturbances as a symptom of underlying inflammation in the brain,” Dr. Kaplan says. “You need to take a detailed history and do the appropriate testing to determine exactly what is the cause and more frequently are the causes of the symptom, in this case, depression.”

Dr. Kaplan’s 3 Tips to Ease Inflammation in the Brain:

  1. Eat a hypoallergenic diet: rice, fish, chicken, fresh fruits, and vegetables. This eliminates all milk and milk products, gluten, soy, and refined sugars. (Learn more about elimination dieting.) There may be other foods such as corn that you may be sensitive to, and you will have to pay attention to how you feel after eating. Stay on this diet for one month and see what’s changed. Remember that while 1 percent of the population has celiac disease, around 6 percent of people are gluten intolerant. There are plenty of other foods that could be causing inflammation in your body and brain, so you need to eat mindfully. (Be sure to avoid mood-wrecking foods!)
  2. Meditate 20 minutes a day. Meditation reduces inflammation in the brain and promotes the growth of new nerve tissue.
  3. Get moving. Regular aerobic exercise reduces inflammation in the brain and promotes brain healing.

“Are too many people taking antidepressants? Yes. We are too quick to treat symptoms and not look for the underlying cause,” Dr. Kaplan adds. “One of my first-line approaches to help people improve their sleep without medication is acupuncture and, if appropriate, herbs.”

Read this article on www.RodaleNews.com.

Dr. Gary Kaplan Interviewed by Time.com

Depression Is a Risk Factor for Dementia, New Research Says

by Alexandra Sifferlin, www.Time.com, July 30, 2014
The two have been linked before, but the new study says depression may be an independent risk factor for the disease

The link between depression and dementia is puzzling for researchers. Many studies have noticed a correlation between the two diseases and a 2013 review of 23 studies of about 50,000 older men and women reported that older adults suffering from depression were more than twice as likely to develop dementia and 65% more likely to develop Alzheimer’s. But these have often only been associations. The newest study, published Wednesday in the journal Neurology, takes it further. The researchers believe that their findings, while not definitive, show that depression is in fact an independent risk factor for dementia — and not the other way around.

To read the article in its entirety you can view on www.Time.com.

Dr. Gary Kaplan Interviewed by RodaleNews.com

New Potential for Alzheimer’s Prevention, Finds Breakthrough Study

by Julia Merz, www.RodaleNews.com, July 30, 2014

The connection between Alzheimer’s and depression has been known for years. The big mystery, though, is exactly how (and if) one affects the other. “Is the depression a consequence of the dementia? Do both problems develop from the same underlying problems in the brain? Or does the relationship of depression with dementia have nothing to do with dementia-related pathology?” asks Robert S. Wilson, PhD, neuropsychologist at Rush University Medical Center in Chicago.

But Wilson and his team have made a discovery that links depression as a major risk factor for Alzheimer’s. They’ve found that higher levels of depression accounted for 4.4 percent of the difference in decline that could not be attributed to damage caused by Alzheimer’s disease. Plus, the more depressed individuals had more rapid decline in thinking and memory skills.

“These findings are exciting because they suggest depression truly is a risk factor for dementia, and if we can target and prevent or treat depression and causes of stress, we may have the potential to help people maintain their thinking and memory abilities into old age,” Wilson says.

To understand the connection it’s important to understand that depression isn’t a disease—it’s a symptom of inflammation, explains Gary Kaplan, DO, pain specialist and author of Total Recovery: Solving the Mystery of Chronic Pain and Depression.

“We also know without question that Alzheimer’s is related to neuroinflammatory processes, and for years we’ve been trying to figure out this chicken-egg question,” he says. “The fact is, according to this breakthrough study, long-term neuroinflammation [like depression] can set you up for other neuroinflammatory diseases, [like Alzheimer’s].”

To read this article in its entirety visit www.RodaleNews.com.

Dr. Gary Kaplan Featured on WomensHealthMag.com

The Mystery of Chronic Pain, Solved

Unrelenting agony with no clear cause has long baffled doctors. According to the new book Total Recovery, a fixable glitch in your brain could be to blame.
Lindsay Burkett, 23, had the job of her dreams: working on Capitol Hill as a congressional aide. Grueling 12- to 15-hour days were the norm, but she thrived in high-pressure environments. When she accepted the job, Lindsay knew the migraines that had started when she was 16 were likely to come with her. But now, the debilitating headaches lasted a week at a time—and were accompanied by panic attacks that caused chest tightness, a racing pulse, back and neck pain, and a general mental fog. She fell into bed at night on the brink of exhaustion, sobbing and flushed with anxiety.
Finding no physical cause for her issues, Lindsay’s doctor sent her to a psychiatrist, who prescribed antidepressants that did little to ease her symptoms. She suffered for three years, until one day, her mother sent her an article that showed a possible link between anxiety disorders and migraines and a surprising cause: gluten intolerance. Could her panic attacks be caused not by nerves, but by the sandwiches she ate for lunch? The article was from the Kaplan Center for Integrative Medicine in McLean, Virginia. Lindsay made an appointment with the center’s director, Gary Kaplan, D.O., an osteopathic physician, immediately.
Connecting the Dots
For years, Kaplan had noticed that patients were coming in with multiple physical and emotional symptoms (not just a migraine or depression, for instance, but both). He suspected there was a common denominator. “One night I read a study suggesting that some forms of physical and emotional pain were caused by neuroinflammation—inflammation in the brain,” says Kaplan. “I wondered whether they were opposite sides of the same coin.”
Inflammation can actually be a good thing: When you catch a virus or scrape your knee, your immune system floods the injured area with white blood cells to help wipe out infection. When the threat has abated, your immune system calls back the troops. But within the past decade, researchers have begun to realize that sometimes, the immune response keeps occurring long after the infection is gone. Scientists refer to this as chronic inflammation and have linked it to some heavy-hitting conditions, including heart disease and diabetes.
Kaplan hypothesizes that one form of chronic inflammation, specifically the overactivity of immune cells in the brain called microglia, is at the root of unexplained chronic pain and depression. His theory: When physical injury, psychological trauma, bacterial and viral infections, and environmental toxins stress the central nervous system, microglia respond by secreting chemicals to destroy the invaders. If a person gets bombarded with a series of these physical injuries or emotional blows, microglia can get stuck in the “on” position, continuing to spew out inflammatory chemicals even after the trauma that originally caused them to become active has already healed. The result, Kaplan believes, can cause mysterious chronic pain, depression, anxiety disorders, fibromyalgia, headaches, and post-traumatic stress disorder—alone or in combination with dozens of other problems that can be caused by chronic neuroinflammation.
Calming Down Inflammation
If Kaplan’s theory is right, it could change the way doctors treat unexplained chronic pain and depression. When a patient complains of general fatigue, depression, and pain, doctors typically take X-rays, MRI’s, and blood tests. If they find nothing, they often suspect a psychological cause and refer the patients to a psychiatrist, as Lindsay’s did.
For these patients to recover, Kaplan thinks, we have to address and treat each ongoing assault that has caused the microglia to become switched on in the first place. According to his theory, only when that happens do the bigger symptoms, like chronic pain and depression, disappear. “You have to treat the roots, not the leaves,” says Kaplan.
In Lindsay’s case, a series of tests showed that she was deficient in a number of essential vitamins and minerals. Ironically, this bright, up-and-coming congressional aide in one of the richest countries in the world was suffering from malnutrition. Although she didn’t know it, Lindsay had severe gluten intolerance.
Every time she came in contact with gluten, it created an inflammatory state in the lining of her intestines. No matter what she ate, that inflammation prevented her from absorbing nutrients—and, Kaplan speculates, caused her microglia to switch on.
Kaplan treated the things that were exacerbating Lindsay’s condition, one by one. She eliminated gluten from her diet, and because she was so malnourished, she had biweekly intravenous drips of magnesium and vitamin C. Acupuncture helped reduce inflammation, eliminate her migraines, and quell her anxiety. She took supplements to balance her nutrition and began practicing Pilates and yoga to improve her physical and mental well-being. Within a year, Lindsay’s intestinal health was fully restored—and her panic attacks and migraines stopped.

Stacking Your Deck
No single supplement or pill can prevent microglia from “upregulating,” or staying switched on. Says Kaplan, “the best way to avoid chronic pain of any kind is to fortify yourself against inevitable assaults to your health.” In other words: If microglia aren’t turned on, they shouldn’t get stuck in that position. Here, five ways to take care of yourself.
Live probiotics can help restore gut health, aid digestion, and maintain a proper balance of bacteria in the digestive tract. Take at least 10 to 25 billion CFU’s (colony-forming units). You’ll need to pop a supplement; a serving of yogurt doesn’t provide enough.
Green Tea
This cancer-fighting, metabolism-hiking beverage contains anti-inflammatory compounds that have been shown to lower LDL’s (low-density lipoproteins), also known as bad cholesterol, which is linked to inflammation in the heart.
Dark Chocolate
The kind with 70 percent cocoa contains flavonols with antioxidant and anti-inflammatory properties. In moderate doses (1.5 ounces), it can help boost your mood, and possibly your HDL (high-density lipoprotein, or good cholesterol) levels as well.
Regular Exercise
One more reason to hit the gym: Working out not only gives you more energy but also might help switch microglia in the brain to the off position, though researchers aren’t quite sure how.
Daily Meditation
The calming technique can lower inflammation, which has a positive impact on heart disease, back pain, headaches, hypertension, arthritis, and many other conditions. Aim for 20 minutes a day (or 10 minutes twice a day).
Reprinted from www.womenshealthmag.com.

Wall Street Journal Reviews "Total Recovery"

How Mainstream Medicine Is Stepping Out of the Mainstream

by Laura Landro, www.WSJ.com, June 30, 2014

Total Recovery: Solving the Mystery of Chronic Pain and Depression offers a glimpse into the nontraditional practices that are working their way into mainstream medicine.
Integrative medicine is a hot topic in health care these days, as even the most traditional providers offer alternative and complementary therapies that promise to treat the whole person.
Integrative practitioner Gary Kaplan makes a pitch for the more holistic approach in the treatment of chronic pain and the depression that often accompanies it. He argues that doctors too often focus on symptoms without ever getting to the root cause of a patient’s problems and rarely take time to listen to the patient’s entire history to look for cumulative patterns and evidence of how disease has evolved over time…

Click here to read the article.

Dr. Kaplan Answers Your Chronic Pain Questions

Dr. Gary Kaplan, pain expert and author of ‘Total Recovery,’ answers your fibromyalgia, muscle pain, and endometriosis questions.

Dr. Gary Kaplan, author of Total Recovery: Solving the Mystery of Chronic Pain and Depression, answered questions that Rodale News readers submitted through our Facebook page and by email. We hope this information from Dr. Kaplan gives you insight into the different origins of pain, and how to potentially solve nagging, chronic problems!
Fed Up With Fibromyalgia
Q: I have been diagnosed with fibromyalgia by a neurologist. I also have chronic neck and back pain. Medication for fibromyalgia causes an unsafe increase in my blood pressure, but painkillers that dull the pain are addictive. I do massage and occasional chiropractic plus physical therapy for some relief, but pretty much have resigned myself to living with it.
Are there any new methods of treatment out there that are safe and alternative and don’t cost a small fortune? Any new research on fibromyalgia that is solid and stands a chance of being proven to disprove the doubters who say it is all in the head?
Dr. Kaplan: As a matter of fact, the evidence is that fibromyalgia is “all in your head”-in your brain to be precise. Fibromyalgia is a neurologic disease that I believe is more properly called central sensitization syndrome. Fibromyalgia is a symptom of an inflammatory condition in the brain.
Read More »
Photo courtesy of Rodale News.

Dr. Gary Kaplan Featured in Prevention Magazine

Is Inflammation What’s Causing Your Depression?

by Kate Lowenstein, Prevention Magazine, April 2014

It’s a riddle that vexes even the most lettered researchers – a widespread medical predicament affecting more people than cancer and heart disease combined, and yet there’s no consensus on what’s to blame. One hundred million Americans suffer from chronic pain, and they deal with it day after day with no clear fix. Twenty-one million have depression, and for many of them, medication and therapy help only so much. In this progressive medical age, doctors can transplant people’s faces and manipulate genes, but they still can’t seem to cure-or sometimes even effectively treat-these common conditions. Why? Gary Kaplan, DO, an osteopathic physician who’s been dubbed the Doctor of Last Resorts, thinks he knows…

Visit  www.prevention.com to read on their website.

Dr. Gary Kaplan Explains Central Sensitization Syndrome in The Pain Practitioner

Dr. Gary Kaplan, along with co-author Juliana Heimur, BA, recently contributed to The Pain Practitioner, the quarterly magazine published by the American Academy of Pain Management (AAPM). The article, titled “Microglia and Central Sensitization Syndrome: A New Paradigm for Understanding and Treating Chronic Pain and Depression,” discusses the role of microglia, a type of glial cell present in the central nervous system, as the mediator in the inflammatory process found to be present in central sensitization.

Central Sensitization Syndrom (CSS) is an inflammatory condition that damages the structure and undermines the functioning of the nervous system. It is both “neurodysregulatory” and “neurodegenerative.” Neurodysregulation refers to the extent to which CSS interferes with the healthy functioning of the body’s nervous system, undermining neural activity in the brain, spinal cord and other neural pathways throughout the body. Furthermore, when a person’s nervous system is operating sub-optimally, their hormonal and immune systems are likely to falter, which in turn, can lead to even more complicated health problems. Neurodegeneration refers to the actual injury and destruction of neural tissue in the brain and body. Both conditions (neurodysregulation and neurodegeneration) can cause or exacerbate physical pain, emotional suffering, and erode mental clarity. The mediating factor in this process is the production and release of inflammatory substances in the brain.

At the cellular level, the fundamental mediator of CSS is the microglia. What we are learning about the pathophysiology of CSS enables us to formulate a new paradigm for understanding how a variety of seemingly unrelated illnesses and traumas can result in CSS. In this article Dr. Kaplan discusses the research on the neurobiology of microglia and their role in the occurrence of central sensitization with emphasis on the clinical implications and application of this research.

Please click here or on the image below to download and read Dr. Kaplan’s featured article.

Dr. Kaplan Appointed to the National Chronic Fatigue Syndrome Advisory Committee

Dr. Kaplan has been appointed by U.S. Secretary of Health and Human Services (HHS), Kathleen Sebelius, to the Chronic Fatigue Syndrome Advisory Committee (CFSAC). The Committee provides advice and recommendations to the Secretary of HHS through the Assistant Secretary for Health on issues related to myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS), such as access and quality of care for persons with CFS, the science and definition of CFS, and broader public health, clinical, research and educational issues related to CFS. Dr. Kaplan is one of four individuals on the 11-person Committee who brings special expertise in healthcare delivery, insurance, and the problems experienced by individuals with CFS.
Chronic Fatigue Syndrome (CFS) (sometimes referred to as “Myalgic Encephalomyelitis” or “ME”) is a debilitating disease characterized by fatigue that interferes with your ability to actively engage in many of life’s activities. It can undermine your capacity to be productive at work, to maintain positive relationships with your family and friends and to enjoy other recreational activities. In addition to a chronic feeling of fatigue, its major symptoms include:
Joint pain
Sleep problems
Persistent muscle pain
Tender lymph nodes
Cognitive difficulties – difficulty with memory and concentration
A sore throat
Increased levels of fatigue and discomfort following exertion
Other symptoms that sometimes are associated with Chronic Fatigue Syndrome include: gastrointestinal problems, psychological issues, sensitivity to lights and sounds, visual difficulties, chills, and dizziness.

More About Chronic Fatigue Syndrome

To learn more about about how the Kaplan Center’s physicians diagnose and care for patients with Chronic Fatigue Syndrome, please click here. Dr. Kaplan has written and lectured extensively on the topic of Central Sensitization Syndrome (CSS), a complex neuro-physiological reaction that can cause chronic fatigue and chronic pain. To watch Dr. Kaplan’s CSS video series, please click here.