3 Types of Days I Have With Ehlers-Danlos Syndrome

Living with a chronic illness is hard to explain to the outside world. I have hypermobile Ehlers-Danlos syndrome (hEDS). I find I have three kinds of days.

Side view of sick woman having coffee on sofa in living room

My favorite days are simple: no dislocations, no subluxations, mind engaged and body somewhat agreeable. No day is 100 percent pain free. No day starts with me jumping out of bed happy to greet the sun, but some days fortunately come after a decent night’s sleep and a dose of meds – these are what I’d call my “normal.”

These are my favorite days. They come and go and I enjoy myself, my family, my life and I can deal with the moderate pain and brain fog and exhaustion. Sometimes on these days you’ll see me walking slowly, using a cane or even a wheelchair. Or I may appear totally fine. I may be smiling. I will have my hair done and some makeup on and I’ll be happy. No day is ever fully pain-free, but I push through.

My middle days are actually the high pain days. The days my hip decides to dislocate, the day I can’t get out of bed because I’m so tired, and the day my brain feels like mush from the brain fog. Those days I can cope. I take pain medication. Sometimes I sleep and I give in to the pain and the exhaustion, and I just let the world slip by. Sometimes sleep or pain meds are not an option so I go on with life.I may be out and about in a ponytail, jeans and a comfortable shirt. I may not be smiling fully but I’ll tell you I’m fine. I have come to terms with the idea that I am going to have one of these days at least once every two weeks when life catches up to me. As much as I can I get into pajamas, let the dishes sit, let the laundry go, let the kids watch TV and let my husband take over fully. I let go. I get as comfortable as I can in bed, sometimes let the dog lay on me, sometimes not. I use a heat pad or an ice pack. I use my tens unit. I soak in the tub or just melt into pillows. I let my body rest and mostly sleep to help it heal as best it can. These days sound miserable to the outside world and usually these are the days people feel bad for me. Others offer to help and send me well wishes, but these days aren’t as bad as you’d think. On these days my mind is able to stop. I binge Netflix, movies and just don’t think at all.

My worst days will surprise you. They are what I call the in-between days. Today is one of them. I’m tired and have aches. I don’t have severe pain, but I’m not feeling good either. To give you an idea, it’s like day one of the flu. I’m not feeling good, but I’m not feeling so terrible that I can do anything about it. I’ll take my medications and try to sleep, but my brain is still going strong. It feels like nothing helps on days like today. I have errands to run, things to do, but my body won’t let me. It’s as though my brain and my body are no longer connected.

I would love to do some shopping as I need new sneakers and some new summer clothes, but my body won’t tolerate the drive or walking — let alone the shower and getting ready. TV isn’t holding my attention long enough for me to really get into a show or even zone out.

Sleep is out of the question. I slept last night and I can’t seem to force a nap even though my body feels tired. My brain won’t shut down enough for that. I’d love to lay outside in the warm sun and enjoy the weather, but I don’t have anything comfortable enough to sit or lay on, and I don’t feel up to heading somewhere public to lounge.

I don’t have it in me to be social today. I don’t want to text or even pick up my phone. But my brain won’t stop going. I can think of a million things I should be doing, need to do, but I can’t find the energy to even open my email and read messages and respond. My brain says, “Go, go, go,” but my body says, “Yeah right!”

I want to play a game with my kids, but sitting at the table sounds like torture right now with wooden chairs and noises from all around. I’d love to visit a zoo, or even a park, and enjoy this weather. However, I can barely type this, so taking a shower and getting up to go isn’t going to happen.

These days are the worst because they make me sad. They fill me with regret for all I’m not doing and they make me long for the days when I didn’t feel this way.

They are the hardest to explain to anyone outside of my EDS support groups. How do I explain to someone who casually asks, “How are you today?” that I’m not OK – but I’m still here? On days like this, time moves slowly. I find myself wishing I could sleep, but I know it won’t happen.

Days like this make me depressed, but I know I will be better once this day is over.

Days like this make me angry. Angry I have this condition. Angry at a world that doesn’t understand invisible illness.  Angry for no reason at people who are out enjoying a fun day while I struggle. Angry at doctors for not finding a cure or giving me better ways to cope.

But in the end days like this give me hope. I know today is going to suck. But knowing I can get through today means I can deal with the other stuff too. Tomorrow will be better. I’ll have a good day because I’m struggling today. I’ll make it through today and live to see another day with my family and friends.

Days like today give me compassion. Compassion for those who are fighting right along side me. Hope for all of us that someday we’ll find a better way to handle days like today.

Knowing today is my worst means tomorrow won’t be so bad. I’m hanging onto that like a lifeline. Tomorrow I’ll be able to enjoy things again. I’ll be walking and talking, living the way I want to be. That makes today bearable.



Psoriasis vs. Eczema: Differences in Signs and Treatment

Dry and scaly skin woes can be due to a number of skin conditions. Two that can sometimes appear so similar that it’s tough for doctors to tell the difference are psoriasis and eczema. Psoriasis is a condition that occurs when a person’s immune system triggers skin cells to grow faster than they usually should. Instead of the dead skin cells coming off the skin, they build up on the skin. Eczema, which is also known as atopic dermatitis, can be caused by a number of factors. These include environmental factors, bacteria exposure, allergens, and family history. Both conditions can cause red, itchy skin but have different causes and different treatments. As a result, it’s important to understand the differences.

Contents of this article:

  • Similarities and differences in symptoms
  • Treatments for psoriasis
  • Treatment for eczema
  • Can someone have both eczema and psoriasis?

Similarities and differences in symptoms

Both eczema and psoriasis are skin conditions that can keep the skin from appearing smooth and healthy. However, there are several differences that a doctor will use to differentiate eczema from psoriasis or other skin conditions. While there is one eczema type, there are five different types of psoriasis. However, the most common form of psoriasis is plaque psoriasis, which is the form that most clearly resembles eczema.


Psoriasis tends to cause thick, red, and scaly patches. They are usually well-defined. Eczema causes patches that are red or brown-gray in color. However, sometimes the areas may be different and appear as small, raised bumps. They can have a “crust” on them and leak fluid.


Eczema tends to appear in the “bends” of the skin, such as the crooks of elbows and backs of the knee. Psoriasis can also appear on the elbows and knees. However, both may also appear on the face, buttocks, or scalp, most commonly in children.


Itching can be one of the significant differences between eczema and psoriasis. Psoriasis tends to cause mild itching while eczema causes intense itching. If a person does scratch the skin, the results can be swollen, sensitive, and even raw skin. Eczema itching is usually worse at night.

Age of occurrence

Children tend to experience eczema at greater rates than adults. According to the Nemours Foundation, eczema tends to subside at about age 5 or 6. However, some young people may have flare-ups during puberty. According to the National Psoriasis Foundation, psoriasis typically develops between the ages of 15 and 35. Babies rarely have psoriasis. The American Academy of Dermatology estimate that 1 percent of children have psoriasis, while 10 percent of children will have eczema, according to the Nemours Foundation.

Additional symptoms

Psoriasis can sometimes cause joint stiffness as well as swelling. In addition, psoriasis can also affect the nails. Eczema does not typically involve these areas, particularly in regards to joint swelling.

Treatments for psoriasis

Certain factors are known to trigger psoriasis episodes or worsen existing psoriasis. Examples include: Infections Cold weather

  • Excess alcohol consumption
  • Smoking
  • Stress
  • Taking certain medications, such as lithium and high blood pressure medicines

Keeping the skin clean and moisturized while avoiding harsh soaps and very hot water can relieve psoriasis discomfort and reduce any itching. Mild-to-moderate psoriasis treatments can include applying corticosteroids. These medications are available over the counter. They work by reducing inflammation and itching. In addition, they stop skin cells from growing too quickly. Applying moisturizing creams is also helpful because it can lessen itching, dryness, and scratching. While it won’t necessarily heal psoriasis, it can reduce the symptoms.

Moderate-to-severe psoriasis can be treated with stronger medications available by prescription. These include:

  • Anthralin: This medication promotes normal DNA activity in the skin, which can reduce the incidence of psoriasis. However, the cream can be highly irritating and staining to areas of skin unaffected by psoriasis.
  • Coal tar: This product can help to reduce inflammation and scaling. The topical product is available both over the counter and by prescription.
  • Salicylic acid: This ingredient is included in medicated shampoos and topical solutions. When applied to the skin, it can reduce psoriasis’ scaly appearance and encourages new skin cells to replace old ones.
  • Synthetic Vitamin D creams and solutions: Prescription Vitamin D creams include calcipotriene or calcitriol.
  • Topical retinoids: Retinoids are a form of vitamin A that encourage new skin cells to replace old ones. However, topical forms can be irritating to the skin and make it especially sensitive to the sun.

Like eczema, psoriasis can be treated with light therapy, which is also known as phototherapy. This treatment involves controlled exposure to ultraviolet light, which slows down skin cell turnover and reduces inflammation. If topical treatments don’t work to reduce the incidence of psoriasis, medications are available by injection. These include retinoids, methotrexate, cyclosporine, and immune-modulating drugs such as etanercept.

Treatment for eczema

No cure exists for eczema, and the condition can be long-lasting. Eczema tends to affect children in greater numbers. Children may “grow out of it” and not experience the condition as they age. A person may also go for quite some time without symptoms, then experience a flare-up.

Steps a person can take to treat eczema include:

  • Avoiding harsh soaps and highly fragranced products
  • Refraining from taking very long, hot baths or showers
  • Avoiding tobacco smoke
  • Applying topical corticosteroid creams to itchy areas
  • Applying an antihistamine cream or taking an antihistamine, such as diphenhydramine
  • Applying cool, wet compresses to the skin to avoid scratching
  • Using light therapy in a controlled manner to avoid the side effects of excess sun exposure, such as skin cancer
  • Taking steps to reduce stress by practicing relaxation techniques such as meditation, yoga, or Tai chi
  • Avoiding extremely hot temperatures as sweat can worsen symptoms

Keeping the skin clean, moisturized, and dry can help to reduce eczema symptoms. Because allergies can trigger eczema, avoiding substances a person knows they’re allergic to can help. Examples of these substances include foods such as eggs, milk, peanuts, soybeans, fish, and wheat. Exposure to dust from furnishings can also contribute to eczema. Placing dust-protective covers over pillows and mattresses and frequent cleanings of dust-attracting items may also help. If a person’s eczema is severe and doesn’t respond to at-home treatments, a doctor can prescribe creams to reduce eczema occurrence and symptoms. These medicines are known as calcineurin inhibitors. Examples include tacrolimus and pimecrolimus. These two drugs should be used with caution as they carry a warning about a possible risk of cancer. Excessive itching may result in open wounds that can become infected. When this is the case, a person may need to apply a prescription topical antibiotic cream or take an antibiotic. Caregivers can also give their child soft gloves to wear in bed to keep them from scratching while sleeping.

Can someone have both eczema and psoriasis?

While it’s rare that a person will have both eczema and psoriasis, it is possible. A study published in the journal Science Translational Medicine studied patients who had both eczema and psoriasis. The researchers found that people have different genes present in the skin tissue of each condition type that could help doctors more definitively diagnose each condition. While there are differences between the conditions, they can present as similar to the other. This makes it difficult for doctors to diagnose the condition and recommend or prescribe the appropriate treatments. As some treatments can be very expensive, it’s important that the most targeted treatment is prescribed. If a person has both skin conditions, they may have to apply different treatments to each. Skin conditions that cause similar symptoms Eczema and psoriasis are not the only skin conditions that can resemble the other.

Examples of other skin conditions that cause similar symptoms include:

  • Athlete’s foot
  • Contact dermatitis
  • Rosacea Seborrheic dermatitis, also known as “cradle cap”
  • Shingles, a viral infection caused by the same virus that results in chickenpox
  • Urticaria, also known as hives

When a person has a skin condition of an unknown cause, they should see their physician to try and find out more about the condition’s potential cause.



5-Ingredient Easy Strawberry Tart (Paleo,Keto, Low Carb)

Easy Strawberry Tart (Paleo, Low Carb) - This easy strawberry tart recipe has only 5 ingredients! Made with fresh strawberries, it's also paleo, sugar-free, gluten-free, and low carb.

This easy strawberry tart recipe has only 5 ingredients! Made with fresh strawberries, it’s also paleo, sugar-free, gluten-free, and low carb.

Like I promised last week, today I bring you another strawberry recipe. It’s an easy strawberry tart, made with just 5 inredients!

My strawberry kick started with last week’s strawberry spinach salad with poppy seed dressing, which turned out to be a huge hit. I loved it, my husband loved it, even my one year old daughter loved it! It’s pretty much the best feeling ever when I see Isabella eating home cooked meals that I prepared, even better when it’s a salad. That has to be my Russian genes kicking in, telling me to be happy when my child eats something healthy. Ha. Nothing wrong with that as long as I’m not forcing her, right?

Easy Strawberry Tart (Paleo, Low Carb) - This easy strawberry tart recipe has only 5 ingredients! Made with fresh strawberries, it's also paleo, sugar-free, gluten-free, and low carb.

I very rarely give my daughter sweets, even sugar-free sweets, because I want to encourage her to eat fresh and real food. But occasionally there are exceptions. This sugar-free easy strawberry tart turned out to be one of those.

Five-ingredient recipes always make me smile. Even better when they are healthy like this one. It’s paleo, sugar-free, gluten-free, low carb, and even vegan. The only carbs come from the strawberries. It does need to be refrigerated to firm up, but otherwise it comes together in no time at all – just a few minutes of prep and 15 minutes in the oven. The sweetness comes from fresh strawberries and natural erythritol. No preservatives, no dairy, no gluten, and no sugar.

Easy Strawberry Tart (Paleo, Low Carb) - This easy strawberry tart recipe has only 5 ingredients! Made with fresh strawberries, it's also paleo, sugar-free, gluten-free, and low carb.

What else is great about this easy strawberry tart? It makes the perfect easy dessert for get-togethers. My husband and I recently reconnected with his cousin and her husband, and we had the best time a couple weekends ago when I brought this over to their house. I’m pretty sure that the next time I eat this tart, I will be reminded of sitting out on the patio with them, drinking cognac, and talking late into the night.

Whether you make this low carb strawberry tart for a late night gathering or a daytime brunch, I hope it locks in some special memories for you. Hello, Mother’s Day

This easy strawberry tart recipe has only 5 ingredients! Made with fresh strawberries, it’s also paleo, sugar-free, gluten-free, and low carb.
slices 15 minutes 15 minutes
  • 3 lb Strawberries (2 1/2 lb halved and 1/2 lb sliced)
  • 1/2 cup Erythritol (or any granular sweetener of choice)
  • 1/2 tsp Xanthan gum *optional, can omit for paleo
  1. Preheat the oven to 350 degrees F. Line the bottom of a 9″ springform cake pan with parchment paper. (If you don’t have one, you can use a regular cake pan, but grease it well.
  2. To make the crust, stir the almond flour and erythritol together in a large bowl. Stir together the melted coconut oil and vanilla extract, then stir into the almond flour mixture to make a very crumbly dough.
  3. Press the dough into the bottom of the lined pan, and about an inch up the sides. Bake for about 13-17 minutes, until set and golden on the edges.
  4. Let the crust cool for at least 15 minutes.
  5. Meanwhile, make the filling. Combine the halved strawberries (2 1/2 pounds) and all of the erythritol from the Filling section in a saucepan. Bring to a gentle boil, then simmer over medium heat for about 10 minutes, stirring occasionally, until the strawberries are very soft and somewhat mushy (they will release a lot of liquid).
  6. Drain the extra liquid through a fine mesh sieve, pressing down on the strawberries to drain as much as possible. You should get well over a cup of liquid out. (If you want to reserve the liquid for another use, do this over a bowl.)
  7. Puree the filling (without extra liquid) in a blender or food processor. Taste and add additional erythritol if more sweetness is needed. (The amount will vary because some of the original sweetener will have drained when draining the liquid, and also depends on how sweet your strawberries are. I added 1/3 cup additional erythritol at this point.)
  8. If using xanthan gum, sprinkle it on top of the filling and quickly puree again. Let sit for a couple of minutes to thicken.
  9. Pour the filling mixture into the crust. Arrange the remaining sliced strawberries (1/2 pound) in a single layer on top. Cool completely, then refrigerate for at least an hour, until set, before slicing.
Nutrition Facts
Amount Per Serving
Calories 171Calories from Fat 126
% Daily Value*
Total Fat 14g22%
Total Carbohydrates 10g3%
Dietary Fiber 4g16%
Sugars 5g
Protein 4g8%
Vitamin C84%
* Percent Daily Values are based on a 2000 calorie diet.

Net carbs per serving: 6g

*Xanthan gum will make the filling more firm. You don’t have to use it – I didn’t for my pictures and you can see the filling spills a little bit, but it still tastes great!



Low Carb Keto Tortillas With Coconut Flour (3 Ingredients) Only 2g Net Carb

Low Carb Paleo Tortillas with Coconut Flour (3 Ingredients) - This easy, paleo, low carb tortillas recipe with coconut flour requires just 3 ingredients! These gluten-free wraps are also healthy, keto & vegetarian.


This easy, paleo, low carb tortillas recipe with coconut flour requires just 3 ingredients! These gluten-free wraps are also healthy, keto & vegetarian

I’ve been wanting to experiment with paleo tortillas and low carb tortillas for quite some time, ideally checking both boxes. I love salads and leftovers for lunch, but sometimes I miss the convenience of having a sandwich or wrap.

I had always assumed that paleo wraps would have to be either fragile, relatively high in carbs, or just complicated to make. None of these options sounded great. I figured that I was bound to come up with a better alternative, though I did expect to go through half a dozen trials before getting it right. I took the idea of coconut flour tortillas and ran with it.

Low Carb Paleo Tortillas with Coconut Flour (3 Ingredients) - This easy, paleo, low carb tortillas recipe with coconut flour requires just 3 ingredients! These gluten-free wraps are also healthy, keto & vegetarian.

The other day an idea struck me to combine coconut flour and eggs, thin out the batter with almond milk, and try frying up some low carb tortillas with the resulting batter. To be honest, I didn’t expect my idea to work. I mean, it’s only three ingredients, and palatable bread replacements tend to be a struggle.

Certainly my first attempt would probably fall apart or taste dry, and I would have to add additional ingredients to compensate. I was wrong. The result was amazing, if I do say so myself. I truly couldn’t believe how well these paleo tortillas turned out.

I’m so happy with how sturdy these low carb tortillas are. You can fold them or roll them up, and they won’t rip or fall apart, so they are perfect for wraps of of all kinds. They store well in the fridge, so I make a batch of them almost every Sunday now and use them up for lunch throughout the week.

I added a bit of sea salt to the batter for flavor, but that part is optional. You could also customize them with your own herbs and seasonings to your liking. I think Italian seasoning would make a wonderful addition if you’re going for savory.

Tips & Tricks: How To Make Low Carb Paleo Tortillas

Based on feedback from readers, I thought it would be useful to include some tricks for making these coconut flour tortillas. Although they only have three simple ingredients, getting the ratios to work together correctly does require adjustments sometimes. Without gluten to bind them together, paleo tortillas and low carb tortillas do require a little practice, but it’s well worth it.

The most important thing to watch for is the right consistency of the coconut flour batter prior to frying. It should be liquid and easy to pour, but not as thin as water. Don’t forget to let the batter sit for a couple of minutes after mixing, to account for the thickening process that is natural for coconut flour. Only then can you judge the consistency. One aspect to keep in mind is that different brands of coconut flour vary, so that will affect the exact amounts needed when adding the other ingredients. (I love this one!)

The batter should be runny for the low carb tortillas to turn out. If the batter is too thick, add additional eggs and almond milk in equal proportions to thin out the batter. Equal proportions are critical here. The tortillas will taste too egg-y if you add only eggs, but they won’t hold together if you add only milk. If it’s too thick overall, you’ll end up with pancakes or even something resembling scrambled eggs. As long as you thin it out properly, you won’t have any problems.

The second part of the recipe is the frying process, and I have some pointers here as well.  Stove temperatures vary, so you may need to adjust yours accordingly.  I have a gas stove that gets quite hot, so medium or even medium-low heat works well. However, if you have an electric stove, or if you don’t see the tortillas darkening on the side touching the pan after 60-90 seconds, you may need to increase the temperature.

They should develop darker spots as shown in the pictures. If you are seeing only a light golden color, like a pancake, you need to increase the temperature and try again with the next one. Finally, don’t forget to re-oil the pan with each new tortilla, and even then, a non-stick pan works best. I like to use a ceramic coated pan to avoid Teflon, but either one will work.

Hopefully these suggestions are helpful. I’d love to hear how you’re using these low carb & paleo tortillas. Let me know in the comments below!

This easy, paleo, low carb tortillas recipe with coconut flour requires just 3 ingredients! These gluten-free wraps are also healthy, keto & vegetarian.
tortillas 5 minutes 10 minutes
  1. In a large bowl, whisk all ingredients together until smooth. Let the batter sit for a minute or two to account for the natural thickening caused by coconut flour. The batter should be very runny right before cooking – it should pour easily (add more almond milk and eggs in equal proportions if needed to achieve this).
  2. Heat a small skillet over medium heat and grease lightly (use oil of choice or an oil mister). Pour 1/4 cup of batter onto the skillet and immediately tilt in different directions to evenly distribute. Cook, covered, until the edges are golden and curl inward when you lift the lid (about 2 minutes). Flip over, cover again, and cook until browned on the other side (2 more minutes). Repeat until the batter is used up.
Nutrition Facts
Amount Per Serving
Calories 63Calories from Fat 36
% Daily Value*
Total Fat 4g6%
Total Carbohydrates 6g2%
Dietary Fiber 4g16%
Sugars 2g
Protein 5g10%
Vitamin A4%
* Percent Daily Values are based on a 2000 calorie diet.

Net carbs per tortilla: 2g

*Please see additional preparation tips in the post above.



Nutritional Influences on Oppositional Defiant Disorder

The aggressive behavioral syndrome is marked by restlessness, irritability, impulsivity and a proneness to violence. Diagnostically, it overlaps the DSM III-R diagnoses of Attention-deficit Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder and Antisocial Personality Disorder. When the syndrome is attributed to organic factors, it would frequently be classified as an Organic Personality Syndrome.1 Constitutional factors, including genetics and the effects of disease and physical trauma, are known to play a major role in determining proneness to overaggressive behaviors. The importance of psychological factors is also well known. By contrast, the contribution of nutritional factors to such behaviors is often unrecognized, and therefore not properly addressed.

Nutritional factors are neglected for a number of reasons. Much of the literature on nutritional treatments has yet to evolve beyond the early stages of scientific investigation. Physicians learn so little about nutritional medicine during their training that they feel too uninformed to include it in their practices. Sub-optimal nutrition is generally believed to be rare in industrialized societies – even though up to 50% of the population may fail to ingest the Recommended Dietary Allowance for one or more vitamins or minerals.2 In regard to behavioral syndromes, nutritional factors are neglected, in part, because marginal nutritional deficiencies are not believed to affect behavior despite growing evidence to suggest that that belief may be false. (For example, subtle neuropsychological impairment has been documented by EEG recordings of older subjects in association with any of a number of marginal nutritional deficiencies. 3 Literature Review

1. Vitamins
Deficiencies of several vitamins are known to be associated with irritability. These include niacin,4 pantothenic acid,5 thiamine,6 vitamin B67 and vitamin C.8 In industrialized societies, the classic vitamin deficiency diseases are rare, although marginal vitamin nutriture due either to inadequate intake or to vitamin dependency appears to be fairly common. Moreover, under laboratory conditions, adverse behavioral changes precede specific clinical findings in a number of vitamin deficiencies.9

It is not known how frequently overaggressive behaviors are a manifestation of marginal vitamin nutriture. While little has been published to prove a relationship between the aggressive behavioral syndrome in humans and marginal vitamin nutriture, Lonsdale and Shamberger, writing in The American Journal of Clinical Nutrition, reported on twenty people eating “junk food” diets who were found to have biochemical evidence of marginal thiamine deficiency. Their subjects, and particularly the adolescents, were impulsive, highly irritable, aggressive and sensitive to criticism.

Following thiamine supplementation, their behavior improved concurrent with laboratory evidence of improved thiamine nutriture, suggesting that marginal thiamine deficiency may have contributed to their aggressive behavioral syndrome.6 Hopefully, well-controlled studies will eventually provide a clearer picture of the importance of marginal vitamin deficiencies in promoting overaggressive behaviors.

2. Minerals
Note: for the sake of completeness, minerals which do not function as nutrients are included in this review.

The most common nutritional deficiency in industrialized societies, 10% of American males and 3% of American females are overtly iron-deficient (ferritin less than 10 mg/mL.10 A deficiency of iron is known to interfere with proper brain function. Dopamine is a major neurotransmitter in the brain, iron is highly concentrated in the dopamine pathways, and animal studies have shown that iron deficiency may cause learning deficits and consequent behavioral impairment by diminishing dopamine neurotransmission.11 Iron is also needed as a co-factor for the enzymes which metabolize not only dopamine, but also serotonin and norepinephrine, which also have a potent influence on behavior.

Evidence is now emerging that iron deficiency may be an important contributor to the aggressive behavioral syndrome. Among adolescent males, iron deficiency has been shown to be directly associated with aggressive behavior (Conduct Disorder).12 Moreover, in a population of incarcerated adolescents, the prevalence of iron deficiency was nearly twice that found in their non-incarcerated peers.13

There is considerable evidence that pharmacologic doses of lithium, which has no known essential function, can reduce abnormal aggressive behaviors including self-mutilation.14 Lithium has been used successfully with treatment-resistant hospitalized children with diagnoses of Conduct Disorder, Aggressive Type,15 as well as with brain-injured16 and mentally retarded17 patients with aggressive, combative or self-destructive behavior. While often effective, lithium at pharmacologic doses (generally 900,000 micrograms or more daily) has serious limitations. It suffers from many potential side effects, some of which are common. Because it becomes toxic at a serum level which is not much higher than the therapeutic range, serum lithium levels must be tested periodically. For these reasons, patients must be under medical supervision so long as they are taking the drug. It is possible that lithium may exert a powerful effect on overaggressive behaviors at far lower levels of intake. Using data from 27 Texas counties, Schrauzer and Shrestha found that the incidences of suicide, homicide and rape were significantly higher in counties whose drinking water supplies contained little or no lithium than in counties with higher water lithium levels, even after correcting for population density. Corresponding associations with the incidences of robbery, burglary and theft were also significant, as were associations with the incidences of arrests for possession of opium, cocaine and their derivatives. Only the incidences of arrests for possession of marijuana, driving under the influence of alcohol, and drunkenness failed to correlate with the water lithium level.18

While the effect of low-dose lithium supplementation on overaggressive behaviors has not been reported, results of an uncontrolled study suggest that low-dose lithium derived from vegetable concentrates may have a powerful effect on mental state and behavior. Thirteen depressed patients with bipolar disorder were treated with natural lithium derived from vegetable concentrates. All improved in about ten days and there were no adverse effects. After six weeks, they were taken off of lithium and all regressed to their former depressed state within three days. Two days after lithium was resupplied, their depressions lifted again.19

If we assume that a person consumes about one liter of water daily from municipal supplies, it is striking that the level of lithium provided from the vegetable concentrates approximates that consumed by residents of the Texas counties with higher lithium levels: “Natural” lithium dosage – 150 micrograms daily; Lithium level of drinking water in the Texas counties with higher levels18 – 70-170 micrograms per liter.

Rodent studies suggest that magnesium has a complex relationship with aggressive behaviors. Magnesium deficiency reduces offensive aggressive behavior but increases defensive aggressive behavior.20 Lower levels of magnesium supplementation increase the number of attacks on intruders while higher levels have the opposite effect.21

In humans, magnesium deficiency, which enhances catecholamine secretion and sensitivity to stress, may promote aggressive behavior. Increased catecholamines, in turn, induce intracellular magnesium losses and, eventually, increased urinary losses of magnesium.22 It has been suggested that the Type A behavior pattern – which is associated with chronic stress and aggressive behavior – may both cause and be caused by magnesium deficiency.22 Also, suicide attempts, which are violently aggressive acts against the self, have been correlated with lowered magnesium levels in the cerebrospinal fluid.23

Manganese is an essential trace mineral. Massive overexposure produces “manganese madness” which may initially be marked by violence, criminal acts and a state of mental excitement; later, neurological impairment slowly develops, with signs and symptoms which resemble Parkinson’s disease.

The behavioral effects of marginal levels of manganese toxicity have not been described. Recently, Gottschalk and his associates consistently found elevated hair manganese in a population of violent male offenders, suggesting that marginal manganese toxicity may be associated with violent criminal behavior. Compared to the hair manganese levels which they found, people exposed to levels of manganese pollution which are known to be toxic possess hair values that are two to six times higher.24

Elevated hair manganese levels have also been reported in hyperkinetic children,25, 26 and men with a history of childhood hyperactivity have an increased rate of antisocial and drug use disorders.27 In rats, chronic manganese exposure initially produces hyperactivity with an increased tendency to fight.28 While any hypothesis concerning the behavioral effects of marginal manganese toxicity in humans is highly speculative, these findings suggest that marginal manganese toxicity may promote overaggressive behaviors in adults.

Heavy Metals
Brain damage due to toxic metal exposure may promote aggressive, antisocial and violent behaviors. Lead exposure is known to cause learning and behavioral problems, problems which are found in a substantial portion of juvenile delinquents.

The strongest evidence to date that lead exposure increases the frequency of aggressive behaviors comes from the Edinburgh Lead Study which included over 500 children between the ages of 6 and 9. After taking 30 possible confounding variables into account, the investigators still found a significant relationship between the log of blood lead levels and teachers’ ratings of the childrens’ behavior on an “aggressive/antisocial” scale and on a “hyperactive” scale, but not on a “neurotic” scale. As in other studies on the relationship between lead exposure and brain damage, a dose-response relationship was found between blood lead and behavior ratings, with no evidence of a threshold.29

Pihl and associates have addressed the relationship of lead exposure and violent behavior in adults. Hair lead levels from 19 violent criminals were found to be elevated as compared with those of 10 nonviolent criminals.30 This study was repeated 8 years later by the same research team with essentially the same results. However, their results were contradicted by those of the recent Gottschalk study on hair manganese levels; in that study, no significant differences were found between hair lead levels of 104 violent criminals, prison guards and local townspeople.24

As with lead, studies comparing hair cadmium levels of violent male offenders to matched controls have had conflicting results. One study published in the Journal of Learning Disabilities looked at hair cadmium levels of 40 apparently normal young men entering US Navy recruit training and found a highly significant relationship between hair cadmium levels and the number of demerits each recruit had received. Moreover, the three recruits who had the highest cadmium levels all displayed serious behavior difficulties during training.31 Exposure to aluminum may also contribute to overaggressive behaviors. Hair aluminum levels of a group of 22 juvenile offenders,32 as well as of another group of 10 severely delinquent, psychotic or prepsychotic adolescent boys,33 were elevated. However, both studies compared aluminum levels to laboratory norms rather than to matched controls; thus other differences between the groups could account for the findings.

3. Amino Acids
Serotonin, a major neurotransmitter, has been found to play an important role in modulating aggressive behavior. Impulsive, violent and suicidal behaviors have repeatedly been shown to be associated with a reduction in serotonergic activity in the central nervous system.34

Tryptophan, an essential amino acid, is the dietary precursor to serotonin, and several lines of evidence have suggested that the amount of tryptophan in the diet relates closely to aggressive behavior. For example, rats given a diet almost lacking in tryptophan develop aggressive behavior towards mice.35

Tryptophan must compete with other large neutral amino acids to cross the blood-brain barrier; therefore the ratio of the amount of tryptophan to the amount of competing amino acids (the tryptophan ratio) may provide a rough indication of the availability of tryptophan in the brain for conversion into serotonin. Kitahara has calculated the dietary tryptophan ratio for 18 European countries to attempt to relate it to homicide rates. While initially no correlation was found between low tryptophan ratios and homicide, once social and cultural differences were controlled for, low tryptophan ratios were found to be associated with high homicide rates.36 A more direct method of examining the relationship between the tryptophan ratio and aggression is by measuring the actual ratio in the blood plasma. When a group of depressed alcoholics was evaluated in this manner, those with a history of aggression, including suicide attempts, also had the lowest tryptophan ratios.37 If a low ratio of tryptophan to competing amino acids is associated with aggressive behavior, will tryptophan supplementation reduce that behavior? Dietary tryptophan was manipulated in social groups of vervet monkeys by providing them with amino acid mixtures that were tryptophan-free, nutritionally balanced, or excessively high in tryptophan. These mixtures were shown to have a marked effect on plasma tryptophan levels. During spontaneous activity, the only effect of the different mixtures was increased aggression in the males on the tryptophan-free mixture. During competition for food, however, while the tryptophan-free mixture continued to increase male aggression, the high-tryptophan mixture reduced aggression in both males and females.38 These data suggest that tryptophan supplementation may be most effective in reducing aggression during times of stress.

When hospitalized male schizophrenics were given tryptophan, only those patients with high levels of hostility and a high lifetime frequency of aggressive incidents benefited; these patients showed a lessening of hostility and depression, a reduction in ward incidents and improvement on a standardized psychiatric rating scale.39 In another study of twenty aggressive patients, 6 g of tryptophan daily for one month failed to reduce the number of violent incidents, although it significantly reduced the need for potent medications to control violent or agitated behavior.40

The rate of firing of serotonergic neurons in the brain increases as the level of behavioral arousal increases; thus increased serotonin levels would be more likely to influence brain function at higher levels of arousal. Indeed, this fact probably explains why the vervet monkeys only responded to tryptophan supplementation when they were put under competitive stress. It also may explain why altered tryptophan levels failed to affect aggression in a study of normal human males, while overaroused, hostile and aggressive psychiatric patients responded well.

In the conversion of tryptophan to serotonin, the intermediate step is its conversion to 5-hydroxytryptophan. Surprisingly, supplementation with 5-hydroxytryptophan may increase aggressive behavior, apparently because, while tryptophan appears to enhance the serotonergic system exclusively, 5-hydroxytryptophan also appears to enhance the catecholaminergic system.41

4. Reactive Hypoglycemia
There is early evidence that hypoglycemia during glucose tolerance testing is related to hostile, aggressive behavior such as that seen in habitually violent and impulsive criminals.34 Virkkunin, for example, found that a group of habitually violent adult criminals had lower basal glucose levels during glucose tolerance testing than controls.42 Even in the normal population, there is evidence of a relationship between hypoglycemic tendencies and both frustration and hostility.43

Assuming that there is an association between hypoglycemia and the aggressive behavioral syndrome, the question of whether hypoglycemia causes the syndrome remains. One method of investigating the issue of causality is by changing the amount of sugar in the diet and examining the behavioral effects. Since dietary sugar provokes insulin production which may cause a reactive hypoglycemia, a change in behavior following a change in sugar intake would be consistent with the hypothesis that dietary sugar influences that behavior. In a series of increasingly sophisticated double-blind studies, Schoenthaler addressed this question by reducing the sugar intake of thousands of incarcerated juvenile offenders in different locations around the United States. Compared to offenders on a placebo diet, he found a significant reduction in various forms of antisocial behavior (such as assaultiveness, fighting, self-injury and suicide attempts) in offenders restricted to a minimal amount of sugar in their diet – but only for the males.44

While Schoenthaler’s work suggests that dietary sugar may influence behavior, he did not examine blood sugar levels; it thus fails to address the role of reactive hypoglycemia in the aggressive behavioral syndrome. The finding that only males responded may either be because males are more likely to engage in aggressive behaviors, or because males are more sensitive to nutritional influences on aggression. (Remember that the lack of tryptophan in the diet only increased aggression during spontaneous play in the male monkeys.) Further studies are needed to address these important questions.

5. Food Sensitivities
It appears that overaggressive behaviors can be provoked by a reaction to common foods. Reactions range from irritability to a psychotic aggressive reaction. Children who improved after food eliminations had previously been irritable, fretful, quarrelsome and could not get along with others. Often they had to be taken out of school as they upset the classes and were considered incorrigible. After food eliminations, however, their personalities dramatically changed, and they became happy and social.45

A study reported in the Lancet suggests that food sensitivities may be quite common among behaviorally- disturbed children. Eighty-one out of a group of 140 children with behavior disorders (almost two-thirds) experienced significant improvement following the elimination of certain foods along with food additives. When they were challenged with the specific foods which had been eliminated, their behavior problems returned. Moreover, 75% of these children reacted to a double-blind challenge with salicylates but not to placebo.46 The following case study, reported in Psychology Today, illustrates how food sensitivities may affect aggressive behavior:

When he was five years and one month old, G.L. was seen because of uncontrollable temper tantrums. He was believed aphasic because of poor speech development, and was too uncomfortable to do initial IQ testing. The EEG showed 14-per-second spikes, large amounts of sharp activity in the motor leads, temporal single, polyphasic sharp waves, and a long run of sharp waves in the right temporal area. Allergy tests revealed strong reactions to milk, chocolate and yeast.

He was placed on a diet free of milk, chocolate, and cola drinks. Seven and one half months later, his EEG was normal. Six months after the repeat EEG, he was learning better and his behavior was much improved. He was challenged again with the suspected foods for one week, during which time his behavior again became uncontrollable.

The EEG now showed two-and-one-half to six-per-second activity on the right, greater in the mid-temporal and parietal leads, accentuated by drowsiness. Light cerebral dysfunction was diagnosed.47

Adults may also display overaggressive behaviors due to food sensitivities. For example, MacKarness has written of a woman who had been hospitalized thirteen times for violent behavior and depression; after common foods were eliminated from her diet, she no longer became violent or depressed. Instead she felt fine and obtained a regular job.48

While the research literature suggests that any commonly ingested food or food additive may be responsible for provoking pathological psychological and behavioral reactions, milk may be a special case. Schauss and Simonsen found that chronic juvenile delinquents consumed much more milk than matched controls without a history of delinquency. The male offenders consumed an average of a gallon of milk daily compared to a little less than a quart a day for the controls, and the females showed similar differences.49

Schauss believes that overconsumption of milk causes antisocial behavior. He has reported that, when several Michigan detention centers reduced their inmates’ milk consumption, the incidence of antisocial behavior declined; when they permitted milk consumption to increase again, antisocial behavior also increased.50

Discussion and Summary
The literature offers numerous clues, but little scientific verification, consistent with the hypothesis that the aggressive behavioral syndrome can be prevented and treated by manipulating nutritional factors. Epidemiological studies have repeatedly found associations between overaggressive behaviors and deficiencies of several essential nutrients: niacin, pantothenic acid, thiamine, vitamin B6, vitamin C, iron, magnesium and tryptophan. While repletion of frank deficiencies is likely to be beneficial, the benefit of correcting marginal deficiencies remains to be proven.

Not an essential nutrient, lithium has been proven effective in reducing overaggressive behaviors when provided at massive pharmacologic dosages. Moreover, even the relatively tiny daily lithium intake from municipal water supplies has been found to be negatively correlated with measures of the aggressive behavioral syndrome. In an open trial, supplementation with such natural levels of lithium appeared to be effective in treating bipolar depression. These findings suggest that natural lithium supplementation may be effective in the management of the aggressive behavioral syndrome, a hypothesis which remains to be explored experimentally.

There is some evidence that overaggressive behaviors may be promoted by the toxic effects of aluminum, cadmium and lead. Exposures to these elements (especially cadmium and lead) should be avoided; it is unknown whether treatments designed to chelate these metals in order to remove them from the brain are effective in reducing overaggressive behaviors.

Reactive hypoglycemia may be more common among people displaying the aggressive behavioral syndrome and, in an open study, reducing sugar consumption was followed by a reduction in antisocial behavior. Whether treating documented reactive hypoglycemia reduces overaggressive behaviors remains unknown. Finally, sensitivities to foods and food additives appear capable of inducing overaggressive behaviors. Most of the evidence remains anecdotal; however, salicylates have been shown to provoke behavioral disturbances under double-blind conditions.

Despite the relative paucity of scientific evidence from controlled studies, clues from case reports, open trials, observational (correlational) studies and animal studies suggest that attention to nutritional factors may reduce overaggressive behaviors and the devastation resulting from them. Those clues, plus the safety of most nutritional interventions, argue that a nutritional approach should be considered in the treatment of the aggressive behavioral syndrome.

1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Washington, D.C., American Psychiatric Association, 1987.
2. Hanes: Health and Nutrition Examination Survey. U.S. Dept. of HEW Publication No. (HRA) 74-1219-1, Rockville, MD, 1974.
3. Tucker DM et al: Nutrition status and brain function in aging. Am. J. Clin. Nutr. 52:93-102, 1990.
4. Gelenberg AJ: Psychiatric Disorders, in DM Paige, Ed. Clinical Nutrition, Second Edition. St. Louis, The C.V. Mosby Company, 1988.
5. Hodges RE et al: J. Clin. Invest. 38:1421, 1959.
6. Lonsdale D, Shamberger R: Red cell transketo-lase as an indicator of nutritional deficiency. Am. J. Clin. Nutr. 33(2):205-11, 1980.


On A Bad Day With Eczema

face covered with cracked surface

Eczema is more than just dry, itchy skin. While common in childhood and infancy, most children grow out of it. Those of us unlucky enough to have eczema as adults face a lifetime of scarring, both physically and emotionally. Most of us were not told as children it would be a lifelong chronic illness (because again, most kids grow out of it). I didn’t find out until I was 28 that I would have it all of my life. Up until that point I still thought it would get better and disappear eventually. I cried when I found that out.

Technically, eczema is a generic term for any type of itchy rash. Those of us with eczema know that description doesn’t do it justice. Our skin also burns, and stings and hurts… a lot.

Eczema is waking up with bloody sheets because you scratched up your legs in your sleep.

Eczema is knowing you are rubbing off a layer of skin while scratching but being unable to stop.

Eczema is not being able to wear black clothing because it gets ashy from skin flakes.

Eczema is not being able to use most soaps, or lotions, or shampoos or even makeup because of how it reacts with your skin.

Eczema is having scars from bad outbreaks.

Eczema is having your clothes stick to your legs or arms because of the weeping, open sores.

Eczema is moisturizing five or six times per day and still being dry and flaky.

Eczema is never being able to take a hot shower or bath because it dries you out even more.

Eczema is knowing you need to shave your legs because it itches, and itching makes it worse, but also knowing shaving will make it worse.

Eczema is needing topical steroids several times a day and praying it doesn’t get bad enough to need oral steroids.

Eczema is having widespread pain across the surface of your skin so bad that you fantasize about dipping your hands in a vat of acid because maybe that will hurt less.

Eczema is not fun, it is not pretty, and it is not easy to deal with. I know what some of my triggers are — certain soaps (even natural ones), fabric softener, grasses and latex. I know I have food triggers, but I can’t always narrow them down. Most of the time I don’t know what is causing a breakout, I just know the longer I go without being able to contain it, the worse it will get. I have a daily routine that includes prescription steroidal and non-steroidal creams, lotions, emollients, gloves when I sleep and do any type of housework.

I’ve been stared at while at the beach and while shopping. I’ve been asked if I was contagious. I was asked to leave a pool party. I had friends in junior high who didn’t want to sit by me. Once I had a breakout so bad that when I went into the doctor’s office the nurse put me into a quarantine room. When the doctor walked into the room he actually gaped and dropped his clipboard on the floor.

And yet, I’m frequently told by people (even dermatologists) that it’s just dry, itchy skin. People frequently tell me things like coconut oil, essential oils, green tea and even exercise will “cure” my eczema. I actually tried one of the essential oil blends a coworker gave me (because I figure “what can it hurt?”). I had a horrible breakout, and when I reported it to her she didn’t believe me. “No one should be allergic to essential oils,” she said. Well I am apparently.

I’ve had 33 years to learn to deal with my eczema, and it’s hard. Hard, because most people don’t consider it a chronic disease. I recently just started identifying as a person with a chronic disease.

But admitting that to myself actually made me free. Yes, I have red, scaly patches on my legs, but it’s part of my chronic illness so why should I be ashamed to wear shorts at the beach? Yes, I have a rash on my face and hands, but it’s part of my chronic illness so why should I tax myself trying to hide it? No, I can’t use the product you are offering because it will make my chronic illness worse, so I shouldn’t worry about offending you.

Yes, I have a chronic illness. Eczema. No there is no cure. Yes, I can live with knowing that.



What Agoraphobia Taught Me About Fear Versus Facts-Wonderful Truth

What Agoraphobia Taught Me About Fear Versus Facts

Most of us get paralyzed by fear at some point, whether it’s in our professional or personal lives. We know that taking a certain action or making a specific change will give us the results we say we truly want. But when it comes time to act, we freeze. We procrastinate. We explain, justify and excuse ourselves from the tough call.

Why? Fear, of course. But if it were as simple as mustering our courage and powering through, we’d all be at the pinnacle of success. Instead, we struggle daily in big and small ways to get around the fear.

Rather than trying to exercise sheer willpower against fear, I want to help you see right through it so you can get to the other side with less struggle.

First, I need to tell you a little story about my history with fear.

When I was 21 years old, I started having panic attacks.

If you’re not familiar with panic and how it’s different from anxiety, you can think of it like this:

Anxiety might be the feeling you get when you’re late for work or about to give a presentation. You feel irritable, scatterbrained, maybe short of breath. Your chest might feel tight and you might even describe yourself as “panicky.”

But real panic, in a clinical sense, is different. Panic is the feeling you would get if you walked into your house at night, turned on the light, and a man in a ski mask was holding a gun to your face. It’s the certain knowledge that your life is on the line. Your mind and body are thrown into a fight-or-flight response. If you can imagine yourself faced with imminent death and the accompanying terror, you’re close to understanding what someone experiences when they have a panic attack.

Now, I’m not a psychiatrist, but I did live for about a year with panic attacks that became so frequent and debilitating that I wound up with agoraphobia. I was terrified to leave my house.

Why? Because every time I did, I had a panic attack. I was experiencing this horrific state of mind and body up to 10 times a day. The stressors of everyday life were no longer just anxiety-provoking for me. They brought on full-blown panic.

When I finally got some professional help, an amazing doctor explained to me that my resting state of anxiety and stress were so high that it didn’t take much to push me over the edge. So we set out to adopt behaviors that would lower that resting state of anxiety as a first step to lessen the frequency of attacks.

Over time, I learned how to control and then stop the attacks before they started. I learned how to calm myself, read my own body for negative signs of stress, and develop an inner voice that could quell the fear that constantly plagued me.

During the process of recovery, I also learned something about fear that I hadn’t known before. And now I realize a lot of other people don’t know this either. Here’s what I learned:

Fear masquerades as fact.

Now, you may be saying, “Yeah, Amy, I know that.” But do you really? I mean, do you really know it so well that you never fall for fear in disguise, much less fall for it every day?

Let’s take a look at three ways that we fool ourselves:

1. We confuse the potential consequences with potential catastrophes.

Here’s what I mean by this: We think about a negative outcome that has a reasonable possibility of occurring, but we fear a catastrophe that is highly unlikely. This incongruence between what we’re preparing for and what we fear causes so much stress and inner turmoil that we get paralyzed.

For example, let’s say I want to start a business. I’m miserable in my full-time job and my family is on board with the idea, mostly. I have a savings account that will last us six months without my paycheck. But I’m terrified to quit my job. Why?

I tell myself—and my spouse, friends and anyone else who will listen—that I’m afraid I won’t be able to make it “in this economy” or “without employer health insurance” or “because I have brown hair.” Whatever.

But deep inside, the fear I experience when I think of quitting my job is not about succumbing to any sort of real-life obstacle. My fear is about the catastrophe that lies in wait on the other side. It’s fear disguised as fact.

I envision myself failing as a business owner, being unable to pay my family’s bills, suffering medical issues that my cut-rate health insurance won’t cover, succumbing to illness, alienating my spouse who is bankrupt and now working two jobs, failing my children, losing the respect of my friends and peers, wasting away and finally dying, leaving my family destitute.

That’s the size of the fear in my chest when I tell my friends I’m afraid I’ll fail as a business owner. Not the whole “what if health insurance is really expensive” excuse. I fear actual death and destruction.

Of course, reading this, you can see how irrational this line of thinking is. Is it a possible outcome? Yes. Is it a probable outcome? No. The fact is that I could succumb to some kind of horrible illness working a 9-to-5 job I hate and still bankrupt my family.

So what am I actually afraid of? If what I fear isn’t a fact, then it’s an illusion. I’m basing my decision to stay miserable on the illusion that I will lose everything if I make a change. Now that’s scary.

Here’s the solution: Ask yourself, What’s the worst that can happen? Is that what you fear? If so, talk it out with someone who is objective and experienced in that issue. Ask for help in discerning what is realistic caution and what is doomsday paranoia.

2. We use our feelings as a guide in making decisions.

Now, I can already hear some of you arguing with me before you even read what I have to say here. So please just bear with me.

First, I am not saying that feelings shouldn’t ever play a part in decision-making. Often how we feel is a primary factor in whether or not we should do something.

What I do want you to pay attention to is how realistic your feelings are and whether they should be the guiding factor in your choices. Let me give you an example.

I email a client about an urgent matter, and I need him to respond within 48 hours. The first day, I hear nothing from him. I follow up with another email the next morning—this time using all caps in the subject line. Still nothing.

My feeling is this guy is ignoring me. His delay will push the entire project timeline back, which will jeopardize the financial outcome. In other words, I’m afraid he’s going to blow the whole deal for me. (Remember point No. 1? Do you hear the catastrophe in disguise as a consequence here?)

By this time, I’m seriously scared, but it feels a heck of a lot like anger. In my mind, I’m bad-mouthing him. I’m thinking of all the other times he was rude or unresponsive or even just slightly on the curt side. I’m thinking he has no respect for me and my work boundaries, and a billion other poor-me thoughts. My feelings are hurt.

These negative feelings can sabotage a scary situation if we allow them to be the guide in our decision-making. If I choose to react to my client out of anger or annoyance, I’ll probably jeopardize that deal all on my own (nobody likes a snarky email).

But what if I back up and remove my feelings from the situation? What if I tell myself that regardless of the outcome, my values dictate that I treat people with respect and compassion? Rather than shooting off a snarky email or a passive-aggressive text, I could pick up the phone and find out if he’s OK or if there’s anything I can do to expedite the turnaround on what I need from him.

The next time you’re about to act out of fear, ask yourself if the negative feelings you’re experiencing are calling the shots. That’s just another way fear pretends to be a fact.

3. We don’t weigh the facts correctly.

This one is tricky because there are actual facts involved. But the fear gives us license to weigh certain facts as if they were more important than they actually are.

For me, this happens a lot when I’m good at something, but my inner critic tells me I should be afraid of doing it anyway. I’ll line up all of the compliments or great outcomes, then excuse them away with lines in my head like, “Well, she’s my friend—what else would she say?” or “Yeah, but I spent 10 months preparing for that. I could never do that again,” or even “Yeah, but I think that was a fluke.”

I’m naming facts, such as preparation time or the love someone has for me and assigning them more weight than the actual results of my actions. If you’re good at what you do, the results speak for themselves. It’s imperative that you measure real results and real feedback as more important than the doubts, exceptions and fears in your mind.

Look, I still feel fear. I wake up some days and think, “Oh no, I’m scared to face that interview/project/discussion/large dog.”

But here’s my final piece of advice: Fear is a fact of life. We’re not going to get rid of it. But we can see through its disguise and choose lives based on facts. I’m writing this so that maybe, just maybe, you don’t have to live a life paralyzed by fear. Because believe me when I say that I know how hellish that existence is.

Just in case you’re confused about what the facts are, let me tell you that the facts, my friend, are these:

You’ve got what it takes. You are loved. Your dream is worth it. And if you need help, there’s someone willing to help. Don’t be afraid to ask.



The US beauty queen making her invisible illness visible

Victoria poses in an open ball gown showing a 25 inch scar from her surgeries down her spine

“It’s not easy to stand on stage in a bikini in pageants. I have a 25-inch scar that runs down my spine.

“And people can see it… like, really see it.”

Victoria Graham, a 22-year-old student from Manchester in the US state of Maryland, had an untraditional journey into the glitzy world of US beauty pageants.

She may look like any other contestant at first glance, but Victoria has Ehlers-Danlos Syndrome (EDS) – a rare genetic condition that affects her connective tissues.

Recalling her first competition, she says: “I walked into orientation in a neck-brace, surrounded by all of these gorgeous sky-tall women.

“I looked to my Dad and asked ‘What in the world am I doing here?’… It was comical.”

Media captionWatch: As part of her role, Victoria visits children in hospital

Victoria wasn’t always so open about her condition. “Until I left school at 19, I hid my illness from others,” she says.

“I would rather have my legs dislocate than someone see me in a knee brace.”

But she’s since realised that speaking out makes her feel empowered – and enables her to help others in the same situation.

‘My injuries weren’t normal’

Victoria grew up practising gymnastics and was told she was “too flexible” by her coaches.

She became aware something was really wrong after a gymnastics accident when she was 10.

“I’d get injuries that weren’t normal – things weren’t adding up,” she says.

Victoria Graham in her latest pageantImage copyrightALLYKATPHOTOGRAPHY
Image captionVictoria’s platform is ‘But you don’t look sick? Making invisible illnesses visible’

EDS is notoriously difficult to diagnose, and she spent three years seeing different specialists, trying to pin down the problem.

Eventually her family found a geneticist who gave her a diagnosis aged 13.

“It was weird because although there’s no treatment and no cure, we were ecstatic because we finally had a name for what was going on,” she says.

In the family

It then became apparent that Victoria’s condition was inherited – only then did her mother, brother and other family members find out they also had lesser forms of EDS.

“My grandmother lived with EDS for nearly 70 years without knowing and my Mom had it 40 years.

“Nobody should have to live that long before finding out what’s going on with them,” she says.

Victoria pictured when she was young, with her mother who also has a form of EDSImage copyrightVICTORIA GRAHAM
Image captionThrough her diagnosis, it emerged her mum, Mary Beth, also had a less severe form of the condition

Over a two-year period from 2014, Victoria had to undergo 10 operations on her brain and spine.

“I’m fused from skull to my bum – all the way down,” she says. “Because I was able to move so much before, the vertebrae were dislocating themselves.

“I have a limited range of motion now, but I need to be stiff so my brain stem isn’t under pressure and my spinal cord isn’t being crushed.”

What is Ehlers-Danlos Syndrome?

  • Ehlers-Danlos syndrome (EDS) is the name for a group of rare inherited conditions that affect connective tissue
  • Connective tissues act like a ‘glue’ to support the skin, tendons, ligaments, blood vessels, internal organs and bones
  • Victoria has a severe form of EDS which means she has cranial and spinal instability
  • She also lives with dietary limitations because of how her condition affects her internal organs
  • For more information go visit the Ehlers-Danlos Society website

Victoria’s EDS affects a lot of aspects of her body, including blood flow.

She says she has to take 20-25 tablets every two hours. Some are for pain relief, but others are supplements to ensure her body keeps functioning correctly.

“I know plenty of girls who are in a near similar situation as me medically who are bed-bound, but I believe lifestyle has a lot to do with your attitude and how you view your situation.”

Victoria leaps into the air in front of the oceanImage copyrightVICTORIA GRAHAM
Image captionDespite her condition, Victoria has been able to live an ordinary lifestyle

Despite the severity of her condition, Victoria finds herself often dismissed and discriminated against because of the invisible nature of her illness.

At school she consistently struggled with teachers’ unwillingness to make accommodations. And she says she often gets shouted at in public for using a disability parking pass.

As part of her efforts to raise awareness and educate people, Victoria now performs a monologue about her condition at pageant competitions.

She says she entered her first competition as part of a ‘bucket list’ deal with a friend after an operation.

Victoria Graham holds a sign saying 'I have an invisible illness' in her pageant crownImage copyrightVICTORIA GRAHAM
Image captionVictoria talks about her condition at the competitions

She won her first local title just months later and now holds Miss Frostburg – a local title within the Miss America Organization.

Through this platform she has been able to meet and support other people with EDS.

“Its not always easy, sometimes you want to be normal – you don’t want to be that girl with those scars on stage,” she says.

‘Medical Zebra’

Despite being only 22, Victoria now runs her own non-profit EDS support group called ‘The Zebra Network‘.

“I was seeing people who were struggling – doctors were often recommended through word of mouth.

“I saw a dire need for a network of sufferers and for someone to dedicate their life to that” she says.

A group of EDS sufferers and supporters hold 'zebra strong' plaquesImage copyrightROSS LEWIN
Image captionShe says her group’s goal is to have a global EDS support system

“I know I’m young and its a bold decision to make without a college degree – but if someone else wasn’t doing it, I would be that someone.”

She explains the network’s name: “In medical school, doctors are trained to think of the common thing when diagnosing through the phrase, ‘When you hear hoofbeats, think of horses not zebras.’

“So if a kid has runny nose or a cough they most likely have a cold rather than a rare form of cancer. But those rare things do happen and are often called ‘medical zebras’.

“So we say, ‘Think zebras, because zebras do exist’.”

Despite her confidence now, its been a fraught journey to this point for Victoria.

Victoria Graham in a hospital bed, showing her IV line and in a head brace.Image copyrightVICTORIA GRAHAM
Image captionVictoria had to undergo ten major operations within two years

At Eastern University in Philadelphia, she was on the soccer and lacrosse teams, but was forced to move colleges to a more flexible programme because of her operations.

She says she also lost friends as she went through so many procedures.

“Maybe my illness is something they can’t deal with or put up with,” she says. “I don’t know what the reason is.”

She also describes having relationships with boyfriends suffer.

Victoria Graham in her lacrosse uniform at Eastern University, with her parentsImage copyrightVICTORIA GRAHAM
Image captionVictoria played soccer and lacrosse throughout school and college.

“I try to be very understanding and not take it personally,” she says.

“You have to think of the other side of things. I think that’s one of the ways I’ve been able to combat the negativity.

“If people are able to be empathetic to my situation in the same way – by recognising some illnesses aren’t as obvious as others – it would make it a lot easier.”




There are those rainy summer days when I don’t want to leave the house but get warm and cozy inside. Maybe I heat the oven and bake some of my all-time favorite munchies for comfort. This superb crisp bread is one of my all-time favorite munchies. Crunchy, tasty and crispy, without gluten and as healthful as possible, it might become one of your all-time favorite munchies as well.

Munch this crunchy crisp bread just like that, or with butter and cheese. For real comfort, top it with sugar-free strawberry or raspberry jam. My favorite way to eat this bread, in addition to load a slice with butter and cheese, is to crumble it over my breakfast yogurt — it’s just like granola, but not sweet, though.




Crisp Bread (Dairy-Free)

2 cups = 480 ml organic sunflower seeds
1/3 cup = 80 ml organic flax seeds
1 teaspoon unrefined sea salt
4 extra large organic eggs
4 tablespoons organic extra virgin olive oil



  1. Preheat the oven to 300 °F (150 °C).
  2. Combine the sunflower seeds, flax seeds and salt in a food processor. Process until the mixture resembles coarse meal. Most of the flax seeds can be whole, though.
  3. Remove the blade or transfer the mixture to another bowl. Add the eggs and the oil and mix with spoon until well mixed.
  4. Line two baking sheets with parchment paper.
  5. Divide the batter in half.
  6. Place one half on a baking sheet. Spread the batter evenly with spoon so that it is approximately 0.2 inches (0.5 cm) thick. Repeat with the other half.
  7. Bake one baking sheet at a time, for approximately 30 minutes, or until crunchy and golden brown. Don’t let get too dark.
  8. Let cool and break into pieces.



Nutrition information Protein Fat Net carbs kcal
In total: 104.0 g 242.9 g 7.5 g 2632 kcal




Gluten-Free, Dairy-Free Crisp Bread | Low-Carb, So Simple!




This is very simple and easy bread to make after taking care of a couple of things: the ideal coarseness of the seed mixture and the ideal thickness of the batter on the baking sheet.

The finer the texture of the ground seed mixture, the better the bread holds together. Really finely ground seed mixture doesn’t produce crunchy bread, though. The bread will be rather leathery if the texture is too smooth. On the other hand, too coarse seed mixture will produce bread which is crunchy, but which is also crumbly.

The thickness of the bread affects also how well the bread holds together. The thicker the bread, the better it holds together and the bigger pieces you can break from the bread. Very thin bread is crumbly. On the other hand, too thick bread is not nice to eat, so you might want to make bread which is something in between. For me 0.2 inches (0.5 cm) has been the ideal thickness.

I use a substantial amount of salt because I prefer my bread rather salty. If you don’t like salty bread, please feel free to reduce the amount of salt.

This recipe makes two baking sheets of bread. If you don’t want that much, or if you just want to try out if this bread is your cup of tea, you can halve the amounts of ingredients.
So, let’s get started. Seeds and salt placed in a food processor.

Gluten-Free, Dairy-Free Crisp Bread; Seeds and Salt | Low-Carb, So Simple!


Then processed until the mixture resembles coarse meal.

Gluten-Free, Dairy-Free Crisp Bread; Processed Seed Mixture | Low-Carb, So Simple!


The blade removed; eggs and oil added.

Gluten-Free, Dairy-Free Crisp Bread; Eggs and Oil Added | Low-Carb, So Simple!


Then just some mixing with a spoon so that everything is well mixed.

Gluten-Free, Dairy-Free Crisp Bread; Mixing the Batter with Spoon | Low-Carb, So Simple!


Batter divided in two parts, each part placed on baking sheet lined with parchment paper.

Gluten-Free, Dairy-Free Crisp Bread; Spreading the Batter with Spoon | Low-Carb, So Simple!


Then spreading the batter with spoon…

Gluten-Free, Dairy-Free Crisp Bread; Spreading the Batter with Spoon | Low-Carb, So Simple!


…until it’s flat and even, approximately 0.2 inches (0.5 cm) thick.

Gluten-Free, Dairy-Free Crisp Bread; Spreading the Batter with Spoon | Low-Carb, So Simple!




Actually, this crisp bread has almost nothing to do with that crisp bread we eat here in Finland and in other Nordic countries. The traditional crisp bread is made from rye flour, salt and water. My version doesn’t have any of those — except salt. But since my version is crispy and it’s bread, I call it crisp bread.

I started developing this bread when my toddler was begging for some crisp bread — obviously because my dad was eating that traditional Finnish crisp bread. Since me and my toddler eat completely gluten-free food, the traditional crisp bread was out of question. And because they don’t sell any healthy gluten-free crisp bread here, I had to develop my own, simple and healthy version.

In this final recipe I have heavily simplified a version which I found from a Finnish low-carb forum. There is almost nothing left from the original version. I’ve tried different ratios of seeds, oil and eggs and this one is the best in my opinion. And the simplest. My family likes it as well, also my dad who loves to eat traditional crisp bread — he immediately fell in love with this one. Lucky me.

But when I first started thinking of crisp bread, I had to choose which nuts or seeds to use. I thought my favorite seeds. Something low-carb and not very strong tasting. Sunflower seeds would be the best option. Somehow I was also thinking of flax seeds — a great addition to otherwise plain sunflower seeds.

Then just salt for better flavor and a couple of tablespoons oil for richer flavor and texture. From three different fats I use, butter, coconut oil and olive oil, the latter was a natural choice for this crisp bread.

In my first experiments I used too few eggs. The bread was hard and it was blistering in the oven. Actually, what was even worse was that the batter was really hard to spread on the baking sheet. The batter was too runny to roll out and too stiff to spread with spoon. That was also a problem I wanted to solve.

Next I added more oil, hoping that the batter is easier to spread. It wasn’t, but the bread tasted delicious! I doubled the amount of eggs to see if that affects the spreadability. It did. The consistency of the batter was just right to get it nicely and evenly on the baking sheet. Even better, the bread didn’t blister in the oven and the texture was crunchy. The bread was almost melting in my mouth.



Gluten-Free, Dairy-Free Crisp Bread; Bread and Butter | Low-Carb, So Simple!




The combination of sunflower seeds and flax seeds is my favorite for this crisp bread. However, feel free to use your favorite seeds. Please remember though, that flax seeds make the batter thicker. For example chia seeds work in a similar way. I tried this bread also with chia seeds instead of flax seeds, and the result was great.

You can replace part of the sunflower seeds with for example pumpkin seeds or sesame seeds. You can spice the bread with your favorite spices, or add some dried or fresh herbs for color and taste.


Gluten-Free, Dairy-Free Crisp Bread; Bread and Stuff | Low-Carb, So Simple!



What No One Told Me About Down Syndrome

Recently, I read a story about a baby boy born in 1982, known to us only as Baby Doe. Interestingly, this baby who had no name quickly became the center of national debate over the sanctity of human life.

In the court of public opinion, some found this newborn baby boy to be guilty of two grave offenses. First, he had Down syndrome. Somehow, he had managed to breeze through pregnancy without being detected, thus taking away his parents’ ability to abort him in the womb. Second, he was born with a (surgically correctable) condition known as tracheoesophagael fistual. Yet while a nearby hospital and its medical team were ready and willing to perform surgery on him, Baby Doe’s parents chose instead to follow the archaic and biased advice of the mother’s obstetrician…and they did nothing.

This tragic story continued with the hospital fighting (and losing) for the chance to provide life-saving measures; many families coming forward with a desire to adopt Baby Doe; and a state child protective services investigation into the situation. In the end, though, medical pleas, legal processes, and state intervention all failed Baby Doe. He lost his life just six days after birth because he was left alone with no sustenance. The cause of death was recorded as “chemical pneumonia, due to the regurgitation of his own stomach acid.”


While the story of Baby Doe’s life and death is, to many, heartbreaking and unimaginable, the reality of the injustices he faced are not all that uncommon. Though his story took place some 35 years ago, I’m afraid that in many ways, the suppression and annihilation of people with Down syndrome still persists, even today. On the heels of reading Baby Doe’s story for the first time, I read another person’s story just a couple of days later. This mother’s story is the story of so many others…a prenatal suspicion or diagnosis of Down syndrome turned into pressure from one or more medical professionals to simply abort the baby and try again next time. It happens all the time (you can read many other mothers’ diagnosis stories here).

As I recall the many stories I’ve read or heard over the years, I can’t help but ask this question: What is the big deal about Down syndrome, anyway?

Entire nations today, such as Denmark (and Nazi Germany many years ago), are waging a war against this population. The prenatal threat against those with Down syndrome has never been greater as prenatal tests become more and more accurate. Furthermore, some medical and ethical scholars continue to argue not only for the abortion of fetuses suspected or diagnosed with Down syndrome prenatally, but for infanticide of those who receive a birth diagnosis. Yes, they are arguing for the legal right to kill babies born with Down syndrome (and other disabilities, as well).

In many ways, these assaults are working, and the population of people with Down syndrome continues to decrease as the years go by. But why?

What’s so dangerous about Down syndrome?

The other day I was thinking out loud and questioning why our world seems so dead-set on eliminating people like our daughter. My husband listened to my rhetorical questions and offered his opinion: “Because it’s not easy. Parenting a child with Down syndrome takes a lot of work.” And while I wasn’t looking for an answer from him, per se, his answer exposed the truth about why our world wants to wipe Down syndrome from our midst: fear.

Facing a reality of Down syndrome exposes our fears and forces us to recognize our vulnerabilities. Naturally, we fear “hard,” so we run from it instead. We try to make it disappear. We fear that Down syndrome will take away from our lives, destroy our normal, ruin our hopes and dreams. Fear drives this social war on Down syndrome, yet we fail to realize what we are trading our fears for in the process.

We are so busy running from pain that we forget the beauty that comes out of hardship. Nature reminds us of this truth, though, that even in the most barren, drought-afflicted desert, a flower still blooms. Even in a land stricken by the devastating effects of volcanic activity, luscious vegetation will emerge once more. Beauty from ashes. Life from death.

What’s so dangerous about Down syndrome? I think we have it all wrong, that we are fearing the wrong things.

I submit that the most dangerous threat Down syndrome poses to us as a society and as individuals is that it enables us to become better people. Down syndrome threatens our devotion to self and reminds us that pursuit of personal pleasures leads to an empty life. A life well-lived is a life in which the needs of others are put before our own.

I will be the first to admit that I grieved deeply over my daughter’s prenatal screening of Down syndrome. In fact, it was one of the darkest and most painful seasons of my life, and it led to an extremely difficult pregnancy, a 9-week stay in the hospital, and many days in my pregnancy of praying that the inevitable would not be true. At one time, I felt that having a child with Down syndrome would mean the end of my world.

I don’t regret for one second the grief I felt and the heartache I have endured in different seasons of this surprising twist to our journey. We did not ask for Down syndrome, and the grief has been a normal process in unexpected and unanticipated life circumstances. But I also don’t believe that the grief I have experienced in any way minimizes or takes away from the value of our daughter Alisa’s life. I will never accept that the detour Down syndrome brought to my original life plans would have ever justified killing Alisa, prenatally or just after birth.

Alisa has Down syndrome, but she is so much more than the many misconceptions and misled beliefs our world still holds about people with Down syndrome. She is not “a blob,” as the obstetrician of Baby Doe’s mom predicted he most certainly would be. She is not “an unbearable burden on the family and on society as a whole,” as is conjectured in this journal’s publication. She is not suffering, and she poses no threat to those who come into contact with her. But even if she was more medically-fragile, and even if she did require even more of my time, energy, and sacrifice, we should never compromise the value of human life for the sake of our own fears.

In those proverbial storms of our lives, if we trade our fears for comfort and pleasure, we lose out on the character, the strength, and the beauty that emerges when a storm is weathered. After all, diamonds aren’t formed in easy conditions or safe environments. If we run from pain and numb our senses to the grief that accompanies “hard,” we miss opportunities to love and to give and to make this world a better place, even if it means just making one life better. Parenting a child with Down syndrome is not always easy, yes, but parenting any child is not always easy. Life is not easy!

Facing a reality of Down syndrome does not have to be the death sentence the world is trying convince us that it is. While Down syndrome reminds us that life does not always go according to our plans, it also teaches us that the real purpose of life is not in getting what we want but in emerging from the unexpected twists and turns of life as people of character, integrity, and strength. People with Down syndrome demonstrate to us that the pace of life does not have to be fast and furious. We do not have to look, behave, and achieve as the world pressures us to do. Human diversity is a beautiful thing in all of its many forms.

We fear the unknowns of Down syndrome, and we believe that it is the person with Down syndrome who is somehow lacking, unworthy, too different to be given the same respect as other human beings. Yet I have found that it is not my child with Down syndrome who has needed to change, but me. It is not my daughter who has Down syndrome who was lacking, but me.

What’s so dangerous about Down syndrome? When Down syndrome touches your life, you cannot remain the same person that you once were. Yet if only we would all but walk into the “hard” and embrace the challenge, we would find that the change Down syndrome threatened to bring was, all along, something that we shouldn’t have feared at all…