Special to L. Neil Smith’s The Libertarian Enterprise

It's been pointed out numerous times in the past few years that many school shooters have a history of being on psychotropic medications such as SSRI (Selective Serotonin Re-uptake Inhibitors) anti-depressants, ADHD medication, or both. Many people have interpreted this observation as a heartless cruelty, a refusal to provide help or even sympathy to bullied teens descending into mental illness. Allow me to refute that with a little context.

In 2003, regulators in Canada, the U.S., and Europe began sending out advisories warning that clinical trials for approved SSRIs were linked to an increased risk of suicidal behavior in children and teens. The FDA had not approved the use of these drugs in children or teens, and in 2004 the agency created a Black Box warning for drug package inserts about possible increased risk of suicide in children and teens.

But after the headlines faded, not all doctors read the package inserts or Black Box warnings. In any case, the use of approved drugs for unapproved uses is quite common in the United States, accounting for nearly 50% of all prescriptions.

Slowly at first, the FDA began a closer look into these drugs and teen suicides, and in 2012, the agency fined GlaxoSmithKline 3 billion dollars for its illegal promotion and payments to physicians to get them to prescribe Paxil and Wellbutrin to children and teens suffering from depression, obesity, and addiction. At a press conference in Washington, D.C., Deputy U.S. Attorney James Cole lauded the judgment, calling it "Unprecedented in size and scope."

Unfortunately for the creators of these drugs, depression in adults and children is much more complicated than a simple deficiency of serotonin, a theory that has long been popular because it reduces a complex condition down to a single molecule. It turns out that microbes in the gut have a profound influence on mood. Microbes interact with gut cells called enteroendocrine cells that produce neuroactive molecules and peptides. These molecules interact with the vagus nerve, which sends signals to the brain.

Microbes in the gut produce neurotransmitters and metabolites that circulate to the brain. Some of these are small enough to cross the blood-brain barrier, and others alter cell activity at the barrier itself. In 2018 researchers at the University of Alabama at Birmingham reported at a meeting that they had found gut bacteria in human brain tissue. The study has not yet been published, and skeptics abound, but it suggests that microbes might somehow be making their way into the brain.

The great Greek physician Hippocrates, father of modern medicine, said, "All disease begins in the gut." We know now that inflammation is a springboard for virtually all disease. Turns out the number one cause of inflammation in humans is the consumption of inflammatory food such as sugar. I think we can probably all agree that kids eat terrible diets now, high in sugar, high fructose corn syrup, dyes, and foods fried in canola oil. Parents of children with ADHD, autism, and depression report a constant struggle with their children to eat food that comes out of the ground and not a plastic package.

Do kids just bounce off the walls when they eat sugar, or is something else going on here? Perhaps an explosion of sugar-loving "bad bugs" such as candida?

Yes, and while candida is a mild commensal organism in healthy people, a diet high in sugar results in a disproportionate and unhealthy increase in yeasts and fungi. On top of the many antibiotic prescriptions given to kids, which also kill off good bacteria in the gut and increase opportunistic organisms such as candida, what we're seeing is the equivalent of a three-alarm fire in the guts of many children.

Acetaldehyde, one by-product of the candida yeast, reacts with the neurotransmitter dopamine, which also leads to mental problems, including anxiety, depression, poor concentration, and feeling spaced-out.

Shouldn't the immune systems of these kids be able to easily dispose of these bad guys? You might think so, but the challenges we all face from overuse of antibiotics are not at all easy for us. Also, about one-third of American kids are born via C-section, a wonderful life-saving procedure that is also overused. That travel through the birth canal is the most crucial part of the formation of a well-functioning immune system. Without being layered in the mother's bacteria during birth, a child's immune system is unable to take the proper directions.

But when kids with these problems are taken to the doctor, aren't they evaluated for gut problems? Very seldom. Though we have known all this for years, it isn't as a rule taught in medical school.

American doctors are siloed into specialties; few child psychologists have any awareness that a gut evaluation may prove more valuable than the latest SSRI. However, now we're starting to see a few physicians stand up and point out the terrible inadequacies of any conventional treatment for the brain that does not address the food people are eating.

One of these physicians is Dr. David Perlmutter, a board-certified neurologist, Fellow of the American College of Nutrition, and 6-time New York Times best-selling author. His 2013 book "Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar -- Your Brain's Silent Killers," was one of the first to popularize the idea that food has a profound influence on both gut health and the brain. The book is now in its second edition, and while most of his work focuses on the prevention of Alzheimer's disease, he has plenty to say about the brain health of children.

In the book's opening, Dr. Perlmutter states, "I believe that the shift in our diet that has occurred over the past century -- from high-fat, low-carb to today's low-fat, high-carb diet, consisting primarily of refined grains and other damaging carbohydrates -- is the origin of many of our modern scourges linked to the brain, including chronic headaches, insomnia, anxiety, depression, epilepsy, movement disorders, schizophrenia, ADHD, and those 'senior moments' that quite likely herald serious cognitive decline and full-blown, irreversible, untreatable, and incurable brain disease."

The book goes on to describe how the modern inflammatory diet rewires the brain into a toxic version of itself, and how this damage can be reversed with diet and lifestyle changes. Simple as most of them are, such tactics are unlikely to be discussed in today's 7-minute office visit.

Instead what happens is a prescription pad is taken out and a "brain problem" drug is prescribed. Such drugs do nothing to decrease inflammation in the brain. Instead, they cover up symptoms while the root cause continues to get worse and worse. Children and teens are more fragile than adults; certainly their livers are less mature. It should not be surprising that drugs tested only on adults affect them more drastically.

What happens when you take a group of "incurable" autistic kids with gastrointestinal problems and give them a powerful gut-healing therapy such as Microbiota Transfer Therapy (MTT), a special type of fecal transplant?

Using this innovative approach developed by Dr. Thomas Borody, an Australian gastroenterologist, treatment was given to 18 children, first showing substantial gut improvement — and two years post-treatment, most of the initial improvements remained. But something even more exciting happened: over the next two years, parents started reporting a steady reduction in autism syndrome symptoms. A professional evaluator found a 45% reduction in core ASD symptoms (language, social interaction, and behavior) at two years post-treatment compared to before treatment began. In other words, the improvements in terms of ASD symptoms also seem to be long-lasting.

An inflamed brain is depressed, anxious, angry, and sleepless. Giving it a pharmaceutical serotonin Band-Aid only results in a bigger explosion. This is why we have so many school shooters and suicidal kids. The drug companies know this, and they don't care. A world in which dietary changes and microbiota transfers are well-known and accepted is a world without monetary incentive for them.

Hippocrates also said, "Let food be thy medicine, and medicine be thy food." We would do well to listen to his advice.