The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine by Donna Jackson Nakazawa

The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine Reviews

• 
  Lisa

  Have you ever wondered what microglia are and what they do? Do you even know they exist? Okay, probably not. They are incredibly fascinating cells and play a vital role in brain health. In her recent book The Angel and the Assassin, Donna Jackson Nakazawa details the discovery of the role microglial cells play in our immune systems and our brains.
  
  "In a healthy brain, microglia secrete nutrients to stimulate new, healthy neurons to grow and create brand-new synapses, wherever they might be needed to help mend the brain. They even release neuroprotective factors involved in repairing sick neurons."
  
  Microglia are also the brain’s clean-up crew. They patrol the brain checking for injury and infection, clearing away pathogens, malformed proteins, and dead cells. They work as macrophages, think little Pacmen, engulfing and carrying away the trash.
  
  Just as white blood cells can get overactivated and create autoimmune conditions,
  
  "When microglia detect that something is off--an overinflux of stress hormones, an infiltrating virus, chemical, allergen, or pathogen on the scene--they all too often went too far, removing every synapse hanging out in the neighborhood."
  
  Lymphatic vessels carry white blood cells throughout the body. Not too many years ago a researcher noticed that these vessels are also found in the protective membranes that encase the brain suggesting a direct link between the immune system and the brain. If the body's immune system is triggered, it could send messages via these pathways which activate the brain's microglia and cause neuroinflammation which could damage healthy neurons and brain tissue.
  
  The brains of people with neurological conditions from Alzheimer's Disease to depression show synapse loss and/or dysfunction. The research suggests that overactive microglia could be responsible. Microglia could also explain why some people with auto-immune diseases sometimes report cognitive symptoms such as memory loss, anxiety and depression.
  
  Note the words suggest and could in bold in the above two paragraphs.
  
  Jackson Nakazawa looks at the work of scientists across many disciplines—neurobiology, genetics, psychology, psychiatry, medicine, and immunology—several of whom she profiles in animated detail. These discoveries have lead to experimental therapies such as transcranial magnetic stimulation, neurofeedback, gamma light therapy, fasting diets, vagal nerve stimulation, immunotherapy, and hallucinogens. Jackson Nakazawa also weaves in the stories of three women who suffer from autoimmune conditions and their experiences with experimental therapies. Note that she has chosen to highlight women who responded positively to these therapies.
  
  Jackson Nakazawa is a good writer. Her enthusiasm for her subject is clear. She writes short, easily digestible chapters in a brisk and understandable prose. Her work is extensively end noted so the reader can look up the scientific papers she references.
  
  I share Jackson Nakazawa's excitement over the possibility of new treatment options for these conditions. And yet there are still many unknowns. I do caution the reader in the author's own words “If we overemphasize the workings of microglia, and the biological mechanisms by which illnesses of the brain emerge, we invite the kind of biological reductionism that overmedicalizes and belittles the intimate connection between the mind and the way it gives birth to our human consciousness.” In her enthusiasm for the potential treatments, she sometimes loses sight of this idea.
  
  Publication 2020
• 
  Morgan Blackledge

  Microglia are a type of white matter brain cell that were until recently understood to play a supportive role in brain health.
  
  The Angel and the Assassin is science journalist and Donna Jackson Nakazowa‘s popularization of our emerging understanding of microglia’s prominent role in various chronic illnesses as well as a host of psychiatric disorders.
  
  In short. Microglia identify and eat dysfunctional or nonessential neurons and synapses, in a process otherwise known as neuronal pruning.
  
  Microglia also identify and eat other neuronal material including amyloid plaques generally implicated in age related cognitive decline.
  
  As creepy as all of this sounds, it’s a very important aspect of the brains immune system and is essential to healthy and efficient cognitive functioning.
  
  Anyway.
  
  Part of microglial function includes the release of pro-inflammatory cytokines.
  
  A little bit of that is OK.
  
  But chronic exposure causes highly problematic neuro-inflammation, which overdrives your microglia and causes your brain to basically eat it self.
  
  This is absolutely as bad as it sounds, and it causes a bunch of really bad problems like psychosis, anxiety, depression, bipolar and Alzheimer’s.
  
  I’m currently working on a doctorate in clinical psychology. My area focus is the neurobiology of substance use and co-occurring psychiatric disorders.
  
  This book started me on a whole new tangent of research on glial mechanisms of addiction:
  
  Basically, when you use drugs of abuse, special little druggie molecules cross the blood brain barrier and interface with your central nervous system, eliciting the psychoactive effects (the high) associated with that particular drug.
  
  These molecules are perceived as pathogenic foreign agents by the brains immune system, activating microglia and subsequent neuronal inflammation.
  
  Again, a little bit every once in a while is less harmful.
  
  But chronic drug use throws your microglia into the flaming overdrive previously described.
  
  If you didn’t have psychiatric problems before, well… you have them now.
  
  This goes a long way to help understand why so many people reporting for substance use treatment have co-occurring psychiatric conditions.
  
  We used to think that people used substances to self medicate underlying depression, anxiety, bipolar etc.
  
  Now we’re beginning to realize that chronic substance use causes these awful devastating conditions.
  
  Particularly in vulnerable populations.
  
  Yuck!
  
  Author Donna Jackson Nakazawa is as crisp and readable as ever.
  
  If you haven’t read her other books, do yourself a favor and pick up Childhood Disrupted. It’s a classic.
  
  So why 4 not 5 stars?
  
  The short answer is, I became uncomfortable with some of the science reporting in the middle of the book.
  
  I can’t put my finger on it, but some of it felt a little too exuberant and slightly half baked.
  
  Much of the science and subsequent medical and psychiatric interventions described in the book are pretty new, and only time will tell how accurate or efficacious some of it is.
  
  That being said this is a terrific book, so please don’t let this minor criticism scare you away.
• 
  Aisling

  A truly terrible title for a terrific book. The "angel and the assassin" bit sounds like a horrible bad romance. The rest of the title is great and in fact exactly covers the topic of the book--a tiny brain cell that changed the course of medicine; the microglia.
  
  I really enjoy books like this that humanize the people behind medical discoveries and the pioneers in treatment and show the current and future areas of research. (Another great one is Switched On by John Elder Robison although that is more memoir and less med research).
  
  In this book Donna Jackson Nakazawa takes the reader on a fascinating discovery of the microglia--a tiny brain cell that was misunderstood and then as research progressed (and is still progressing) became so important in the world of treating mental and brain diseases. This book humanizes the scientists who made early discoveries and follows a few patients with various issues (depression, anxiety) and shows how new and promising (and NOT pharmaceutical) treatments are revolutionizing their lives.
  
  This was really a fascinating read, very nicely manageable for the non scientific reader and (dare I say?) a mind blowing look into how incredibly complex the brain synapses and immune responses are. All in all absolutely a 5 star non fiction read but ugh that title.
• 
  Joy

  Disclaimer: I am HUGELY skeptical of science journalism (as everyone should be). Journalists often sensationalize scientific findings in ways that are (sometimes extremely) misleading. So, yes, my critical hat is on as I read this, so a few initial thoughts:
  
  1) The author does, at times, acknowledge that "correlation does not equal causation". This is where many scientific journalists trip up. At other times, however, her language edges extremely close to inferring that the jury is no longer out and all causal ties have been validated and locked up. It's a fine line.
  
  2) The author appears to equate psychoanalysis with psychotherapy. They are NOT synonymous. Psychoanalysis is a type of talk therapy, the school of therapy developed by Freud. Which, by the way, is not evidence-based and has largely fallen out of favor with scientific psychology, for good reason. So, yeah, please don't equate the two.
  
  3) The author uses anecdotal evidence from one psychoanalyst (see above) to make points. Anecdotal evidence is not science!! EDIT: It's not just that one case. LOTS of anecdotal evidence present, and in one case a "treatment" discussed turns out to be patented and sold by the treating provider (that's not fishy at all...).
  
  4) The author pretty much glosses over the use of psychotherapy to treat psychiatric disorders. She mentions the shortcomings of psychoactive medications but fails to note that in the majority of cases, psychotherapy has been found to be more effective in the long-term. Yes, it's not perfect, but let's not pretend that it doesn't exist.
  
  5) The "hey kids, don't try this at home" disclaimer is in the footnotes, which we know not everyone reads. Given the experimental nature of many of these treatments, particularly the diet stuff, a more forceful disclaimer in the text would have been more effective.
  
  Now that I have been overly critical, I will say that the subject matter is fascinating, and the author's attempt to bring in personal accounts, to humanize the very heavy neuroscientific jargon, is admirable. Not to mention the fact that inflammation is the "in" science, particularly in the areas of dementia and other neurological disorders. I just hope that the public will see this for what it is - journalism - not scientific literature.
  
  
• 
  Barbara (The Bibliophage)

  Donna Jackson Nakazawa is a favorite nonfiction author of mine. Her book,
  The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope was one of the first books I read after being diagnosed with Rheumatoid Arthritis 10 years ago. And I’ve devoured every one she’s written since.
  
  The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine is her latest, and publishes in January 2020. It introduces a component of our brains called microglia to the general public. Microglia are cells in the body that don’t get much attention even though scientists are aware of them. But, as Nakazawa explains, some ground-breaking scientists are now intensely researching microglia.
  
  And what they’re learning is stunning. In its simplest form, studying microglia proves that brain, mind, and body are intimately tied together. This seems obvious, but medicine and science don’t treat them as connected. Instead, we focus on the barriers between them. And we assume that the immune system doesn’t exist in the brain, just because we don’t see the same elements as we see in the body.
  
  But Nakazawa explains that this is all old science. Now we know that physical trauma affects the brain, and thus, affects everything about mood, cognition, and brain function. This trauma could be as common as a concussion, all the way up to complicated and traumatic brain injuries.
  
  In addition, diseases that affect the body’s immune system are also likely to affect the brain—a relatively new concept called neuroimmune function. This also changes the way we’ll treat diseases like depression, bipolar disorder, and Alzheimer’s in the future.
  
  Ultimately, the fields of neuroscience, genetics, psychology, psychiatry, medicine, and immunology are all more closely connected than ever.
  
  My conclusions
  First, I’m not explaining this as eloquently as Nakazawa does. The science is complex and multi-layered. And yet, she walks readers through the information step by step. The way she integrates stories of real-life patients makes the clinical and research details come to life. Having examples makes everything easier to absorb, and along the way you cheer for the people searching for solutions.
  
  Which leads me to my next point. I particularly like that Nakazawa doesn’t stop at discussing the science. She helps readers understand if and how they can bring these cutting edge concepts into their own lives. Part way through, I was definitely searching online to find specific neuroimmune-related services in my area.
  
  It’s not common to find a book with innovative information that is also so readable. I never felt talked down to, despite my lack of scientific education. Nakazawa is a patient who writes for patients, not researchers. She’s the advocate you’ve always wanted, and by writing books, she helps many more patients than she could do individually.
  
  Read this if you like learning more about how your body, especially your brain, works. You’ll see how the science of microglia is already changing what we know about our brains. Definitely recommended for people with neurological, autoimmune, and mental health conditions of all kinds (and the people in their lives).
  
  
  Pair with either of Norman Doidge’s
  books about neuroplasticity. If you’d like a shorter option, pair with
  The Beautiful Brain by Hana Walker-Brown (an Audible Original). This one’s about concussions. I’d also pair this with
  The Ghost in My Brain or
  Brain on Fire, which are memoirs about neurological journeys.
  
  Acknowledgements
  Many thanks to NetGalley, Random House Publishing Group, Ballantine Books, and the author for the opportunity to read the digital ARC in exchange for this honest review.
  
  Originally published on my book blog,
  TheBibliophage.com.
• 
  Nat

  This is a very important book, highlighting game-changing research relevant to so many people (anyone with mental illness, chronic inflammatory conditions, autoimmune diseases, neurodevelopmental disorders, and neurodegenerative diseases, as well as to medical professionals.)
  
  Microglia make up 10% of the cells of our brain. Originally dismissed as annoying little cells that contaminated neuronal cell cultures, over the last few years, it’s become recognised how extremely important these immune cells are.
  
  Up until recently, the brain’s immune system was thought to be non-existent. Now we know “that the brain is a sensitive immune organ, constantly on the lookout for possible new threats—and that myriad immune triggers can slowly change the habits of microglial cells in the brain, so that they remodel our synapses in suboptimal ways, just as environmental triggers can alter the habits of immune cells in the body.”
  
  Absolutely fascinating.
• 
  Payel Kundu

  We read this for a neuroscience book club I co-run. Comment if you want our notes 😊
  
  The author of this book became interested in the topic because she developed a serious and disabling autoimmune disorder. She developed a stomach virus, which her immune system took care of, but then it went overboard and knocked out the myelin sheaths around her nerves as well, which led to GB syndrome. She noticed she also had cognitive symptoms, including memory problems. Thus, she wondered how the two interact.
  
  I was pretty into this book for the first third or so. I remember the shift, while I was in grad school between 2013 and 2018, of more and more evidence accumulating that the brain was not in fact “immune privileged.” There was an increasing body of literature indicating a clear interaction between peripheral immune reactions and the immune response in the brain. This included both peripheral immune cell infiltration through the blood-brain-barrier itself (through dedicated channels), as well as peripheral immune signaling that in turn, signaled to the brain’s immune cells. The brain really is separate from the body’s immune system in some ways, which is completely essential to protect this largely non-regenerative organ from inflammatory damage due to peripheral infections. This was discovered when unmatched skin grafts directly onto the brain of rabbits were not rejected readily, but they were when grafted just under the skin. But the story turned out to be more complicated. If an animal was immunized peripherally first, and then the graft was introduced to the brain, the graft was readily rejected. This implies that cells (in this case it turned out to be T-cells) primed in the periphery, can travel to the brain. We also now know neurons contain receptors for peripheral cytokines, further increasing the evidence that peripheral immune cells signal within the CNS.
  
  Meninges are a critical site of immune surveillance in the brain, it has turned out. The outermost dura layer is very tough, and the inner layers (pia and arachnoid matter) house CSF. The outermost dura is heavily vascularized and by normal blood vessels, not tight junctions. So peripherally produced cytokines can go from dural vessels, across the arachnoid matter, into the CSF, and then into the brain through glymphatic influx.
  
  Microglia are the resident macrophages of the brain. We’ve known for about 100 years that they are able to phagocytose other cells, and that they change in response to various stimuli. A lot of breakthroughs have been made in the last 50 years because we’re now able to culture them, see what stuff they produce, and identify cellular markers for different subsets etc. They’ve been found as a component of senile plaques in AD. A further breakthrough came when we were able to express GFP in mouse brain driven by a promoter for a receptor only found on microglial cells. So now we can look at them without IHC, in a live brain. It was then found out that even when they’re “resting” they’re super active and surveying the environment. Also that if there’s brain injury, they immediately stop what they’re doing and shield off the injured site. Microglia are actually mesenchymal in origin (along with blood, muscles, etc), but they enter the CNS early in development. Most interesting to me, microglia play a role in early learning-related synapse pruning, and also seem to play a role in synaptic plasticity in adulthood. For example, adult mice left in darkness for 24 hours were seen to have microglia-mediated synaptic restructuring in the visual system.
  
  The author covers all of the above info, and does it well. That’s the first third of the book. After that, it really goes off the rails. She asks:
  
  “What’s driving rising rates of early-onset Alzheimer’s, midlife distress, depression, addiction, and suicide, and an epidemic of debilitating anxiety in adolescents? Is something in our environment triggering these tiny cells to express more inflammatory factors, and potentially eat more synapses—resulting in more disease?”
  
  Her answer: haywire microglia. This could be due to over-influx of stress hormones, an infiltrating virus, allergen, other pathogen, toxic chemical, etc. “All too often [microglia] went too far, destroying every synapse in the neighborhood.”
  
  Just like the rampaging microglia of her narrative, the author seizes on a bit of true information, and runs wild. There is evidence that overactive microglia may exacerbate pathology in some neurodegenerative diseases. For example, in the field of Alzheimer’s disease, Rudolph Tanzi at Harvard discovered that CD33 (a microglial marker and on/off switch) is elevated. He believes that we didn’t evolve to live long enough to get dementia, so microglia see any sign of brain damage and clear it aggressively, thinking it’s infectious. But ironically, this contributes to the dementia. Many scientists still thought that maybe microglia were just reacting to the pathology and actually helping, until TREM2 was discovered soon after. TREM2 reins in microglial activation, and knocking it out worsened symptoms and overexpressing it improved symptoms in mice. Higher TREM2 in humans is associated with less severe disease in AD. These recent findings are new, and whether microglia actively exacerbate pathology in AD remains unclear because mouse models of AD don’t replicate the full scope of human disease well. Mice for example, can be induced to accumulate human Aβ after the introduction of human genes (mice don’t get AD normally) but the accompanying cognitive deficits are elusive. In development now are a handful of drugs that specifically inactivate microglia that are being tested in animal models of various diseases. This will likely yield really interesting information in the next 5-10 years, especially once they go to human clinical trials. Right now, the evidence is suggestive, but by no means conclusive.
  
  So it’s true that any neurological disease you care to name involves activated microglia, but it isn’t necessarily true that overactive microglia are causing these diseases. You could just as easily say all peripheral diseases are caused by a pathological overactivation of white blood cells. The author is intent on framing everything through the lens of overactive microglia, and weirdly, also through the lens of autoimmunity, perhaps because of her own personal experience. You can have immune cells misbehaving and exacerbating the disease they initially were trying to quell without it being an autoimmune issue. For example, monocytes in the blood initially help clear plaques in atherosclerosis, but after prolonged activation and inflammatory changes, they transition into foam cells and actively contribute to the worsening of the disease. That’s not autoimmunity. But in this book, the author seems to forget that these two things don’t necessarily go together.
  
  As a scientist with a background in toxicology, I found it especially exasperating when she went from “we are exposed to eighty thousand chemicals that have never been tested on the human immune system” to they’re definitely poisons and contributing to our confused microglia. I kept getting hints that she was a certain kind of crazy when she started assuming all chemicals were poisons and kept lauding people in the book for “staying paleo” and “eating clean.”
  
  Similarly, she clearly doesn’t understand sLORETA and its limitations very well (you can’t look at output from it and decide someone has “ruminating thoughts” for example), and she’s very hazy on neuroscience and the immune system in general. She makes basic mistakes like misclassifying T-cells as separate from white blood cells.
  
  Overall, the does a good job in the first third of the book, but then reaches well beyond her understanding. In the first third, she writes clearly and informatively about real and very exciting science about microglia, which is a topic many readers will not have heard of before probably. So that’s very cool. She weaves science and personal stories together well, though relied too much on story in the latter 2/3 of the book for my personal taste. Also, the “science” in the latter 2/3 of the book is mostly wrong, and somewhat dangerously presented. The combination of overestimating the knowledge we have about the role of microglia in brain diseases along with misrepresenting the efficacy of current treatments will, I worry, be a perfect storm of fear mongering to agitated sufferers of hard to treat illnesses. They’ll likely not have access to the cutting edge research techniques she outlines, but from reading this book they’ll think they’re being denied extremely efficacious and non-invasive quick-fixes.
  
• 
  Mary

  Terrible Title. Instead of a book about new developments in the field of neuroscience, one would think it was a pulp fiction novel based on its very poorly chosen title.
  
  For years scientists believed that the brain was in someway isolated from the rest of the body. However, new studies have shown that is not the case. Glia cells are the star of this book. The author follows three different patients who are being treated with different therapies based on their symptoms.
  
  It turns out that the glia cells rambling around in our brains are the shiftless no action cells scientists always believe them to be. It turns out that these cells play a major role in how our immune systems works both in our favor and to our detriment.
  
  For example, glia cells can play a role in the destruction of brain synapses. It’s a good thing for glia cells to remove the old, dying connections, but they can go overboard and begin attacking useful needed connection. And this activity may play a role in the development of Alzheimer’s disease. Scientists also now believe that glia cells may play a role in auto immune diseases like lupus. But glia cells can also be used through different therapies to treat depression, anxiety, and reduce inflammation in the brain which may cause diseases like schizophrenia.
  
  Good reading.
• 
  Ashlee Bree

  My first thoughts: Illuminating. Startling. Objectively informative. Emotionally and psychologically resonant. Broad conceptually yet personal in context. Explanatory on the whole without crossing the line into yawn-inducing drudgery that slaps research statistic after research statistic, or fact after scientific fact, to the forehead in the hopes that details about microglia will be absorbed into the brain via osmosis then fired from synapse to synapse until it embeds itself there: read but not comprehended, learned but not in a way that warrants more questions or reflection after the last sentence has ended.
  
  Also: Scientifically significant. Balanced between person-focused narration and fact reporting. New knowledge, tailored medical treatments. Surprising connections that send your mind into empathetic overdrive, churning those thinking wheels to exertion so as to induce elbow-under-the-chin musings.
  
  To speak more plainly, this book may be many things but dull and impenetrably dense isn't one of them. It offers a penetrating look into present knowledge and future therapies for inflammatory disorders. Doing so in approachable language, with person-by-person examples, Nakazawa catalogues how microglia, as the white blood cells of the brain, can act as destructive "assassins" that invade healthy cells and cause physical/psychiatric disease or as healing "angels" that already are (or may be) manipulated by scientific intervention someday to reverse damage in the body.
  
  Seeing as how I suffer from multiple autoimmune issues myself, I found this to be instructive as well as intriguing. Relatable, too, given the mental/physical struggles that accompany anything chronic or malignant.
  
  This foray into microglia's role in the body gives the mind/body connection of disease concrete validity. Something definitive, observable, and testable in laboratories around the world. Nakazawa lays out research and interviews with experts who discuss how microglial cells are the main culprits of inflammation in the brain because they "were/are mistakenly eating away synapses that shouldn't be pruned away," thereby contributing to neuropsychiatric or neurodevelopmental disorders like depression, Alzheimers, glaucoma, lupus etc. The author also personalizes the science by weaving in her own trials with Guillain-Barré syndrome, by chronicling treatments that Katie Harrison, Heather Somers, and Lila Chen all try to alleviate their symptoms. Doing so allows readers to bounce back and forth between the faceless objectivity of science and the human subjectivity of what it means to suffer from a persistent illness.
  
  I am so glad I picked this up! It demolished my meager expectations. It was amazing to ponder the idea that science has uncovered a specific underlier of inflammatory disease. A cellular bridge between mind and body--finally.
  
  Thanks so much to NetGalley and Ballantine Books for the ARC!
• 
  Lauren

  I loved this book! I'll admit that I'm partial as someone who studies the cells, microglia, that she writes about in this book. I also have a fondness for having read the science she describes when it emerged and met many of the scientists she interviews.
  
  Generally, though, she's a gifted "popular science" writer and humanizes the translation of bench science to the clinic in a tender, careful way. If you've been struggling with mental illness and treatments are not working, it might be an inspirational book for asking for new treatments and working toward a liveable life.
• 
  Cynthia

  This excellent piece of medical journalism explores new research on the brain and the immune system. The writing is fresh and interesting, and the author is a born storyteller. She takes you into the lives of several patients suffering neurological malfunctions, following them through their debilitating symptoms, initial consultations, treatment, and their lives after ground-breaking medical procedures.
  
  This book is highly recommended for anyone seeking to understand the underlying causes for psychological and neurological disorders and diseases. Researchers on the cutting edge of brain research are profiled in depth, along with details of their findings and procedures. The book is understandable by intelligent lay people willing to dig deep on a fairly technical topic. Excellent book, highly recommended.
• 
  Iryna Khomchuk

  На позір це книга про медичне відкриття. В анотації так і написано: йдеться про мікроглію — крихітні клітини, на які зазвичай не надто зважали медики й біологи. Аж доки не з’ясували, що ці клітини, активуючись для виконання своїх основних завдань: прибирання відмерлих клітин й допомоги імунітету, — можуть значно нашкодити своєму власнику. Психологічні проблеми, когнітивні порушення, автоімунні недуги — часто це все наслідок неправильної роботи клітин мікроглії, які з янголів перетворюється на вбивць.
  
  Однак насправді книга не лише про медицину. Вона про багато дуже й дуже важливих речей, нібито не дотичних до біології, які, проте, впливають на здоров’я кожного з нас. Авторка підіймає багато проблемних питань, які змусили мене подивитися на деякі речі під зовсім іншим кутом, дещо переоцінити, а щось і взагалі викинути з життя (принаймні постаратися це зробити).
  
  Загальновідомо, що до багатьох фізичних хвороб призводять психологічні причини. Однак у нашому суспільстві про це говорити не можна! Чомусь бути хворим фізично — пристойно, а психологічно — ні. Стигматизація психологічного нездужання призводить до того, що про будь-які його прояви, як-от апатію, хронічний стрес, емоційне вигорання, депресивні розлади, люди воліють мовчати. Ліпше приховувати такі проблеми, ніж дозволити іншим вважати тебе ненормальним. Таким чином, ці невеликі спочатку порушення мають серйозні наслідки.
  
  Статистично доведено, що найчастіше від психологічних порушень страждають жінки. Вони настільки зосереджені на тому, аби забезпечити добробут (у тому числі й психологічний) дітей і чоловіка, а часто — й усієї великої родини, що піддають себе надмірному емоційному й стресовому впливу. Відчуття нікчемності, провини від того, що ти не здатна забезпечити свою дитину всім, безсоння — це вже ознаки психологічного розладу. Хто у нас на них зважає? А найгірше те, що такі жінки не дозволяють навіть собі самим визнати: у мене є проблема. То як і хто має нам допомогти, якщо не ми самі? Отож...
  
  Крім того, нині потрібно враховувати тиск соціальних мереж і показово щасливого життя. Це все викликає токсичне отруєння, особливо в підлітків (здебільшого в дівчат — теж статистика). Постійні й наполегливі підказки, як має виглядати тіло, які гендерні ролі мають виконувати дівчата, як чинити в тій чи іншій ситуації, аби тебе любили, поважали й заміж покликали, — це ніщо інше, як психологічне зґвалтування. І його дедалі більшає... Ніхто не відміняв і сексуального домагання — як у реалі, так і у віртуалі. До того ж з усіма стресами дівчата мають впоратися самі — у сучасному суспільстві, як правило, бракує розуміння та підтримки в сім’ї, адже ми всі дуже й дуже зайняті власними проблемами, з якими мусимо впоратися самотужки. Хлопці також, звісно, страждають — соціальні вимоги щодо успішності й маскулінності ніхто не відміняв. Проте їх це зачіпає все-таки менше.
  
  Коротко кажучи (хоча коротко вже не виходить)), оце-от все шалено впливає на фізичне здоров’я. Бо стрес — це адреналін. Адреналін одразу активізує імунітет (а раптом вас вкусить вовк, від якого ви наразі втікаєте, й треба бігом від бактерій, вірусів тощо позбавлятися?). Імунітет своєю чергою робить свою роботу й активізує мікроглію. А вона старанно включається в роботу, знищуючи в тому числі й синапси клітин головного мозку... Здається, коротко все-таки вийшло викласти механізм, описаний в книзі))) А докладніше й науковіше про нейроімунологію ліпше розкаже Донна Джексон Наказава.
  
  У книзі, крім згаданого, йдеться про методи лікування психічних розладів, деменції (хвороби Альцгеймера) посередництвом впливу на мікроглію. Докладно розповідається про методи нейрофітбеку — це коли мозок "тренують" не стресувати, а працювати іншими своїми клітинами (якось так))). Розвінчується усталене твердження про гематоенцефалічний бар’єр: уже доведено, що лімфосудини пропускають у мозок клітини, що відповідають за імунітет. І ще багато всякого-різного цікавого, викладеного доступно й науково водночас.
• 
  Rosie Gearhart

  HOPE. That's what this book gives me. Hope for people with mental illnesses that have been unresponsive to current methods of treatment.
  
  The overall goal of the book is to let the layperson know about the progress that has been made in the last 10 years in brain research. Apparently, contrary to what everyone has thought, your brain is an immune organ. Little cells called microglia act a lot like the blood cells in your body. Just like your regular immune system can get out of whack and start attacking instead of helping the body, so too can microglia. Research is moving in the direction of figuring out how to get microglia to do what they are supposed to do.
  
  A lot of the new treatments aren't going to be approved for a while or are currently very expensive, which tampers down my hope a bit, but I was able to find several psychologist/psychiatrist offices near me that use one treatment, and another treatment I can do on my own and is completely free. So, I press forward, thankful that there is more to try....
  
  The book was written by a journalist and very easy to read. She included real life case studies and explained the science clearly. Highly recommended for those interested in the topic.
  
  Some quotes I don't want to forget (since I borrowed this from the library):
  
  During these years [2012-2017], scientists also unveiled that these microglial cells in the brain were chatting with the body's immune cells in direct and indirect ways: If there was inflammation in the body, there would almost inevitably be immune changes within the brain. Moreover, these immune changes in the brain could manifest themselves as cognitive or neuropsychiatric disorders.
  
  These immune changes could affect the brains synapses and neural connections even when there were no signs of physical illness in the body itself.
  ...
  
  In the body, when the immune system gets overwhelmed and signaling mistakes occur, our immune cells can begin to attack the body's own tissue and organs. In the brain, when the immune system gets overwhelmed, or microglia receive faulty signals, they start to spew out inflammatory chemicals and eat away at the synapses that give us mental stamina, hope, joy, and clarity of mind.
  ...
  
  Hundreds of research studies tell us that strategies to tame stressful thoughts and rumination also help to reduce the day in, day out toxic cocktail of "fight, flight, or freeze" inflammatory chemicals sent forth by our nervous system whenever our stress response is set on high. Lila makes good use of a number of these mind-body methods. She is a fan of body scans, guided imagery, breath work, neural "self-talk," hypnosis, strength training exercise, restorative yoga, and walks in nature, all in an effort to downshift her stress response and calm down her immune system in any way she can.
  ...
  
  "When you have a person fast in a safe, controlled, and measured way, everything in the body shrinks down a little, including the immune system," says Longo. " By tricking the body into thinking that it's running out of fuel, the immune system uses this opportunity to reduce its function, refresh, and restart; it gets busy destroying damaged autoimmune cells. When you begin to add calories back in, everything rebuilds--only this time, at least in mice, the damaged cells are gone and healthy new stem cells repopulate the body. They start making necessary repairs."
  
  Degenerated myelin regenerates.
  
  In animals on the fasting-mimicking diet (as compared to a control group), there is a noted reduction of both inflammatory microphages in the body and inflammatory microglia in the brain. Both body and brain hit the Refresh button.
  ...
  
  Not only does untreated depression do more damage to neurocircuitry over time, but treatment with antidepressants may help, to some degree in ways we don't yet completely understand, to slow microglial damage.
  ...
  
  But there are also problems with this concept that neurotransmitter imbalances are the primary driver of psychiatric disorders.
  
  First, although some individuals with depression do demonstrate low levels of serotonin or other neurotransmitters, many do not. Some have abnormally high levels of serotonin. Neurotransmitters may be out of whack, but the resulting chemical imbalances are different in each individual. And that is because neurochemical imbalances are not, in and of themselves, the cause of the disease, but rather a sign of a more profound underlying problem.
  
  The microglial universal theory of disease tells us that when microglia, and the immune system of the brain, sense unmitigated stress, trauma, infection, illness, or toxins, or receive inflammatory signals from a microbial imbalance in the gut, this in turn triggers them to morph from brain savers to synapse slayers, and to release toxic cytokines. These actions alter the availability of neurotransmitters and growth factors, which changes how well signals move between neurons. As the brain's ability to synthesize brain chemicals is diminished, it leads to neural impairments that poison mood, sleep, stamina, concentration, and cognition.
  
  Happy microglia, on the other hand, help to nourish and support neurons and synapses, and this in turn helps to refresh neurotransmitters and maintain them at healthy levels.
  
  Disorders of the mind are first and foremost immune disorders that reflect alterations in the brain's basic immune health.
  
  This is no doubt why the serotonin theory of brain disorders has not really turned out to be the great hope it was initially thought to be: Chemical imbalances are not the root of the problem, but a symptom of it.
• 
  Hana

  2.4⭐️
  
  I don’t find the time to read as much as I used to, so I tend to pick books that I expect to really like. The reasoning behid my (kinda) harsh rating is that, comparing this book to others I’ve read it falls short as I pick my books somewhat carefully ig?
  
  I love non-fiction science books but this book was far too reductionist and pseudo-sciencey for my taste. I felt like the author (as she is a science-communicator/journalist) sensationalizes the findings too much and presents cherry-picked experiences. + sometimes it felt like a chapter was a commercial for patented diet/ treatment
  
  However, this book included some interesting theories and facts (evolutionary theory of depression as an “autoimmune protection?”, statistical data about depression,…).
  
  
• 
  Haur Bin Chua

  Microglia is a brain cell that maintains the balance within the central nervous system by removing dead or unwanted cells and mediate neuroinflammation. This book explains, in simple terms and through stories, how this cell can be an angel or an assassin if not kept in homeostasis.
  
  There can be many reasons behind the imbalance - environment, genetic, physical or psychological trauma, drugs etc. Once microglia goes berserk, they start chomping on other brain cells and stop mediating neuroinflammation, which can result in diseases like MS, Alzheimer’s and schizophrenia.
  
  There are early-stage treatments for regulating microglia including magnetic stimulation of the brain, neurofeedback trainings and diet but nothing conclusive yet. Hope for more breakthroughs in this space!
• 
  Justin Lamb

  Great way of explaining a level of psychological neuroscience that would be boring and hard to understand in an academic setting. The real world, real time storytelling aspect helps the reader to understand the role of the microglial cells, as well as the various treatments that are being reached to control their synaptic feeding.
• 
  Anne Gentine

  This book is INCREDIBLE. I love it, so fascinating
• 
  Lisa Wells

  I'm not one to use "scientific" and "exciting" in one sentence, but this book has brought me to just that. DJN takes some pretty heavy-duty and cutting-edge science and makes it accessible to readers that is exciting, but also a bi alarming and promising. The combination of these three and the beautifully written narratives make this informative and exciting.
• 
  Ben Zimmerman

  While The Angel and the Assassin summarizes an extremely important topic in the neuroscience of brain pathology, it makes many of the types of errors that lead to sensationalism and overextended science journalism. I think that these kinds of errors are dangerous. This was especially disheartening for me to see here because I don’t think that this topic really required this kind of overstepping to sell a good story. The shifts in thinking about the interaction between the immune system and the brain and the role of microglia in brain pathology has really made astounding progress in the past decade and has really changed the way that a lot of neuroscientists think about brain pathology.
  
  However, the writing could be a study in the classic kinds of errors that lead to bad science. It’s easy to say “correlation does not equal causation,” but the reason that we repeat it so often is because it’s so intuitively easy to do. In general, I got the feeling that the author had bought so strongly into the microglia narrative that she was unable to see how causation could work in some other direction. For example, she states that ECT and TMS work for depression because they de-activate microglia, which cause depression. No alternatives are presented. Even though it is just easy to believe that TMS and ECT may change the brain in some way that influences both depression and microglia activation independently. Or that changes in neural activity, caused by TMS or ECT, could then subsequently lead to decreases in microglia activation.
  
  One of the cardinal sins of neuroimaging is called “reverse inference.” This is when you infer some cognitive state or behavior from some kind of pattern of neural activity measurement. This is dangerous primarily because brain areas do many different things, differ somewhat on an individual basis, and also because our measuring tools are not exact. So for example, if I scan the brains of 60 individuals while they look at upsetting images, and then do a group analysis, I may find that, on average, the amygdala is significantly more active while participants are looking at upsetting images. This does not mean that when I scan the brain of any individual, that if their amygdala is activated it means that they are looking at an upsetting image. We see reverse inference play out particularly in chapters on real-time EEG. One of the personal narratives in the story follows Heather. Heather is not presenting with cognitive problems, but her brain imaging shows non-normal brain activity in her frontal cortex. Because these areas have shown up in studies on attention, the physician concludes that Heather has attentional problems and didn’t even know it, even though she appears to be functioning normally. Heather later comes to agree. To me this is the worst kind of unsupported reverse inference leading to suggestive influence. To the author, it’s just more incredible evidence of the success of the technique. It reminded me of a person I once met who told me that she had a special device on her wrist that treated Lyme disease with magnets. She went on, “The craziest part was that I didn’t even know I had Lyme disease before the device diagnosed me.”
  
  Another major scientific sin is extrapolating from weak effects based on large groups in the scientific literature to individual cases. An example of this is when a patient does not show substantially increased alpha power with her eyes closed. This is normally observed. The physician concludes that this is evidence of her being depressed. Firstly, abnormal oscillatory power has been implicated in many kinds of pathologies, not just depression. Alpha reactivity, which is the measure that he is using, has been observed in studies on a range of mental disorders. Secondly, not all people with abnormal alpha power patterns have a mental disorder. There is substantial individual variability, both in brain dynamics, but also how those dynamics may be measured on the scalp. Oddly, I don’t have identifiable changes in alpha power with my eyes closed either, an annoying feature that I learned about myself during an experiment. I am not depressed.
  
  In a similar vein, the author talks about how in a study of low back pain, the researchers could tell whether someone was a pain patient or a control just by looking at their PET scans of microglial activation. That is an astounding statement, and while that 2015 paper was very impressive, I think that such a statement should lead with more caution. Those authors had only 10 patients and 9 age and sex-matched controls. What the authors found was that for all 10 of the patients, they had a greater magnitude of the microglial activation marker than their age/sex-matched control. But the range of the microglial activation measured between the groups overall overlapped. It is not clear at all, based on the sample size of 19, that this result would extrapolate to the entire population.
  
  In general, science journalists should use anecdotes and case studies to draw in the reader, but rely on well-conducted, peer-reviewed science to make their scientific points. In this book, the author relies heavily on anecdotal evidence to actually make the scientific points. For instance, in talking to a physician, the physician states that he believes that dialectical behavior therapy and cognitive behavioral therapy work better with neurofeedback, and this is presented to the reader as if it is true. This empirical, scientific statement is what we in the industry like to call “a hypothesis.” This one is a very reasonable hypothesis. I didn’t look this one up, so I have no idea if it’s true. It’s annoying to need to keep track of the facts that have been experimentally validated and facts that some guy believes (even if that guy is well-educated).
  
  Finally, I felt that new technologies and interventions were presented with a little too much gusto. For instance, gamma light flicker therapy worked very well in reducing amyloid plaques in a few mouse studies. This is an exciting breakthrough! But there is a lot of precedence to be worried about translating a result like this to humans with Alzheimer’s disease. There have been myriad treatments now that work really well in preclinical trials in rodents, only to fail at clinical trials. So far, Cognito Therapeutics looks like it will be similarly less effective than in the initial animal trials.
  
  There were also just red flags to me in the way that the author discusses certain topics. For example, sLORETA is an algorithm, not a “program”. Furthermore, sLORETA tries to solve the inverse problem of source localization for EEG on the scalp. This problem is unsolvable if there are multiple dipoles (which there are), and so source localization is contentious in EEG research because the problem is ill-posed and there is lots of highly correlated activity throughout the brain. The localization of brain activity through EEG has excellent applications – like neurofeedback – when you have strong assumptions about the location of sources of neural activity. But it might not be advised for, say, diagnosing someone with ADHD or attention problems. There is no discussion of the cautions and benefits to using sLORETA, even though so much of the science presented is based on it in the book.
  
  While I enjoyed learning about the history of the discoveries that led to the growing evidence supporting the previously overlooked role of microglia activation and inflammation in disease, l disliked how much work it was to parse the wheat from the chaff. It shouldn’t be my job to write so many caveats in a review. A good science journalist would put caveats everywhere and would do an excellent job making it clear what scientific information stands on solid ground, supported by lots of replications of good evidence.
  
  I did appreciate a lot of the themes of carried on throughout the book. I loved the themes of how diagnostic techniques intersect with treatments. For example, is “depression” one thing or several things, each waiting to be treated a different way. I appreciated a science journalist bringing attention to the value and need for better diagnostics because I think it is intuitively more appealing to spend all our money and energy on finding treatments to relieve suffering. The author shows us why seriously investing in diagnosis is just as important. I liked the philosophical musings about how the history of scientific and philosophical thought, like mind-body dualism and Freud’s appeal to distance psychotherapy from biology, may still have ramifications percolating through the way we do science today. And I enjoyed the focus on how the world is changing, and how those changes interact with our biology in sometimes unpredictable ways. There is a lot of good in this book, but it needs to be studied with such skepticism and diligence that I would not generally recommend it.
  
• 
  Linus Williams

  I really hate to give this a 3* rating. The topic matter is super interesting, but the book whiffs on its execution. Correlation does not imply causation, and this book is super reductionist (and it has to be!) Inflammatory microglia might indeed be the cause of all mental illness everywhere--or they might be one part of a multifactorial condition. Or they might even be the symptom of intrinsic derangements in the brain. Who knows. I approve of the attempt, but to simply say that A + B = C almost never holds true in biology. Personal anecdote and the placebo effect also have to be mentioned--how much of the improvement in the patients she interviews is due to access to support and the feeling that the treatment is working? A sham group would be nice, although possibly unethical to interview.
  
  It's interestingly written, but it suffers from the critical flaw of all science journalism everywhere, which is a reductionist, entirely too simplistic, approach. 3.5*
• 
  D.A. Brown

  Mind Blown.
  
  Suddenly there seems to be a window of hope for resistant diseases like depression, schizophrenia, Alzheimer’s, and more- through the manipulation of glial cells.
  The advances in knowledge of the brain have been fantastic in the past 10 years. This book lays them
  out in a very accessible, involving manner- I sped through it, wrapped up entirely in the patients and scientists interviewed.
  Mind boggling.
  Perhaps the best science book I’ve read in years.
• 
  Heli

  The facts deserve 5stars, so it's very beneficial to read this book. To me the style, walking you though every dialogue someone had about treatments received was redundant, but I get it that to regular audience such slow pace is more relevant to get the message home. So all in all it's a recommended read, especially to psychiatrists.
• 
  Dina

  Writing 5; content/science 2.5
• 
  P D

  In 2008, I asked my immunology professor if there was a relationship between the immune cells and the brain. He told me, flat-out, no. So it's honestly incredible how far the science has advanced since then.
  
  This is very, very much a book aimed at patients, families of patients, and those who would simply like to understand more about all the potentially microglia-connected diseases out there, but who do not come from a science background. The notes give you a sense of just how much research went into all this, but the presentation of the book is much more focused on people. Even the segments on research are told more as simple quotes from the researchers, as opposed to nice long paragraphs that wouldn't be out of place in a particularly accessible textbook.
  
  Anyway, that made it a hard read for me. Bio majors, you may want to reference the notes here and borrow someone's university access if you don't have one yourself.
  
  Anyway anyway, what I did appreciate - and what is definitely relevant to me - is the neglect, and more importantly the dismissal, of diseases that tend to be more prevalent in female populations. (Yes, she mentions males. Don't twist your panties, MRAs...although I realize that's a lost cause.) The personal stories focus on women who are in turns dismissed by their families as exaggerating/etc, who are expected to provide care while working and dealing with their own severe illnesses...so on and so forth. Not only that, but decades of medical science have done jack shit for them. (Never forget that, even through recent times, there were more papers written on male pattern baldness than endometriosis.)
  
  Even though mental health disorders cost billions of dollars a year - medical expenses, inability to be active, etc - a significant portion of patients with these conditions haven't been successfully treated by modern medicine. (I believe it's 15% of depressed patients who have 'treatment resistant depression' - which is to say that throwing neurotransmitters at the problem doesn't work for them.) However, with the introduction of immune pathways, new treatment options are opening up. Nakazawa is careful to mention that these don't work for everyone, although the case studies in her book are successes.
  
  People with autism may not appreciate how she talks about it as a disorder - I'm not sure if being clear to differentiate between the associated disease state of neuroinflammation, versus behavioral differences that are simply a different but no better/worse mode, would help there - but I rather think that is supposed to be implied.
  
  This isn't a bad primer to the current state of microglia research, and how it's transformed our understanding of immunity in the brain, although it's definitely aimed at the lay audience. (Which is probably a selling point!)
• 
  BOOKLOVER EB

  If you have never heard of microglia (they function as the white blood cells in your brain), you will learn a great deal from Donna Jackson Nakazawa's thought-provoking work of non-fiction, "The Angel and the Assassin." Nakazawa is an accomplished science writer who tackles a complicated subject and makes it comprehensible to the average reader. The book's premise is that the human brain and body are inextricably linked. Environmental chemicals, traumatic brain injuries, chronic stress, infections, and autoimmune diseases, such as lupus, Crohn's, multiple sclerosis, and rheumatoid arthritis can trigger deep depression, anxiety, psychosis, and even early-onset Alzheimer's. When someone's immune system goes into overdrive to reduce inflammation, small cells known as microglia may protect and repair the brain's neurons and synapses or, conversely--when things go awry--severely damage them. The consequences can be devastating.
  
  Nakazawa's interest in the subject was piqued when, after coming down with Guillain-Barré syndrome, she spent "all told, a year in bed or in a wheelchair." Her doctor at Johns Hopkins explained that her body's immune system was "behaving erratically, like an army gone rogue." Although she eventually recovered, the author was eager to understand the cognitive changes that she experienced during her illness. Not only did she suffer from a "black-dog depression," but her memory became erratic, as well. She believed that this was more than just a side effect of her physical challenges.
  
  To illustrate the toll taken by harmful microglia (these cells can be "angels" when they clear toxins and other rubbish from our brains), Nakazawa recounts the struggles of three patients--their names and histories are disguised to protect their privacy--two of whom had autoimmune disorders coupled with distressing psychological symptoms. In addition, the author interviews researchers who explain what can happen when the immune system lays siege, not only to our bodies, but also to our memories, moods, and ability to carry out routine tasks. Fortunately, there are therapies, such as transcranial magnetic stimulation and neurofeedback, that may offer substantial relief. In "The Angel and the Assassin," we learn about the game-changing work of pioneers such as Dr. Beth Stevens, an associate professor of neurology at Boston Children's Hospital and Harvard. Donna Jackson Nakazawa's fascinating exploration of neuroimmunology, a revolutionary field of study that holds great promise, sheds new light on the intricacies of the mind-body connection.
• 
  William Burruss

  Written for people like me with minimal scientific knowledge and questing for information about mental illness, Donna Nakazawa starts with the incredible research by Dr. Beth Stevens regarding the workings of microglia – how they work and don't work. Stevens becomes a 2015 MacArthur Fellow and the recipient of $20M for her work. What is so fantastic about this research is how it has opened the doors for so many others, especially in what we considered mental illness.
  
  Like so many others looking for hope for a loved one, I needed to find a way to connect. Angels and Assassins show me that I want to reevaluate and enhance my understanding of biology and psychoanalysis. Nakazawa explains that dualism, the separation of mind and body, needs to be rethought. This philosophy is brought to fruition by Descartes, stating there is a separation of the brain from the body. Yet, recent research into microglia shows a connection between the two. Psychoanalysis, exclaims Nakazawa is another to be evaluated. Its father, Sigmond Freud, cautioned about bringing medicine and psychology together, but recent developments show the two are converging and becoming a different field of knowledge.
  
  This book's microglia story brings in several subjects. They live with rheumatoid arthritis, major depression disorder, concussions, Crohn's disease, Alzheimer's, anxiety disorder, obsessive-compulsive disorder, etc. Before 2015 we would not have known they had any connection with microglia; now we do. Before 2015, we thought that rheumatoid arthritis had no relationship with depression, but now we see that it can connect.
  
  How does this research change a life? Amazingly, in a short period since Dr. Beth Stevens' research, we are seeing a shift from pharmaceutical treatment to alternative medicine or a combination of the two. Several of these remedies are mentioned here by patients Nakazawa interviewed. They include TMS (transcranial magnetic stimulation), qEEG neurofeedback, gamma light flicker therapy, and fasting diets. - The reason for me reading this book is the change my loved one made with TMS treatment after trying medicines that were not working.
  
  People like me with minimal scientific knowledge desire information that we understand. We need a book like this. With improved knowledge, we can communicate with our loved ones, their medical staff, and insurance providers. Having several family members and friends with mental health issues, I want to thank Donna Nakazawa and her subjects for making their stories public.
• 
  Meric

  I’ve always been fascinated with human brain, how it functions and the vastness of its mysterious nature of it.
  You can imagine how intrigued I was when this book was mentioned during my Somatic Experiencing Trauma Practitioner training. Although summertime is usually when people chose to read lighter books, here I am, patting my back for making a great decision and reading this mentally stimulating book at this time.
  
  This fascinating non fiction book written in journalistic style by Donna Jackson Nakazawa makes complex topics accessible to general public thanks also to her great storytelling.
  
  In a nutshell, Microglia, a tiny brain cell, which was completely misunderstood for decades is now crucial in understanding and treating mental health and brain diseases. Understanding how microglia functions as the white blood cell of our brains and how it can repair or destroy neurons in our brains proved me once more how our bodies and minds are interconnected.
  
  Author not only explains everything clearly but also provides readers with real life experiences of people challenged with various conditions and allows the readers to connect, feel and get excited about their journey as well as the future of science.
  
  If you enjoy this book as much as I do, you surely will find yourself continuing your research on TMS (transcranial magnetic stimulation), neurofeedback, novel concussion protocols, gamma light flicker therapy and fasting diets as well as watching videos and reading more about amazing scientists like Dr Beth Stevens and feel gratitude towards all researchers who commit their lives to further our understanding of our bodies and minds and help human race.
  
• 
  Laura Weldon

  Thanks to insomnia, I read a good pile of books each week. I stayed up nearly all night to finish Nakazawa's revolutionary & relevant-to-everyone The Angel and the Assassin. Suggestion --you'll want a highlighter and post-its. Here are two tidbits:
  
  "The higher an individual's levels of inflammatory biomarkers, the more prevalent their psychiatric symptoms tend to be... This turns out to be true even when no signs of physical illness or inflammation are detected."
  
  "Whatever term we use to refer to these brain changes, they all mean the same thing: Tiny microglia are engulfing and destroying synapses, and this is the catalyst that sets in motion hundreds of different disorders and diseases that have long remained the black box of psychiatry and neurology. This means that the long-held line in the sand between mental and physical health simply does not exist. When an individual's immune system is overtaxed, for some, disease may show up in the brain, while for others it may show up in the body. It could inflame your joints, or your mind --- or both."
  
  The author shares information about possible treatments to restore the activity of our brain's immune reaction, moving from over or under-reaction to a healthy mean. This has profound implications for dementia, depression, and many other conditions resistant to treatment.
  
  My only criticism is I wish the author had used a less gee whiz tone when writing about these cures and had stepped well away from the proprietary side of the fast-mimicking diet, but these are very minor issues for a huge wow of a book. I want to buy a slew of copies to place in the hands of loved ones who might benefit from the hope in these pages.