Have you ever drunk alcohol in excess and gotten thoroughly intoxicated? If so, you have gotten a taste of what it’s like to have a toxic brain.

Alcohol is a socially acceptable toxin. When you are intoxicated, your brain is toxic. You cannot think clearly, your speech is slurred, you make poor decisions, you stagger around with loss of balance and coordination, and you become emotionally unstable—maybe tearful or belligerent and full of violent rage. Fortunately, when the alcohol clears from your body and the hangover passes, you will regain your former personality. In your case, the brain damage is temporary. Not everyone who experiences brain damage from toxins is as fortunate. 

Although toxic chemicals can affect any part of the body, the brain often suffers the most damage. Many of the most toxic chemicals in our environment are lipophilic which means that they have a strong attraction to fat. Over 60% of the brain is made of fat. 

Numerous toxic pollutants interfere with the functioning of the brain and nervous system and can lead to psychiatric symptoms. 

Although poor indoor air quality is part of American life, too few medical doctors and psychiatrists consider toxic chemicals as a cause or contributor to psychiatric symptoms and toxic encephalopathy.

What is toxic encephalopathy?

The words “toxic encephalopathy” refer to pathological changes in the brain caused by exposure to neurotoxins—chemicals that harm the brain and nervous system. Neurotoxins cause inflammation that can lead to impairment of learning new information, memory problems, and inability to concentrate. Neurotoxins are also known to cause anxiety, depression, rage attacks, panic attacks, obsessive-compulsive and bipolar behavior, suicidal thoughts, and other signs of emotional instability.

The neuropsychiatric symptoms are often preceded by a constellation of symptoms that can include chronic fatigue, headaches, lightheadedness, aches and pains, nightmares, insomnia, rashes, sinus pressure, burning eyes and blurred vision, asthma, and frequent upper respiratory infections. With low-level, short-term exposure the symptoms are usually reversible.

Persistent long-term, low-level toxic exposures can lead to degenerative brain disorders such as dementia, ALS, multiple sclerosis, and Parkinson’s.

How do toxic chemicals harm the brain?

There are myriad ways that chemicals can cause brain damage. They can mimic neurotransmitters and cause the brain to malfunction. They can attach to neurotransmitter receptor sites and block transmission of signals, leading to depression and cognitive impairment. Conversely, chemicals can cause an increase in the function of certain neurotransmitters, resulting in anxiety, mania, and schizophrenia.

Certain chemicals like pesticides and carbon monoxide are known to cause brain cells to die, leading to brain atrophy, impaired cognition, and sometimes dementia. Carbon monoxide poisoning causes oxygen starvation in the brain that can lead to long-standing brain damage from loss of neurons.

Case History 

Susan, a thirty-nine year-old woman from Denver, came to my office for the first time complaining of depression, anxiety, uncontrollable crying spells, irritability, debilitating fatigue, and “brain fog.” She had no idea why she felt so bad. She had a happy marriage, no financial worries, and got along well with her co-workers at an investment firm where she worked for the past two years.

Her friends told her that she was probably just stressed out by her work and didn’t realize it, and that she should take up some stress-reducing activities like a long vacation, mental health counseling, regular exercise, and mindfulness meditation.

Nothing seemed to help Susan feel better, including talk therapy. She consulted with several doctors about her symptoms. They ordered many blood tests and an MRI scan of the brain. The results of all the tests were normal. Because of those normal results, her doctors told her that she didn’t have anything physically wrong with her.

The last internist she consulted urged her to see a psychiatrist who prescribed an antidepressant called Paxil, and an anti-anxiety medication called Xanax. Susan said that the medications made her feel less anxious about her symptoms as they continued to progress, including difficulties with her memory and an unintentional loss of weight.

One of Susan’s neighbors in Denver had heard of me through a friend of hers who had consulted with me in the past about mold exposures. The neighbor suggested that Susan make an appointment with me to see if there was something in her home or workplace or in her diet that was making her sick.

Susan came to the appointment nicely dressed and coifed but looking anxious and pale, with bags under her eyes. She read to me a summary of her health history that she had written up the night before for the appointment, at my request.

Susan had been an outstanding athlete in her younger years and had excelled in school. She had never experienced any major health problems except for mild food and pollen allergies. About a year and a half ago, she began getting recurrent upper respiratory infections—six of them in one year. She also began getting headaches and body aches. In the past few months her list of symptoms had grown. She began to feel less able to do her job. She called in sick a few times with great reluctance, given her conscientious and hard working character.

I quizzed Susan about any history of sensitivities in her earlier life, before she went to work for the investment company. She said that she had always been sensitive to alcohol and could only drink about an ounce before she felt the effects. She also remembered how her eyes, nose, and throat burned when she walked down the aisles with the laundry products at her local grocery store. She remembered having similar sensations when she had new wall-to-wall carpeting put down in her home a few years ago.

Susan’s parents and siblings were healthy except for a brother who had rheumatoid arthritis. A review of her diet did not offer me any insights into her illness. Her husband worked as a park ranger and enjoyed excellent health.

The first clue to Susan’s puzzling symptoms came when she said that she and her husband liked to camp and how great she felt in the outdoors and how lousy she felt when she returned to work. She assumed her response meant that she had an unrecognized psychological problem with work.

From that one clue, I suspected that something in her workplace was making her sick. When I looked at the timeline of her symptoms that she had made for me, I could see that her first noticeable symptoms—headaches and burning eyes—began a few weeks after she started working at the investment firm. As time passed, her symptoms became increasingly more concerning and included episodes of confusion and trouble with her memory. Her husband noted that she had also become uncharacteristically irritable with frequent crying spells for no apparent reason.

Susan said that she probably wouldn’t be able to continue working because of her deteriorating brain function. As she said those words, she cried inconsolably. Through her tears, she confessed, “I’m terrified about what’s happening to me. I’m actually losing my mind.”

Before the consultation came to an end, I gave Susan a homework assignment to find out how old the building was where she worked, and if it had recently been remodeled. Her second assignment involved contacting the janitor and finding out if her company sprayed for insects, what they used and how often, and what kind of cleaning products they used, and if they used air fresheners.

Two weeks later Susan had her follow up appointment with me on the phone. She had learned that the building where she worked had been remodeled a few months before she got hired. The remodel included new carpets and cabinets.

The janitor gave her a list of the products he used for cleaning. Susan brought the list to the appointment. The janitor said that a company came in once a month on the weekends to spray for bugs—even though no bugs had ever been seen on the premises. The pest control company used Dursban. The main ingredient is chlorpyrifos, a pesticide known by the Environmental Protection Agency (EPA) to cause brain damage.

The results of Susan’s homework assignment gave me all the information I needed to say with certainty that she was working in a toxic building and that the cleaning products, the materials used in remodeling, the air fresheners, and the pesticides were damaging her brain.

I wrote a letter to the president of her company and asked that Susan be given “reasonable accommodation” under the Americans with Disabilities Act (ADA). I asked that she either be allowed to do her work from home or that a good faith effort be made to remove the toxic substances in the building and to replace them with less toxic materials. I included in the letter a list of non toxic products to use as possible replacements for the toxic chemicals Susan had been exposed to at work.

Susan’s boss contacted me and said that work from home was not possible and that changing all the products they currently used in the building was not realistic. He said that he would be happy to accommodate her in other ways, like giving her an office all to herself, with a window that could be opened, and a high quality air filter that she could run continuously in her office.

Susan felt hopeful that the new arrangement would make it possible for her to keep her job with the investment company. After a month, Susan reported that she still felt awful and realized that she had to quit and figure out some other way to support herself.

This unfortunate chapter in Susan’s life eventually had a happy ending. She took a year off from work and dove headlong into her get-well program, with the emotional and financial support of her husband. Weaning off the two psyche medications was the first item on her agenda.

Although the toxic exposures had left Susan with an onerous condition called multiple chemical sensitivities, she learned how to successfully navigate our toxic world.

Over time and with unwavering dedication to getting well, Susan eventually reached a level of mental, emotional, and physical health that she had never experienced in her life.

She wanted to share what she learned with all her friends and family. Unfortunately, they didn’t show much interest in pursuing a similar path. Undeterred, Susan signed up for a yearlong course to learn how to be a health coach. She said to me, “I found a big silver lining in that horrible experience at work. In the end, it changed my life for the better. Who would have ever guessed?”

Indoor Air Pollution 

Employed people living in the U.S. spend an average of 92% of their time indoors, 6% in transit, and 2% outdoors.

These statistics are significant in light of the disturbing fact that indoor pollution can be as much as 100 times higher than outdoor levels and can have a profound impact on our overall health and wellbeing.

Two primary sources of indoor air pollution are the materials used to construct or remodel our buildings, and all the chemical products brought into those buildings, including air fresheners, scented laundry and body products, and pesticides.

Many of the toxic products found in the home and workplace release volatile organic compounds (VOCs) that can cause short-term and long-term health effects, including toxic effects in the brain.

Chemicals in household products are not federally regulated. The companies that manufacture the products are not required to meet any safety standards before bringing their products to market.

The average household contains dozens of toxic chemicals that we are exposed to continuously over a lifetime—from synthetic fragrances to the noxious fumes from paints and solvents. Chronic exposures increase the body’s “toxic load,” adding to the risk of cancer, reproductive disorders, hormone disruption and neurotoxicity—including mental illness and mood disorders.

What neurotoxic chemicals can be found in a typical home or workplace?

Potentially dangerous chemicals can be found in nearly every room in a typical home and office building. Many of the chemicals are known to cause health problems that range from mild to serious.

The most dangerous substances are volatile organic compounds (VOCs) that outgas their noxious chemicals into the air. The word “outgassing” refers to certain chemicals in a solid or liquid state that readily evaporate into the air as gases.

Let’s take a virtual tour of the rooms in a typical American home. We’ll look at a few of the many toxic products that are commonly used.

Kitchen. In a new or recently remodeled home, formaldehyde outgasses from the plywood and particleboard used to make the cabinets.

Formaldehyde exposure can cause multiple health-related problems, including inflammation in the respiratory tract and the brain, seizures, mood instability, cognitive decline, and multiple chemical sensitivities.

The dish soap is scented with artificial fragrances. Ninety-five percent of the chemicals used in synthetic fragrances are derived from petroleum (crude oil) and include benzene derivatives, aldehydes (in the formaldehyde family of chemicals), toluene, along with other chemicals, many of which are known to be carcinogenic. Synthetic fragrances can also affect the brain and nervous system adversely, causing bipolar symptoms, irritability, rage attacks, anxiety, and depression.

Scented products are becoming a significant source of air pollution. Researchers have compared the level of pollution from traffic to the levels created by artificially scented products.

One of my patients remarked that artificial fragrances have become the new second-hand smoke that we’re breathing—whether we want to or not.

Under the sink, among the many containers, is a can of Raid. This insecticide contains pyrethroids, piperonyl butoxide, and permethrin. These chemicals kill insects by disrupting their nervous system, resulting in paralysis and death. In susceptible people, the chemicals in Raid can cause permanent nerve damage.

Other insecticides include chlorpyrifos and diazinon. Repeated exposure to these chemicals can cause headaches, depression, anxiety, flu-like symptoms, “brain fog,” and cognitive decline.

Living room. New synthetic carpets along with their backing can outgas many neurotoxic chemicals for months, polluting the indoor air and putting the occupants at risk for anxiety and depression, and neurological symptoms.

Rug and carpet cleaners contain perchloroethylene (used in dry cleaning fluid), naphthalene (main ingredient in moth balls), and ammonium hydroxide. The fumes given off by these products can cause cancer, damage to the liver, anxiety, irritability, insomnia, and depression.

Furniture polish often contains petroleum distillates, phenol, and nitrobenzene. These chemicals can cause cancer, liver damage, anxiety, irritability, exacerbation of bipolar disorder, and depression.

Bathroom. Air fresheners are often found in bathrooms. They contain chemicals that are highly polluting to indoor air quality. Most air fresheners contain formaldehyde, petroleum distillates, p-dichlorobenzene, and aerosol propellants. These chemicals can cause cancer and brain damage. In addition to irritating the upper respiratory tract, they can cause insomnia, irritability, rage attacks, panic attacks, anxiety, depression, “brain fog,” and bipolar behavior.

Cosmetic products often contain hormone disruptors and synthetic fragrances. People who wear the synthetic fragrances are usually pleased with how they smell, not realizing that they are increasing their body burden of toxic chemicals, as well as sickening the chemically sensitive people nearby.

Laundry room. Here we can find laundry detergents, dryer sheets, and all-purpose cleaning products.

Laundry detergents typically contain noxious ingredients, including petroleum distillates and synthetic fragrances. One of the by-products of the ingredients is 1,4 dioxane, a chemical known to be toxic to the brain, kidneys, liver, and respiratory system.

Fabric softeners are full of toxic chemicals and are a major contributor to indoor air pollution. Some of the chemicals they contain include alpha-terpineol and benzyl alcohol, both of which cause central nervous system depression, chloroform which is neurotoxic and carcinogenic, ethyl acetate that can cause headaches and narcosis (stupor), linalool which causes central nervous system disorders and depression, and worst of all is pentane which can cause headaches, depression, anxiety, rage attacks, confusion, drowsiness, and cancer.

All purpose cleaners contain detergents, degreasers, solvents, and disinfectants some of which are highly toxic, like monobutyl acetate.

Bedroom. New mattresses and the bedding can outgas noxious chemicals, including formaldehyde. Dry cleaned clothes in the closet emit toxic fumes, as well as moth-balled clothing.

Perchloroethylene or “PERC,” found in dry cleaning solutions, spot removers, and cleaners for carpet and upholstery, is neurotoxic and carcinogenic.

Garage. The garage can be a repository of myriad toxic substances, including paints, solvents, and garden products such as weed killers, like RoundUp. 

Why is this a problem for some people more than others? 

As with exposure to mold and mycotoxins, how people react to toxic chemicals depends on many factors. Some of these factors include age, nutritional status, the amount and length of time of the toxic exposure, whether or not other chemicals were involved synergistically, and genetically inherited tendencies regarding the detoxification pathway in the liver where most of the chemicals are cleared from the body.

Many years ago a lawyer asked me to be an expert witness in a legal case involving two females office workers who had become temporarily disabled after a heavy exposure to pesticides in the office where they worked. The pesticide company mistakenly sprayed for bugs while the workers sat at their desks. Of the ten people who were inadvertently sprayed, two became disabled, five developed an array of non-disabling symptoms like allergies, “brain fog,” fatigue, and mood instability. Three of the men had no noticeable symptoms.

Although I had prepared a convincing explanation to present to the jury about how people have varying capacities to clear poisonous chemicals from their system, at the last minute the pesticide company offered to settle the case with the two plaintiffs. Thankfully I didn’t need go to court.

Resources: 

The American Academy of Environmental Medicine is an organization that trains physicians in treating patients whose health has been impacted by their environment. If you feel that some of your symptoms could be related to toxic exposures, you could contact the academy and find a physician in your area trained in this field of medicine. https://www.aaemonline.org

Environmental Working Group (EWG) is a non-profit, non-partisan organization dedicated to protecting human health and the environment. Their mission is to empower people with knowledge to live healthier lives in a healthier environment. They offer educational materials and breakthrough research about chemicals we encounter in our world today. https://www.ewg.org/about-us

EWG’s guide for choosing healthy cleaning products https://www.ewg.org/guides/cleaners/content/top_products

Beyond Pesticides. The Safer Choice: How to Avoid Hazardous Home, Garden, Community and Food Use Pesticides

Prescriptions for a Healthy House, by Paula Baker-Laporte, Erica Elliott, MD, and John Banta. This book can be used as a guide for creating a beautiful, non toxic and health-enhancing home.

 Conclusion 

We live in a toxic world. Many of the toxins we are exposed to have the potential to seriously impact our brains. Mental illness and mood disorders can be caused or exacerbated by exposure to neurotoxic chemicals.

If you are a healthcare provider with mentally ill patients who don’t respond to talk therapy or medications, then it might be helpful to consider other possible underlying causes, including the possibility of exposures to toxic chemicals.

If you suspect that toxic chemicals are contributing to some of your patients’ symptoms, you could refer those patients to physicians trained in environmental medicine for a comprehensive evaluation and possible treatment.

Part VI of this series will address the role that lifestyle plays in combatting mental illness and mood disorders. Stay tuned!