Causal analysis how to break a vicious cycle

It sounds like good advice and it probably would help you feel better, but how are you expected to start exercising when you can barely get out of bed and take a shower each morning?

When you are in the throes of depression, it’s hard to summon the energy to do just about anything, especially exercising, re-connecting with friends and family, and eating a healthy diet. Even taking your medication may feel like a chore.

But breaking the cycle of depression is the only way to reclaim your life, experts tell WebMD. Here’s what you can do to take charge of depression:

Is It Depression?

Recognizing that you are depressed is the first step toward feeling better, says Subhdeep Virk, MD. She is an assistant professor of psychiatry at Ohio State University Werner Medical Center in Columbus.

  • Withdrawal from family and friends
  • Feelings of hopelessness
  • Preoccupation with death
  • Loss of energy
  • Loss of pleasure from things you used to enjoy
  • Sleeping too much or not enough
  • Eating too much or not enough
  • Increased anxiety
  • Increased irritability

Although everyone feels down from time to time, depression lingers and often interferes with your ability to live your life and cope with daily stressors.

When Antidepressants Are Necessary

“If you are so depressed that you can’t get up to wash or do your chores, and just getting out of the house feels like a tremendous hurdle, medication is definitely the way to go,” she says. “Antidepressants can help take the edge off and allow you to engage in therapy and get out of the vicious cycle.”

Medications may also help by stopping some of the negative thinking patterns that make it difficult to see out of a depression, she says. Thoughts such as “this will never end and will go on forever” make it hard to move forward. “Therapy is beneficial along with medication, especially if you have psychosocial stressors in your life that are contributing to how you feel,” she says.

Some antidepressants are started at lower doses in case there are any side effects. After one or two weeks, doses can be gradually increased — if needed — to get the desired effects on your mood. Antidepressants typically don’t work overnight. Some may take longer than others to kick in. It usually takes about six weeks, on average, for antidepressants to begin to have a positive effect on your mood, Virk says. “Be patient and stay in close contact with your doctor.”


The good news is that there are many antidepressants for your doctor to choose from today. If one doesn’t work, they can adjust the dose, switch to another, or even add a second medication to the mix.

“The choice is often based upon which symptoms are most prominent and what kind of side effects might occur,” says Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital in New York City. For example, some antidepressants may cause “sedation” and this can sometimes be useful for people who are depressed and having trouble sleeping.

“It is important that you stay in close contact with your doctor if you take medication to treat your depression — especially when you are starting new medication or making any changes,” he says. This will allow your doctor to monitor any side effects, should they occur.

Managing Depression with Lifestyle Changes

Lifestyle changes including getting regular exercise, eating a healthy diet, and getting plugged back into life also make a difference, especially when paired with medication and therapy.


Making these changes may be easier said than done if you are depressed, but it’s possible, says John L. Beyer, MD. He is an assistant professor of psychiatry and behavioral sciences at Duke University Medical Center and director of the Duke Mood and Anxiety Disorder Clinic in Durham, N.C. “Act as if you are not depressed in anticipation of feeling much better,” he says.

“Make a schedule for when you should shower, eat, exercise, go to sleep, and wake up, and stick to it.” The rest will follow. “After a while, it becomes much less difficult and things will begin to become enjoyable,” he says.

These healthful habits can also help prevent recurrences of depression. For people who are prone to depression, life stressors can propel them back to that dark place.

“We can’t change genetics, but we can change our environment to protect against relapses,” he says. The best way to do this is to bolster your personal resilience factor. “Difficult things can occur, but part of being well and being human is to develop social ties and networks,” he says.

Don’t let yourself become isolated. “This will build resilience that prevents depression from getting a grip on you in the future.”


Subhdeep Virk, MD, assistant professor, psychiatry, Ohio State University Wexner Medical Center, Columbus, Ohio.

John L. Beyer, MD., assistant professor, psychiatry and behavioral sciences, Duke University Medical Center; director, Duke Mood and Anxiety Disorder Clinic, Durham, N.C.

Bryan Bruno, MD, acting chairman, psychiatry, Lenox Hill Hospital, New York City.

Writer, Yoga Instructor (RYT 200) Read full profile

Causal analysis how to break a vicious cycle

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Whether it’s the friend who keeps falling for the wrong person, the employer who can’t seem to make things better at work, or the individual who won’t stick to a healthy routine, we all know someone caught in a negative cycle. The concept of the vicious cycle is nothing new. In yogic philosophy, the repeating patterns that manifest in our lives are called samskaras. [1]

Samskaras can be positive or negative. They are reinforced by repetition until they become second nature. Some yogis use the imagery of a butter knife running along a pat of butter as a way to explain samskaras. The knife leaves tiny ridges on the butter, and as you continue to run the knife along the same pattern, the grooves become deeper. When we develop positive patterns, they become easier to maintain over time. When our samskaras are negative, we enter into what is referred to in systems thinking as “doom looping.” Doom looping is as ominous as it sounds–problems compound and initial solutions don’t seem to have a positive effect.

It really isn’t easy at all to get out of a doom loop.

It’s easy to get caught in a vicious cycle. Imagine, for instance, a person trying to lose weight. This person may vow to exercise daily and eat better food. The morning begins full of commitment to the goal of living a healthier lifestyle, but then the person encounters a big pile of doughnuts in the break room at the office. This individual, feeling the mid-afternoon energy-slump that is perpetuated by their unhealthy body and schedule, eats a doughnut or two. He or she gets through the work day on a sugar high, but after arriving home, there’s dinner to cook, the sugar buzz has worn off, and ultimately the person becomes too tired to exercise.

Despite all those good intentions, the individual reinforced a negative pattern that will be harder to break tomorrow. Tomorrow when they get up, they will feel the cumulative effects of poor habits plus their recent failure to stick to a goal. Thus, they have initiated the doom loop.

But breaking the vicious cycle is the only way to stop negativity from coming back.

Employee turnover, poor health, and unhappiness are a handful of the many symptoms of being caught in a doom loop. In some cases, struggle may feel so natural that it is the only condition that people know. The cycle of poverty is a classic example of this. [2] Even though people in this situation understand that there are better possibilities, they lack access to them because of a series of compounding factors. This sort of cycle must be broken at a systemic level, and is not likely to be resolved through the power of a single individual.

In other cases, businesses or entities may become reactive to problems instead of performing a proper causal analysis. They respond to an immediate need without fully understanding the problem. A company may notice that employee turnover is high, which leads them to increase their benefits package. This may draw new workers, but they fail to address the root of their issue, which is the tyrannical manager that makes every day a challenge for employees.

A school with a poor performance record may develop a turnaround plan that involves firing most of the teachers. Such drastic measures fail to yield results that districts desire in most cases. [3] In this instance the environment has been further destabilized by the reactionary policy.

Whether you are personally affected by doom looping, or you are watching it play out for someone else, there are steps that can break the cycle. The results may not be instantaneous, but they will be sustainable.

Sometimes we are so close to the problem that it can be difficult to see where we’re going wrong. The actions that lead us to this place feel normal to us, after all. Negative cycles can rob us of our power. You may be able to recognize the problem on your own, but there’s no shame in reaching out for help if you feel that you can’t resolve the issue alone.

Here’s a powerful way to stop circling the drain.

One of the main reasons that people fall into doom cycles is that they don’t take time to perform a causal analysis on their situation. If you attempt to tackle a problem without fully addressing its roots, you are putting a bandage on a broken arm. Our fast-paced world values quick results. Self-reflection, the key to breaking the vicious cycle, has become secondary to ideas that provide instant gratification.

To get to the root of the problem, you can use the “5 Whys” method. [4]

At its most basic level, this method involves naming the problem, and then asking yourself why the problem is occurring five times.

  1. Employee turnover is high. Why?
  2. Workers are unhappy. Why?
  3. Their work-life balance is poor. Why?
  4. Their manager expects them to take work home with them. Why?
  5. As a company, our goals for this quarter are too ambitious for our staff. Why?

As you can see, this reflective line of questioning can yield some insights into what has led to such a high turnover rate for the company. [5] After this causal analysis, leaders may decide that they need to re-evaluate their quarterly goals so that they do not put inordinate pressure on the manager. By rethinking their strategy, they may be able to keep the manager from asking employees to take work home with them, which may make them feel better about their jobs.

A second way to break out of the doom loop involves using the following line of inquiry: [6]

1. Name a symptom of the problem. What is something that seems to be getting worse for you as time goes on?

I struggle to pay my bills every month.

2. Choose three immediate and independent causes. What are three things that lead to the symptom you described above.

My job doesn’t pay me very much. I buy things on impulse. I feel social pressure to keep up with everyone else.

3. State the consequences of the causes. How are your behaviors impacting your life?

I’m stressed all the time. My cupboards are always empty. People think I have more money than I do.

5. Demonstrate how the consequences perpetuate the causes. How do the consequences of your actions enable the symptom to continue?

Since people think I have more money than I do, they expect me to lead a certain lifestyle that involves spending lots of money. This keeps me from saving and causes me to dip into my rent and grocery money.

Break your chains!

Samskaras are a natural part of our existence. When vicious cycles arise from negative patterns, it is up to us to break them. Causal analysis should always begin with self-study. Whether you choose to use one of the methods listed above, employ the assistance of a life-coach or therapist, keep a journal, or engage in mindfulness exercises, persistence will allow you to identify the core of the doom loop.

Don’t allow yourself to be a prisoner to unhealthy mindsets and habits. You are the driver of the change that you want to see in your life.

Causal analysis how to break a vicious cycle

“If more of us valued food and cheer and song above hoarded gold, it would be a happier world.” ― J.R.R. Tolkien

They may not readily admit it, but most runners run to lose weight or at least to manage their weight.

I know, I’m one of them. I love food, I do. But it’s never that simple. I also have a very long and complicated emotional relationship with food. Well, it’s not THAT complicated – I eat when I’m emotional. Hunger plays a dismal role.

Can you relate?

So when I discovered running, it was the answer to my prayers! I could run (sometimes quite far) and then eat whatever I felt like. Yup, I had found the ultimate ENABLER. This was my ticket to guilt-free binge eating.

And the further I ran the more freedom I had to eat whatever I wanted. Calories in = calories out. Isn’t that the rule?!

Until my first significant injury. I couldn’t run. At all. For three months! And that’s when I discovered the flaw in this plan. The proverbial Achilles Heel.

I was used to eating without much concern. Vast quantities of mostly the wrong types of food (never assume athletes are a healthy bunch). And being an emotional eater it was how I inadvertently “smothered” my emotions.

It was a vicious circle which steadily morphed into a downward spiral. Removing my enabler only created more emotional conflict. And my failsafe response to an emotional conflict was – yes – eating. A lot of eating.

It wasn’t a pretty sight. I felt wretched. And guilty. And fat.

Eating disorders are NEVER that simple. It’s taken many years of repeat performances and uncomfortable self-discovery to finally get to a place of balance.

Causal analysis how to break a vicious cycle

Now I’d like to tell you that I saw the light, found my inner happy and lived a binge-free (and skinny) life. But sadly not. Eating disorders are NEVER that simple. It’s taken many years of repeat performances and uncomfortable self-discovery to finally get to a place of balance.

Here, in short, is what I realized:

  • I set myself up to fail.

Eating was a crutch to avoid dealing with my emotional issues. Running was the enabler that allowed me to indulge this crutch.

I’d built myself a flimsy house of cards which was held steady by external factors beyond my control. And as with anything flimsy, it eventually collapsed.

And so did I. Metaphorically speaking.

  • I gave away my power.

When I could run I felt good. Even happy. And that’s because I could eat. Whatever I wanted. Which also made me feel happy. For a short time. Until I stopped eating.

There was no time to face emotional stuff – I would simply run and then eat. Boom. It was the perfect combination. Or so I thought.

But when I couldn’t run, the emotions remained. And got stronger. As did the desire to eat.

Who was really in control here?! Not me. Not really.

I had created internal agreements whereby my happiness depended entirely on eating. Which, in turn, depended entirely on my running.

One crutch supported another.

We simply cannot rely on something outside of ourselves to help us feel good. Or even just feel okay.

  • Get happy FIRST and THEN eat, run or do whatever you enjoy.
  • Remember, happiness is a state of BEING – we can’t find it or chase it. It’s our natural state underneath all our layers of “stuff”.
  • It’s important to DEAL with your emotions, not to suppress them. Feel them, however intensely, let them flow through you and then let them go. It really IS that simple.

Maybe you need to seek therapy. Or punch a pillow. Just do whatever it takes to see past them or get them out of the way.

And THEN you can live life fully. And embrace your power.

Without the need for any crutches. What follows are a few of the really simple ways I learned to reach for a GOOD FEELING in the moment:

Find something (anything) in your immediate surroundings that you can FEEL APPRECIATION for right now.

The cup of coffee you’ve just had or the comfortable chair you’re sitting on.

An easy go-to for me is to individually appreciate each of my 5 senses. Right now.

Smell something, touch something, listen carefully, really taste your coffee and visually soak up your entire surroundings with curiosity.

Spend some time OUTDOORS – preferably in nature when possible.

Simply look up to the sky and appreciate the vastness above. Breathe in the fresh air and listen to the sounds of life happening outside of these 4 walls.

Try and stay PRESENT and really notice all the different elements around you.

Move around wherever you are. Take the stairs, walk around your building or stand at your desk for 5 minutes instead of sitting.

And whilst you’re moving remember to BREATHE. Deeply.

PET YOUR DOG. Or your cat. Or someone else’s. Just find an animal and share some love with it. This one is guaranteed to work.

2 weeks ago I injured my hip and I’ve been advised not to run for a few weeks (or so). Within these 2 weeks I’ve often reflected on those early years and realized just how far I’ve come.

Interestingly, I no longer measure myself by my eating habits or my weight.

I still feel happy. And calm. And I’m enjoying resting my body for a bit.

No anxiety. No stress.

These days I enjoy running simply because I enjoy running. Not for any other reason.

And I run when I want to, not because I have to.

Who knows. Maybe I’ll take another week off.

Causal analysis how to break a vicious cycle

Like drugs and alcohol, certain things should not be mixed. Stress and drinking can be a similarly toxic combination that has unfortunately become normalized. Studies suggest that individuals who claim to have high levels of stress show a propensity toward using alcohol consumption to mask their worries, according to a report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

What is Stress and How Can Lead to Alcoholism?

People have different reasons for drinking: Some associate the activity with socializing or celebrating, while others turn to alcohol to deal with outside pressures or responsibilities. The National Institute on Alcohol Abuse and Alcoholism defines stress as “anything that challenges the body’s ability to function in its usual fashion,” heightening feelings of “anxiety, anger, fear, excitement, or sadness.” Stress manifests in several forms and can be caused by day-to-day stressors as well as traumatic events. While drinking may provide temporary relief, using alcohol as a coping mechanism for stress can have disastrous long-term consequences.

One group that knows the pitfalls of drinking to alleviate stress all too well are college students. Due to the different types of pressure they face, they are more likely to develop a substance use disorder. Despite the common association between binge drinking and celebratory events on college campuses, the primary reason students drink appears to be to combat unstable, negative emotions. Researchers from Penn State University instructed freshman students in college to record their drinking activity and any instances of stress in a journal, discovering that students who noted more daily stressors were more inclined to drink. This study concluded that students were eight percent more likely to drink every time an additional stress trigger was introduced. The researchers also found that the individuals who drank more on high-stress days were more at risk of developing alcoholism by their senior year.

Alcoholic beverages may help some people relax, but drinking alcohol to make stress subside is not advisable. This mentality can cause individuals to mistakenly turn to alcohol as a mood enhancer and a crutch for dealing with real-world issues.

How Does Drinking Alcohol Increase Stress Levels?

While many use alcohol to deal with stress, drinking tends to cause greater stress in the short and long term. Substance abuse problems can negatively impact school or work performance, familial and romantic relationships, and finances, intensifying the potential stress triggers that caused the individual to drink in the first place.

Aside from altering behavior and interpersonal relationships, alcohol puts stress on the mind. This phenomenon is so common that the colloquial term “hangxiety” has become more widely used to describe feelings of anxiety during a hangover. A night of drinking can actually trigger stress: as alcohol is removed from the body, blood sugar levels fall, aggravating symptoms of anxiety.

An article for the Research Society on Alcoholism demonstrates that alcohol also places more stress on the body in physiological terms by increasing levels of cortisol, a hormone the body naturally generates when stressful events occur. Though cortisol can be beneficial in smaller increments, high levels of the hormone can have damaging consequences, including inflammation, spikes in blood sugar, high blood pressure, and diminished cognitive abilities. The same study found that individuals who experience alcohol dependence or abuse display higher concentrations of cortisol during both inebriation and withdrawal. When the presence of cortisol throughout the body becomes chronic, individuals may suffer from central nervous system and organ damage.

Managing Stress and Alcohol Misuse

When it comes to managing your stress, counseling is vital. Cognitive-behavioral therapy (CBT) and Motivational Interviewing (MI) are examples of clinical treatment offerings that are helpful for people with anxiety and alcohol dependence. CBT is a form of psychotherapy that focuses on how emotions influence behavioral patterns. People afflicted by co-occurring disorders may also favor Motivational Interviewing, a counseling technique centered on encouraging the client to set and accomplish goals.

Additionally, those struggling with alcohol use and mental health disorders can try holistic therapies such as yoga and meditation to help alleviate feelings of anxiety and stress. For those who feel like they are alone in their struggle, AA meetings can provide them with the community support and guidance they need.

The first step is to know that your questions and feelings are normal. The next step is to talk to someone about those feelings.

Click below to start your recovery journey today!

By Shayan Belliappa

Breathe in. Breathe out. Look around. People are leading happy lives. While their good fortune plays on your mind, your own life seems crippled with never-ending problems. You are getting in and out of bad relationships, hurt over and over again, emotionally drained, and physically tired.

At work, your situation is no different. You have been procrastinating tasks endlessly for weeks, resulting in poor productivity and low morale. With each passing day, stress seems to be reaching alarming levels. And to cope with this, you pick up bad habits. Clearly, you are no stranger to repetitive, negative patterns.

You are not alone. Many amongst us are stuck in negative patterns we can’t seem to get out of. We wonder ‘Why me?’, and wallow in the misery of being victims of the situation. What we probably fail to do is notice the repetitive nature of certain patterns. So what is the root cause of these repeated patterns? How do they impact us, and how can we break this negative loop to lead a happy and stress-free life?

According to research, there are at least 10 common negative thinking patterns, and these patterns take shape very early in life. In fact, prenatal impressions play a significant role in repetitive patterns. Counsellor Amita Mani explains, “Right from conception in the mother’s womb, some patterns of thought, emotion, and behaviour get impressed on our psyche. These lead to the manifestation of repeated patterns because that’s what we think or have programmed ourselves to believe. These are self-defeating mental blocks.” However, the negative patterns can also become a part of the script in the first seven years of an individual’s life, she points out.

When we are young, we don’t understand why these patterns repeat, let alone give a thought as to how they might already be imprinted in our minds. We probably even dismiss such patterns as coincidental. Truth is, if a life event has repeated more than twice, chances are it is not merely a coincidence. It is only when this realisation dawns on us that we begin to wonder why we are attracting similar negative patterns.

Sometimes there might be more to the negative cycles in life than psychology. The cause could be explained esoterically. It is said that some negative patterns may be carried across many lifetimes. Life skills coach and motivational speaker Neelam Kumar is a practising Nichiren Buddhist. She says, “I believe repeated cycles of issues in relationships and finances are an accumulation of the causes we have created over several lifetimes, of which we are seeing the effect now.”

Negative patterns—whether they are the result of prenatal impressions, or get accumulated over lifetimes—are detrimental to our growth, as they impact our understanding of the self. “We end up having many blind spots—don’t really know who we are and what we want. We develop too many fears, resentments, and shoulds, musts, and have-tos that restrict our lives,” says Mani.

These patterns not only rob us of our happiness but also manifest physically, especially as stress. Generally, phobias, back pain, joint pains, migraine, insomnia, acidity, and digestives issues like Irritable Bowel Syndrome (IBS) are by-products of negative cycles. But do we ever associate these ailments with patterns in our life? Many of us even dismiss that psychosomatic ailments are a real thing. For instance, if we have been in a toxic relationship that makes us physically sick every other day, it is necessary for us to either communicate with our partner and fix the root cause or get out of the relationship. But if we are swayed by the few days that might turn out to be good, we might find ourselves forever stuck in the toxic cycle, feeling the literal pain in the neck.

How do we break such a cycle? It does need tremendous effort to break recurring patterns, but we can begin by acknowledging that the problem exists within us and not in our external circumstances. With this acknowledgment comes awareness and with that comes change. While it might seem like a herculean amount of inner work, there are ways to ease the process. The internal transformation can be facilitated through psychotherapeutic tools like Neuro-linguistic Programming (NLP). Mani says therapies like NLP have techniques such as reprogramming and anchoring positive behaviours, which help bring the negative patterns to the foreground of awareness so that they can be changed.

While some might find their remedy in psychotherapy, others might find that walking the path of spirituality helps break their negative cycles in life. Neelam, for instance, has found her remedy in practising Nichiren Buddhism. She says, “The simple act of chanting Nam Myoho Renge Kyo can turn any ‘poison’ of repeated patterns of karma into the best ‘medicine’. Through chanting, one can see an honest human revolution within them. This helps an individual change to the best version of himself.” She believes that this inner revolution empowers the practitioner to fight these negative cycles. Many others like Neelam who meditate share similar views and experiences.

Whether we choose to break the negative cycles in our lives using psychotherapy or spirituality, break we must. Or else, we’d likely limit ourselves and not live up to our fullest potential. Having said that, we do need to realise that combatting negative cycles is no overnight affair. From identifying the reasons behind these patterns to understanding the root of the problem to set the transformation in motion, the process takes time, perseverance, and practice. The path might be a difficult one to tread, but in the end, when you break through the vicious cycle of negativity, it allows you to live life to the fullest.

Novartis researchers aim to quash inflammation to treat chronic disease.

In response to dry soil, a sensor in a garden triggers a sprinkler to deliver a shower of rain. Disaster strikes, though, if the sensor gets stuck in the “on” position. The shower turns into a stalled storm that floods the garden.

A similar problem can occur in the body. Immune cells contain danger sensors. They respond to danger with a sprinkling of signals that trigger healing inflammation. But if the danger sensor gets stuck on, the result is chronic inflammation that can cause more damage than good.

Novartis researchers aim to break this pattern by silencing part of the body’s danger-sensing system, particularly in the case of chronic disease. This system, driven by a molecular machine called the inflammasome, is gaining attention from drug hunters because blocking it could potentially help stop damaging inflammation where it starts. This precise approach to lowering levels of inflammation in the body is part of a wider effort to find new ways to treat chronic diseases from Alzheimer’s disease and cancer to osteoarthritis and gout.

The idea to target the inflammasome seems sensible, but it would have been impossible just two decades ago. Back then, no one knew this danger sensor existed.

What is the inflammasome? Animation by Mark Mazaitis.

“This is one of the oldest machines in biology from an evolutionary perspective, and we’ve only recently just learned of it,” says Guido Junge, a clinical expert in inflammatory diseases at the Novartis Institutes for BioMedical Research (NIBR). “We suspect it’s a powerful player in many diseases.”

A powerful system

In 2001, scientists in the US learned about a mutation in the gene that codes for a protein called NLRP3. At the time, they knew only one thing about NLRP3: Mutations that alter it are devastating for the people who have them.

“It was a dream come true to find this gene,” says Dan Kastner, an inflammatory disease expert and scientific director at the US National Human Genome Research Institute, who in the late 1990s uncovered the genetic roots of related illnesses. “Although there was speculation that it might somehow regulate inflammation, no one knew what it did. So the idea of a treatment was still just a dream.”

If untreated, children with NLRP3 mutations have near-constant fevers, chills and joint pain. Chronic inflammation takes a toll and their lives are often cut short.

Not long after the discovery of NLRP3, researchers linked it to the inflammasome, and more research linked the inflammasome to an inflammatory signal called IL-1 beta. That signal became a guiding star: Elevated levels of IL-1 beta are a sign of chronic inflammation.

“You’re looking at tons of data and suddenly you see a pattern,” says Junge. “A signal that could help guide therapies.”

Causal analysis how to break a vicious cycle

Today, medicines that block IL-1 beta enable patients with NLRP3 mutations to live longer and livelier.

“The inflammasome is a very powerful system that can be modulated to great benefit,” says Kastner. “Those successes give us hope for benefit in more subtle situations, such as chronic illness.”

Chronic disease and a runaway danger sensor

Researchers eventually figured out that NLRP3 is a danger sensor. The human body has 24 of these danger sensors, most of which notice bacteria and viruses.

The NLRP3 sensor is different. It recognizes crystals, protein aggregates and unhealthy cellular stress.

When it senses these dangers, it self-assembles into an inflammasome, which resembles a microscopic ray gun. Its job is to send out flares that alert the rest of the immune system to launch an inflammatory response in an attempt to resolve the problem.

Trouble occurs when the NLRP3 sensor gets stuck in the “on” position. This can be caused by mutations, but researchers are learning that chronic diseases can also cause the NLRP3 sensor to constantly sense danger.

In Alzheimer’s disease, for example, plaques in the brain can trip the sensor. So can hardened arteries in patients with cardiovascular disease and crystals that occur in patients with gout. A tripped sensor can create a constant state of inflammation.

“If we have a chronically alerted immune system, that’s not good,” says Joerg Eder, an immunology expert at Novartis. “People think the problem is the disease, but the damage to the tissue may also come from the immune system.”

In cancer, for instance, tumor cells themselves appear as danger signals and trigger the inflammasome. The resulting inflammation ends up promoting tumor growth rather than inducing an assault on the tumor. As a result, the cancer cells persist and continue to appear as danger signals.

“Chronic disease can cause a vicious cycle of inflammation and damage and more inflammation,” says Junge.

The NLRP3 inflammasome may also be involved in some cases of COVID-19. Some people with COVID-19 experience a runaway immune reaction to the coronavirus.

Doctors call the effect a “cytokine storm” because the immune system floods the lungs with inflammatory signals such as IL-1 beta. It is an example of a shower of immune signals in response to viral damage turning into a stalled and raging storm. Scientists around the world are investigating existing medicines that quiet the immune system to see if they might be safe and effective against COVID-19.

This is one of the oldest machines in biology. We suspect it’s a powerful player in many diseases.

Guido Junge

Damping the danger sensor

Several companies, including Novartis, have identified a range of ways to interrupt the NLRP3 inflammasome. There are many viable approaches, from blocking the signals the inflammasome produces to preventing the inflammasome from assembling in the first place.

Novartis researchers discovered a way to block NLRP3 activation. Simultaneously, researchers working at a company called IFM Tre made a similar discovery. The approaches turned out to be complementary, achieving the same anti-inflammatory goal in different ways.

Novartis acquired IFM Tre in 2019 and is the first company to have an anti-NLRP3 therapy in early-stage human clinical trials, though it certainly won’t be the last. There is much to be learned about how patients with chronic diseases respond to this approach.

“This is our great task ahead of us,” says Eder. “To find those chronic inflammatory settings where the NLRP3 is triggered and begin testing our hypothesis in patients.”

Causal analysis how to break a vicious cycle

How to Break the Cycle of Binge Eating: The Root Cause is a Guest post written by graduate, Annika Duden, FNTP.

What is Binge Eating?

Binge eating begins with emotions, and transforms into the body’s cry for nourishment. Binge eating, or “uncontrollable” eating, is a common habit that can be associated with disordered eating. Many have struggled with this seemingly endless cycle of loss of control when it comes to food. Any person struggling with this unhealthy behavior may use similar words and phrases to describe how they feel:

  • “In a trance”
  • “I can’t stop even when I want to”
  • “I never feel satisfied”
  • “I’m scared to go home because I have _____ there, and I won’t be able to stop eating it”
  • … and the list goes on.

It’s hard to understand this behavior, especially when it’s happening to you. Frustration and panic set in as you struggle to grasp the helplessness you feel when a binge overtakes you. Similar to other types of “binge” behaviors such as uncontrollable shopping, cleaning, etc., the root of each of these behaviors have two things in common: stress and deprivation. On an emotional level, a void exists that one is trying to fill. The binge that this person partakes in is their attempt to comfort themselves and feel fulfilled. Psychologically, it’s a principle that makes sense. When it comes to binge eating specifically, it can often times stem from an eating disorder. There are many forms of disordered eating that can cause this to arise in a person:

  • Any form of food deprivation (extreme calorie counting, cutting out a macronutrient food group too aggressively, etc.)
  • Eating disorders including anorexia, bulimia, orthorexia (fixation on a certain diet or way of eating/exercising), and more..

It has been stated that, “these factors, including stress, food restriction, the presence of palatable foods, and environmental conditioning, parallel many of the precursory circumstances leading to binge eating in individuals with bulimia nervosa and binge eating disorder.” (NCBI; Mathes, Brownley, Mo, & Bulik). However, I believe for each binger, there is a point in which the trigger of the binge shifts. At first, binges occur in order to fulfill a void caused by deprivation, restriction, sadness, or other powerful, negative emotions.

Then, in a moment, everything shifts. When the body has been deprived from calories or from certain foods for too long, it shifts into survival mode. Our body recognizes that it hasn’t been receiving adequate or even specific nutrients, and therefore takes over our brain and our actions in order to ensure its most basic need is being met: the need to be nourished and fulfilled on a caloric, macronutrient, and/or micronutrient level. Once this shift has occurred, we are stuck. Our bodies have transitioned into a state where they are demanding satiation at all costs.

There’s a reason why, the longer one binges, the more the binger feels trapped in this behavior and cannot escape. Binging is scary. It takes away our feeling of control, self-trust, and self-confidence. We often feel like a prisoner in our own bodies, and a slave to food. As daunting and confining as this feeling is, I believe full recovery is possible, because it truly comes down to science.

How to Overcome Binge Eating

As a former chronic binger, I have experienced all of these feelings. I have also experienced true healing and have now been binge-free for over two years. These are the five easy steps I’ve followed to control and ultimately end my binging:

Sue Abderholden, MHP, is the executive director of the National Alliance on Mental Illness (NAMI) of Minnesota. She has received numerous awards for her advocacy, including the Distinguished Service Award from the Minnesota Council of Child Caring Agencies, National Association of Social Workers Citizen of the Year, Excellence Award from the NAMI National Executive Directors group, the Paul Wellstone Advocacy Award from the Minnesota Psychiatric Society, the Advocacy Award from the Pacer Center, and others.

Mental illnesses and poverty go hand in hand. Having a serious mental illness can lead to poverty; living in poverty increases the risk of developing a mental illness.

Having a mental illness can lead to poverty: According to the World Health Organization, mental illness is the leading cause of disability around the world. Once your mental illness is disabling, meaning it severely limits your ability to finish your high school or college education, and it severely limits your ability to work, you will be living in poverty. The 2009 federal poverty threshold for a single person is $930 per month. If you have little work history, you end up on General Assistance for $203 per month, or Supplemental Security Income, which is around $700 per month. Even if you have enough work history to qualify for Social Security Disability, the average monthly income is $1400.

While you can work a limited number of hours without losing Social Security income and medical benefits, people with a serious mental illness have the highest unemployment rate. The stigma surrounding mental illnesses is so great that few people will disclose a mental illness to potential employers. Without disclosure it is impossible to provide employment modifications or access the protections afforded under the Americans with Disabilities Act, and thus many people are not hired or are not able to keep their job.

Poverty can lead to a mental illness: There is research pointing to causal links between poverty and mental illness, particularly depression. Knowing the impact that stress and trauma can have on a person’s mental health, it is not hard to recognize that people living in poverty have higher stress and may be more prone to developing depression.

If you live in poverty, you have less control over your life, where one emergency can lead to homelessness. You may have poor social supports and no one to help with children or financial emergencies. You are more likely to be exposed to violence in your home or neighborhood. On top of that, people living in poverty may not have health insurance, access to transportation, and may have a difficult time finding a culturally competent mental health provider. Untreated depression can cause additional stress, such as losing one’s job, or housing, or feeling rejected by one’s community. And so a vicious cycle is created.

We can break this vicious cycle: If we are to tackle this issue, we need to work on both fronts – the mental health system, and the poverty reduction programs. This includes making sure that:

  • There are culturally competent mental health providers in low-income communities.
  • Poverty and mental health programs are paired together.
  • There is access to supported employment programs.
  • An adequate supply of affordable housing exists.
  • Early identification and resiliency programs for children are available.
  • Programs work to lift people out of poverty.
  • We continue to work to reduce stigma.

We must use integrated approaches to tackle this issue, such as supportive housing programs, where housing is affordable and services are on-site, or school-based mental health services. These issues are huge, and can at times seem unsolvable. But we do know what works; we just have to do it.

Read more about it

Opinions in the For Discussion columns are the authors’ alone and do not necessarily reflect the views of Minnesota Compass. Compass welcomes a range of views about issues pertaining to quality of life in Minnesota.

by Marichen Van Der Westhuizen, The Conversation

In response to a wave of protests following a spate of brutal attacks on women, South African President Cyril Ramaphosa has again committed himself to addressing this problem urgently.

In a recent speech he emphasised the need for harsher sentences for the perpetrators of gender-based violence and femicide. He also announced an “emergency action plan” to combat the problem.

The plan, to be implemented within the next six months, includes:

  • Additional funding for a host of new interventions, as well as for sexual offences courts,
  • The need to address patriarchal attitudes and practices that encourage domination and violence,
  • Emphasis on interventions that include men, youth at risk and offenders inside of prisons,
  • Making sure that women’s rights and gender/power relationships form part of the education system,
  • Gender sensitivity training for the police, prosecutors, magistrates and policy makers,
  • Amending laws to ensure harsher punishment for perpetrators.

The president’s plan is commendable. But, previous efforts to address the problem have failed. Research on gender-based violence has shown that services for victims and perpetrators are often not available, or aren’t accessible to people who need them.

Also, where these are available, interventions are for periods that are too short to be effective. And there is lack of sensitivity from service providers, leading to secondary trauma for the victims. Finally, there has been poor alignment of the available resources.

These mistakes can be avoided if the president, and his team, draw from research that’s been done by academics on the issue of violence against women. We believe that research has a distinctive role to play because it gives pointers on what is needed to create long-term change.

What do we know

Findings from some research conducted in recent years provide a number of useful insights.

Family interventions. Often, child victims know their perpetrators. And in terms of the family history, a majority of sex offenders have a history of exposure to domestic violence and abuse of alcohol in the family, as well as their own history of substance abuse. Various studies have indicated how violence in the family repeats itself over generations, becoming a vicious cycle.

Perpetrators: Research shows that there is often a history of poor relationships between parents and the child. This leads to the offender objectifying people, emphasising power and control over them, and not having compassion for others.

Intimate partner violence: Research shows that boy children who are exposed to family violence or childhood victimisation are more likely to direct violence at an intimate partner. And men who show aggression to their partners are at risk of falling victim to violence in the future. It’s important not to ignore attitudes towards this kind of violence. This is because there is a common thread across socio-political, religious, cultural and personal attitudes that support or condone spousal assault. These implicitly or explicitly encourage patriarchy, misogyny and the use of violence to resolve conflicts.

In families affected by domestic violence, services for the whole family are needed, including the perpetrators.

Services for children exposed to domestic violence require accessible social services that are long-term and integrated. To break the cycle of violence, children need services that focus on problem-solving and conflict management skills, healthy self-esteem and self-worthiness.

Positive peer groups and social support are also needed. Victims of gender-based violence reported that preventative services should consider contributing factors such as substance abuse, poverty and financial stress, youth development and empowerment, as well as communication patterns, problem solving and conflict management within families.

Research also shows that community awareness programmes should address the causal factors of gender-based violence, as well as empower victims and children exposed to violence. Such programmes should focus on:

  • child awareness of rights and responsibilities,
  • child and victim awareness of support systems available and how to access them, and
  • community awareness of how to respond to acts of violence and to support victims of violence within a community context.

For the national action plan to work, and to be based on a bottom-up approach, the planning and implementation should be rooted in research findings.

There needs to be a multi-disciplinary approach to the work. This requires all role-players to be gender sensitive as they work towards services that inform prevention, treatment and community well-being.

Secondly, preventative and proactive services can’t be once-off, or short-term. The focus should be on giving people life skills. This requires children and youth who are at risk to have spaces where they can integrate the skills into behavioural patterns.

Thirdly, there needs to be a focus on what causes gender-based violence. This will ensure that young people at risk are empowered with new understandings and behaviour to break the cycle.

Fourthly, service providers have a role to play too. They can protect women and children using risk assessment management tools. Men can be linked into the programmes to help them take responsibility and become rehabilitated.

Fifthly, when it comes to intimate partner violence, legislation on its own won’t be enough. Respect for women’s rights and dignity should form part of the education system, and be integrated into services for young people at risk of gender violence, including perpetrators. Cultural practices should also be addressed.

And when it comes to gender-based violence and femicide substance abuse and dependency must be addressed.

Lastly, antisocial behaviour must be addressed when treating or rehabilitating sexual offenders and recidivist sexual offenders. This should focus on substance abuse treatment in conjunction with the treatment of other problems like deviant sexual interest and preoccupation. This would help reduce the incidence of sexual recidivism among sex offenders.

None of these interventions will work unless government and civil society work together. Non-governmental organisations should be supported to develop their services further. Above all else, the government needs to make sure that the South African Police Service, court system, correctional services, social development, health and education are reformed.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Article publication date: 27 November 2017

Issue publication date: 7 February 2018



This paper aims to understand and explore the causal relationship of elements responsible for the macro vicious cycle of poverty in Guinea-Bissau, and discuss policies to break it.


The methodology used in this study is based on the system dynamics simulation paradigm.


Breaking the Guinean poverty cycle requires a multifaceted approach involving more resources and the building of several national capabilities. Traditional approaches tend to fail.

Research limitations/implications

Limitations come from the level of abstraction used in the model, which does not detail the processes for building specific capabilities and their interrelationships, and the necessary exclusion of variables that may have an impact in the process. Considering implications, the study models the evolution of human development index (HDI) in Guinea-Bissau, linking it to the economy and political sectors and allowing the simulation of different scenarios.

Practical implications

The study presents a critical stance towards common recommendations from international agencies, and it provides a blueprint for development of more effective public policies.

Social implications

Overcoming the poverty trap in sub-Saharan countries remains a challenge for the international community. The study aims at helping in the process of integrating different frameworks into a compact and manageable model.


The study contributes to the system dynamics and economic development literatures by presenting an integrative model of human development in Guinea-Bissau. There is no study in the system dynamics literature modelling the relationship of HDI to economy and political sectors while different and contradictory points of view characterize the economics literature, leaving well-meaning public officials in Guinea-Bissau at a loss of mental models to tackle the poverty trap in the country.


  • System Dynamics
  • Economic development
  • Human development
  • Complex problems
  • Guinea-Bissau


Só, B., Franco, E.F., Carvalho, H.C., Santos, J.R.d. and Armenia, S. (2018), “Nobody deserves this fate: the vicious cycle of low human development in Guinea-Bissau”, Kybernetes, Vol. 47 No. 2, pp. 392-408.


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