Monty Lyman (Torva)
At university, I had two roommates with irritable bowel syndrome (IBS), a painful condition affecting the digestive system. Both also had anxiety. But there was a key difference between them that stuck with me. While one found IBS treatments attenuated her anxiety, the other found relief through the opposite approach: her stomach pain only eased after seeing a psychiatrist. It was an astonishing lesson for me in the complexity of the relationship between body and mind.
This intricate connection forms the foundation of The Immune Mind: The new science of health by Monty Lyman, a medical doctor and research fellow in psychiatry at the University of Oxford. Lyman explores the complex, fascinating connection between our bodies, our minds and our gut microbes. He argues that viewing physical and mental health as separate entities has been detrimental to our well-being. Instead, we need to see our bodies as a delicate balance between brain, immune system and gut. Only then can we become our healthiest selves.
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Lyman鈥檚 passion for the subject is evident from the start. Rather than shying away from the complexity of the immune system, he embraces it, carefully detailing how and why immune responses occur. Yet his writing is rich, playful and illuminating. He describes the immune system as a 鈥済ossipy community鈥� that 鈥渂lends the balance of a ballerina with the offensive capabilities of an elite Marine unit鈥�. Such metaphors transform dense subject matter into a breezy and delightful read.
The book starts by unravelling the long-standing belief that the brain and body are distinct, with Lyman citing some remarkable findings. For example, in a , researchers gave immune-suppressing drugs to rats along with sugar water. After a few bouts, they started giving the sugar water without the drug. This was enough to greatly reduce the rats鈥� immune responses. A few even died.
Research has increasingly shown that the brain and immune system generally work in tandem to anticipate threats. But this can go wrong, as Lyman points out, sometimes leading to a reaction when no real danger is present. Some schizophrenia cases are misdiagnosed and are actually instances of the immune system mistakenly attacking the brain, for example. One woman spent 20 years in a psychiatric hospital before her doctors discovered she had lupus, an autoimmune condition that could be treated using immune-suppressing drugs.
Real-life stories like this run through the book, helping to ground complicated biological processes in real experience. Lyman also cites a large number of recent findings, making the book a worthwhile read even for those who are familiar with the area. For example, at the University of Minnesota and her colleagues that people treated with the diabetes drug metformin, which has effects on the gut microbiome, were 41 per cent less likely to develop long covid than those who weren鈥檛.
The Immune Mind wraps up by exploring how we can bolster our body鈥檚 defence system. This is probably the least substantial bit 鈥� and I think Lyman would agree. Still, there is sound advice, such as eating a fibre-rich diet and regularly exercising as a means of strengthening immunity.
The trouble is that lifestyle fixes can鈥檛 solve all our health problems. Nor does Lyman pretend they can. He emphasises the limitations of diet, movement and sleep. There is 鈥渘o best chess-move 鈥� it depends on the context鈥�, he writes. It seems obvious, but this message is often lost in a world of general advice on lifestyle and wellness.
At times, the book鈥檚 accessibility can feel forced. Most chapters open with an anecdote or example to illustrate their theme. This mostly works, but can misfire, such as when Lyman uses a few hundred words on border disputes between Egypt and Sudan as a segue into how some chronic conditions don鈥檛 fit into a single specialty.
But this is nitpicking about a book I highly recommend for its comprehensive, eye-opening overview of the interplay between the immune system, mind and gut microbiome. As a health writer too, I tip my hat to Lyman: turning neuroimmunology into a page-turner is no easy feat.
