I felt this sensation in the pit of my stomach – it was a combination of sympathy and anger – listening to Annie tell me, through tears, about her postpartum journey into the world of psychiatry. “Three separate psychiatrists dismissed me when I expressed concerns about taking an addictive medication like Klonopin. It’s been two years, I can’t get off it, I’m on 4 psych meds and I feel worse than I ever did before I started this treatment.”
Annie was ushered into the promise-filled halls of psychiatry 3 months after the birth of her first baby when she began to experience racing heart, insomnia, vigilance, irritability, and a host of physical complaints including joint pain and hair loss. No one did blood work, asked about her diet, or cared about any of the myriad observations about her body and its changes in functioning. This was a “head-up” intervention. I believe women deserve better. People deserve better.
Most patients who come to me for treatment of depression and anxiety do so because they want answers. They want to know WHY they are struggling. The closest they will be offered by their prescribing psychiatrist or primary care doc is some reductionist hand waving about serotonin imbalances. I think it is time to speak to these patients with respect, truthfulness, and to offer them more than a life-long relationship with a pill (or pills, as it will inevitably become over the years).
First, let’s review some basics:
Depression is NOT a Serotonin Deficiency
Thanks to direct-to-consumer advertising and complicit FDA endorsement of evidence-less claims, the public has been sold an insultingly oversimplified tale about the underlying driver of depression. Here’s how we know depression is not a serotonin deficiency corrected by Zoloft:
What Is It Then? Inflammation! Inflammation is a buzzword that produces 41 million+ Google hits for a reason: it appears to underlie just about every chronic disease plaguing Americans today. A contribution of genetic vulnerabilities likely determines who develops heart disease or cancer or obsessive compulsive disorder, but many researchers are convinced that depression may have a significant inflammatory component. Just as a fever is one of your immune system’s mechanism for eradicating intruders, suppressing a fever, in no way, serves to resolve the underlying infection or to support the body’s return to balance.
What Drives Inflammation?What causes inflammation in the body that can affect the brain? This is the subject of an excellent book, Why Isn’t My Brain Working? A Revolutionary Understanding of Brain Decline and Effective Strategies to Recover Your Brain’s Health — and it turns out the list is long. But these are the contributors that I see most commonly in my practice:
It’s in almost every packaged food. Seriously. Look for it and you will find it. It may come with different labels – cane sugar, crystalline fructose, high fructose corn syrup – but it’s all sugar. The way the body handles fructose and glucose is different; however, which may account for why fructose is 7 times more likely to result in glycation end products or sticky protein clumps that cause inflammation. In addition to the above mood and anxiety rollercoaster, sugar causes changes in our cell membranes, in our arteries, our immune systems, our hormones, and our gut.
Gluten, soy, and corn have been identified as allergenic foods and a leading speculation as to how these foods became and are becoming more allergenic is the nature of their processing, hybridization, and genetic modification rendering them unrecognizable to our immune systems and vehicles of unwelcome information. Gluten and processed dairy, when incompletely digested, result in peptides which, once through the gut barrier, can stimulate the brain and immune system in inflammatory ways.
The epidemic incidence of autoimmune disorders in this country is a direct reflection of environmental assault on our system. The body’s ability to determine self from other starts with the gut and our host defenses there. Unfortunately, it doesn’t end there because autoimmune disorders typically have psychiatric manifestations. This makes sense – the body’s immune system is misfiring, and the immune cells of the brain (called microglia) are following suit. Beyond rampant inflammation, autoimmune disorders such as Hashimoto’s thyroiditis (more here) also result in symptoms related to damage to tissues. Low or erratic thyroid function can cause anxiety, depression, flattened mood, cloudy thinking, metabolism changes, and fatigue. Sometimes even the presence of immune system misfiring can predict depression as was noted in this recent study where women with thyroid autoantibodies in pregnancy went on to develop postpartum depression.
Original article by Dr. Kelly Brogan - Read Here