LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

depression

Toss the Prozac and Try This for the Kiddos

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Without dredging up horrid memories of high school, do you remember that our cells are made of a lipid bilayer?
That means that the outside of our cells are formed of two layers of fats sandwiched together.  For cells to function properly, a message needs to pass through this sandwich layer.  It works out that the healthier the fats in this sandwich, the better a message gets into or out of a cell.  Things just work better.
So, healthier fats = better messages.  Unhealthy fats = messages get lost.
Consider this in the brain.  Would you want the message to get to where it’s supposed to?  Of course.  So, better fats = better sandwich = better messages.
This can translate to neurotransmitters like serotonin or epinephrine or dopamine getting from one cell to another.  So, of course we would expect to see psychological problems like depression get better with higher intakes of healthy fats.  Seems pretty simple, huh?
Which leads us to this particular study, where researchers looked at the relationship between dietary fish intake and depressive symptoms in over 6500 Japanese children who were between 12 and 15 years of age.  Here’s what they found:
  • In boys, higher fish intake was linked to 27% lower risk of having depressive symptoms.
  • EPA intake had the strongest effect (29% for EPA, 21% for DHA).
  • Looking at omega-3 intake (and not specifically fish intake), there was a 28% lower risk.
  • The protective effect was limited to boys.

Antidepressants; Billions of Dollars for a 2.7% Improvement

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There are some treatment approaches that sound good at the onset; find a neurotransmitter that helps to elevate mood and just synthetically increase the level of the neurotransmitter with a drug.

Conduct a few biased trials with the deck stacked in favor of a benefit and start marketing the heck out of the drug.  Prosac was launched in 1988.  There was a 600% increase in the use of SSRIs during the 90’s and the cost to the US in now well into the billions of dollars per year.

But, once we take out the biased research, what are we left with?

How ’bout a 2.7% sustained improvement according to this particular article?

Do you think PCPs are looking their patients in the eyes as they hand them the script with a smile and saying “you’re going to feel almost 3% better as soon as you start taking this!!”  At least until you get bone loss, become obese or develop diabetes.  Then you’re more upset than before you started.  Compare this improvement to use of fish oils, St John’s wort, 5-HTP.  Throw in some exercise and we’re not even in the same ballpark.

I truly think that if the public knew the sordid details about how little benefit we derive from most drugs, the entire industry would fall like a house of cards.

Is YOUR Stress Programming Your Kids for Depression?

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There is absolutely no doubt that stress is a major factor in the declining health of our country.  From the standpoint of treating patients in my office, helping patients manage their own stress is one of the most difficult tasks I undertake.  Sadly, only on rare occasions are patients successful.
I know that my own life is virtually stress free (despite its challenges) but I am unfortunately all to often unable to help guide patients to the same state of mind.  Maybe if patients truly understood how devastating stress is the outcomes would be better.
This particular article points to previously unforeseen consequences.  Basically, early on (preschool up until 3rd grade), children who were at high risk of dysphoric disorder had a slower than expected cortisol response to stress.  At some point in the next few years, these same high risk kids OVER react to these same stressful situations.
There is something that happens very early on to our children that may predispose them to depression.  Alterations in healthy stress responses begin as early as preschool.  Research has even suggested that life in the womb can predispose children to altered stress responses.
Is YOUR stress affecting your children more than you think?

 

Serotonin, SSRIs and Depression; The Myth Behind the Marketing

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depression risk factors
serotonin and depression

If you go into your PCP’s office and mention that you’ve been feeling down there’s a good chance you’re going to get a prescription for a SSRI.

SSRI stands for Selective Serotonin Re-uptake Inhibitor.  This is a class of drugs that slows the brain cell’s ability to pick up the hormone serotonin that your brain cell just used to send a message to the neighboring brain cell.  To put it in simpler terms, SSRIs keep serotonin in play longer, increasing the likelihood that a message is going to be relayed.

The typical concept that is used in explaining the use of SSRIs is that you have a chemical imbalance in your brain (serotonin) and this drug will fix it.

Sounds pretty straightforward and seems to make sense.  It also gives many people hope that there is a drug to fix how he or she is feeling.  There is something WRONG and it can be FIXED.

But what if this entire concept was MADE UP?

Couldn’t be possible, right?

There’s no way a concept like a drug that can fix a chemical imbalance in the brain and help with depression could become as well-founded in medicine and society as drinking water to cure thirsty.

You know where I’m going with this although this point you’re probably about as skeptical as you’ve ever been.  This information was all brought up in an editorial in the BMJ by Dr. David Healy, a professor of psychiatry in Wales.  The full text of this editorial can be found on his website by clicking here.

Let’s review some things that we already know first:

  1. SSRIs have been shown to be pretty much worthless in the medical research beyond placebo (especially when ALL the studies are taken in account—not just the positive ones).
  2. The placebo effect is very, very powerful and deals with the brain. Which is ironic since depression and anxiety are “brain” problems.
  3. While a small few do benefit, the vast majority of patients in my office who are on this class of drugs don’t notice all that much of an improvement in mood with use beyond 3 months. Most give me a sheepish shrug and a grunt of “maybe” when I ask if they seem to help.

With these three things in mind, it’s time to clarify a few more myths and identify the timeline of SSRI development, marketing and use.

Serotonin levels and depression

Early clinical studies attempted to demonstrate that people with depression had lower levels of serotonin.  This was never able to be proved.  To make this a little bit more confusing, the SSRIs have never been shown to actually increase serotonin levels (except theoretically in the synaptic cleft between brain cells).  Contrast this with compounds like tryptophan and 5-HTP, which give the body the building blocks to make more serotonin if needed.

There has been no evidence that the strength of the SSRI’s effect on blocking serotonin reuptake was related to the better outcomes (in other words, stronger SSRIs did not have a greater effect on depression).

Just to make matters worse, the original clinical trials pitting SSRIs up against the tricylic antidepressants like Elavil and Amitriptyline had them failing miserably.

Finding a use for the SSRIs

The SSRIs were developed in the late 1980s, but originally had no indication.  In other words, the drug companies had a neat new drug but no idea what to do with it.  The original thoughts were to use it for controlling blood pressure of maybe weight loss, but these ideas were quickly scrapped.

But concern was rising with the risk of dependence from the use of tranquilizers, creating a potential market for the SSRIs.  However, the general public had been trained to expect an immediate response from their anxiety and diabetes drugs and the SSRIs didn’t fit this expectation.

So the drug companies needed to retrain the public and doctors by reframing how we thought about depression.

It’s amazing what gobs of money can accomplish.

So the drug companies created the idea of a chemical imbalance linked to serotonin levels.  Luckily, the white horse was already on its way in.

So where does that leave us?

All of this does not mean that serotonin was a worthless concept.  But it does likely mean that the use of drugs that affect serotonin reuptake are not the answer.  Don’t expect this message to be adopted anytime quick, though.  This is still one of the most successful classes of drugs on the market and there are enough prescriptions written in the Westernized world to treat every adult.  Many of these prescriptions are being used because patients could not get off of them.

The long list of side effects that are experienced with withdrawal are sometimes used to convince patients that they NEED to be on the drugs.  What a way for the drug companies to create their own market.

The real long-term answer to psychological disorders lies with brain health.  Making sure that the cells of your brain have the energy they need to function at their best.  Making sure that the cells are healthy enough so that they can communicate with each other when needed as well as NOT communicate with each other when needed.

Tools for this should include:

  • Exercise
  • Stress management techniques (yoga, biofeedback, meditation)
  • Counseling—you NEED a good therapist on your team to help you learn long-term coping strategies
  • A brain-healthy lifestyle (you can check out my Depression eBook by clicking here)
  • Positive outlook—waking up each day at looking for the positives, always focusing on these rather than the negatives
  • Brain-healthy supplements like vitamin D, magnesium and fish oils

I’m not saying that there is no need for drugs that affect the psychological aspects, but these drugs should be used short-term while you get the motivation and education to rise above your current mental state.

Some may still need drugs long-term, but these drugs, like any other drugs, should not be the ONLY tool in your toolbox.  Rather, they should be just one of many (like those on the list above) of the tools you use to help your brain.

Have a Skinny Friend? Maybe You Should Borrow Some of This

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probiotics and obesity
Kirsty Pargeter / Dollar Photo Club

Obesity and weight loss are complicated issues. It’s no longer about calories in versus calories out.

In a prior article I wrote about the contributions of environmental chemicals to obesity and diabetes.  And this contribution is not a small one.  You can read more about this relationship by clicking here.

Certainly the quality of the foods you eat, the calories and the amount of calories that you burn play a role.  You can’t sit on the couch and eat 4,000 calories a day and not expect to gain weight.  But what about the other extreme?  What if you watch your calories, watch the quality of your calories as well as exercise consistently using both aerobic and resistance training and still cannot get to your ideal weight?

That is the frustrating situation you may find yourself in, ultimately throwing up your hands and giving up.  And unfortunately, I can’t provide you with a direct, immediate answer.  The answer to maintaining an ideal weight is not an easy one.  It certainly requires attention to diet and exercise.

The harder factors to account for and change are the environmental ones I mentioned earlier.  I know that in our household we have moved to stainless steel pitchers for our tea, glass and stainless steel for our water bottles, glass for our cups, natural / fragrance free dish soaps, laundry soaps and cleaners as well as getting any other chemicals that we can identify out of our lives.  Not an easy task and we have to make some sacrifices as a family.

Talk about confusing.  I cannot tell you how many patients are unaware that drinking out of plastic water bottles can make them fat.  But what if the story got even MORE confusing?

Just what you wanted to hear.  But that’s exactly what this particular study does.  There has already been some hints from medical research that the bacteria in your gut can play a role in body fat.  Stress, artificial sweeteners and antibiotics have all been shown to disrupt the delicate balance of the bacteria in your gut towards obesity and diabetes.

The researchers in this study took it quite a bit further.  They took the bacteria in the gut of mice fed a high fat diet and transplanted this bacteria into mice who had basically had their guts wiped clean of bacteria so it was a clean slate.  Here’s what happened to the mice given the high fat diet bacteria:

  • There were disruptions in exploratory, cognitive, and stereotypical behavior (there were actual behavioral changes in the mice).
  • There were disruptions in markers of intestinal barrier function (aka leaky gut).
  • The was increased circulating endotoxin (more toxins from the bacteria in the gut).
  • There was increased lymphocyte expression of ionized calcium-binding adapter molecule 1, toll-like receptor 2, and toll-like receptor 4 (basically, the white blood cells were gearing up for a fight with something).
  • There was increased inflammation in the brain as well as alterations in the blood flow within the brain.

All of these changes from something as simple as changing the bacteria in the gut.  Some would say this is just a mouse study and has no relevance.  That argument is a little weak when you look at the human studies previously mentioned that have found relationships between bacteria in the gut and obesity.  Then when you consider the reports of weight gain in patients who has undergone fecal transplants for C. diff infections this study becomes even more important.

The take home message is that the bacteria in your gut plays a strong role in your weight.  The stress you experience, the foods you eat, your exercise and the drugs you take in (from anti-inflammatories and steroids down to antibiotics) all have an influence on your gut bacterial populations.  Think on that when you decide to adopt a behavior that is known to negatively affect the bacteria in the gut.

MS, Seizures, Migraines–Can Your Gut Protect Your Brain?

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gut bacteria and the brain
fotoliaxrender / Dollar Photo Club

Anyone with a neurological condition, whether anxiety, depression, epilepsy, migraines or MS, will tell you that symptoms wax and wane.  But why?

While a common occurrence, it seems that few question why this is so.  It is considered more as just a course of the condition.  But what if the fluctuations of symptoms are not only explainable, but possibly controllable?

The blood brain barrier (BBB) is a layer of cells that basically separates your brain cells from the rest of your body.  Consider it like the Great Wall of China for your brain.  And there are very specific gates that restrict access to only what your brain needs.  Even immune cells cannot cross this barrier.  Luckily, the brain has its own set of immune cells (called the microglia) to fight off anything that threatens to attack the brain cells.

The BBB develops very early in the womb and, as a result, the immune system never really “sees” the cells that make up the central nervous system.  In other words, it’s a very sheltered, protected environment due to the presence of the BBB.  Or at least it would be if the BBB remain intact.

We know that in certain neurological conditions, like multiple sclerosis (MS), the BBB solidity fluctuates, sometimes doing what it is supposed to be doing and sometimes letting in chemicals, compounds and immune cells that the brain would be better off not being exposed to.  This leaky BBB has been linked to symptom flare ups in MS.

What if you could better control your blood brain barrier through lifestyle choices?  That’s exactly the question raised by this particular study.  In it, researchers looked at two groups of mice.  The first were born to mothers who were raised in sterile, germ-free environments.  In other words, this group of mice did not have the benefit of being exposed to bacteria from the womb on.  The second group was born to mothers who were raised with normal exposures to bacteria.

Here’s what happened:

  • The germ-free mice had a leaky BBB while the normal mice did not.
  • The leaky BBB started in the womb and continued through birth and during adulthood.
  • The mice with leaky BBB had reduced expression of proteins that protect the brain barrier (tight junction proteins occludin and claudin-5).
  • However, when the gut bacteria from the normal mice were put into the damaged BBB mice, the blood brain barrier stabilized and there was a higher production of tight junction proteins.

This is an animal study and done under controlled conditions, but given how much the gut bacteria have been shown to play a role in other neurological conditions, the results of this study are likely to fit in with what we already know.  The relationship between the bacteria in our gut and just about every aspect of health is literally exploding at an exponential rate.  It seems like every day we learn more about how it affects our health and risk of chronic disease.

Despite this, I have patients come in time and time and time again given drugs like antibiotics, steroids and NSAIDs that completely disrupt the delicate balance of the bacteria in the gut.  This remains a topic that mainstream medicine seems determine to remain oblivious to no matter how much research is published.

Depression and Essential Fatty Acids (i.e. Fish Oils)

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DID THE 90’S DESTROY OUR BRAINS??

Few things have had such a detrimental effect as the release of the USDA’s food guide pyramid in 1992.  There was no differentiation between healthy and unhealthy fats.  Over the next 15 years, the American public was brainwashed by this pyramid, and with the demonization of fats, “fat” became synonymous with “fattening.”  We saw rates of cancer, diabetes, heart disease and psychological disorders increase.  Given the importance of DHA in the brain, this particular study should come as no surprise.  Researchers looked at 14 studies and found those diagnosed with depression had lower levels of omega-3 fatty acids.  So, if you have dealt with any type of psychological condition and your doctor has NOT recommended fish oils, you need to find a new doctor.  If a doctor has not cracked a medical journal in their specialty in over a decade, this is not the type of physician I want treating me or my family.

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Psychotropic Practice Patterns for Youth–A 10-Year Perspective

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Psychotropic Practice Patterns for Youth–A 10-Year Perspective.
The idea that utilization of psychotropic meds for youth is closing in on adult levels that drops my jaw. Are our children that disturbed? And, even if they were (which I strongly doubt…) would anyone out there like to bet their right arm against the fact that these drugs in no way interfere with proper neurological development? Remember that the brain is plastic–it is constantly regenerating itself. The old adage that killing off brain cells in college never to be replaced is not true. Those new cells being produced are being bathed in meds that we have no true long term studies (unless you consider 3 years long in the life of a child) showing their safety.

Psychotropic Practice Patterns for Youth: A 10-Year Perspective – Click here for more information.