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depression

Autism, Schizophrenia and Depression; Surprising Thing They Have in Common

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Disorders of the mind have never been as easy to grasp for doctors. While therapists have a larger toolbox, most physicians are limited to medications.

For me, medications that screw with the essential way that your brain cells function in relationship to one another are a wee bit on the scary side.  We really know so little about the brain so it seems that using medications to alter it would be akin to cavemen using rocks to fix an iPad.

But alas, this is all we do in modern medicine.  The lucky ones will find their way to a good therapist and find tools to help.

But rarely does the topic of lifestyle changes come up.  The prevailing attitude is the opposite—there is little that can be done in the way of diet and lifestyle to manage these conditions.  But contrary to this opinion is an increasingly growing body of medical literature stating the opposite.

There is one key factor all these conditions and all this research have in common.

Inflammation.

Yup, that all so subtle, lifestyle-driven state of immune dysfunction.  It ranges from full-blown autoimmune conditions where the immune system is attacking tissues and organs it should not be to allergies and asthma when the immune system completely ignores the tissues inside and runs around like a Tasmanian devil trying to keep innocuous dust and particles at bay.

In all these situations, the resources used to drive the inflammation leaves the inflamed patient fatigued and prone to infections.  The constant insult to the body, the zapping of the body’s resources, the need to repair tissues again and again ultimately increases the risk for all chronic diseases, especially heart disease, dementia and many cancers.

But what does this inflammation do to the brain in the here and now?

It is very clear that current inflammation wreaks havoc on the brain.  This little fact, however, has escaped the notice of psychiatrists for decades.  Until now.

At this years’ (2014) annual meeting of the American Psychiatric Association the cat was let out of the bag by Dr. Eric Hollander of Montefiore Medical Center and Albert Einstein College of Medicine, New York City.  During the next several presentations, Dr. Hollander and others covered several important examples that demonstrate the links between inflammation and psychiatric disorders.

Dr. Andrew Miller of Emory University School of Medicine, Atlanta discussed the relationship between depression and inflammation.  He used these findings as proof:

  • Several studies have demonstrated that patients with depression have higher levels of inflammatory messengers (cytokines) in their blood and cerebral spinal fluid (specifically IL-6, TNF-alpha and CRP).
  • In treatment-resistant depression (about one-third of all depressed patients) there is an increase in inflammatory chemicals that have the ability to sabotage and deactivate the action of antidepressant therapy.
  • In one of the first studies in psychiatry linking a biomarker to treatment response, the high-powered drug used to block TNF-alpha (infliximab) was used in those with treatment-resistant depression.  Those patients who had high CRP levels had the best response to infliximab.
  • In a related study, Miller’s team were able to tell, using gene expression profiles, which patients were going to responded to infliximab within 6 hours of the first infusion.

The topic of schizophrenia was addressed by Dr. Norbert Müller of Ludwig Maximilian University of Munich, Germany.  Here were his points:

  • Infections and inflammation play a role in the development of schizophrenia; prenatal and postnatal infections are risk factors for schizophrenia.  The risk increases with the number of infections.
  • A number of studies using anti-inflammatory cyclooxygenase-2 (COX-2) inhibitors in addition to antipsychotic medication have had positive effects.
  • Timing is important: no benefit was seen in who had chronic schizophrenia, but anti-inflammatory therapies given early in the course of the disease were effective.

Dr. Hollander addressed the relationship between autistic spectrum disorders (ASD) and inflammation.  He notes:

  • Increases in inflammatory chemicals have been found both in the cerebrospinal fluid of patients with ASD and in brain tissue at autopsy in those with autism.
  • The bacteria in the gut may play a large role (the gut “microbiome”).
  • In support of the “hygiene hypothesis,” developed countries have higher rates of autoimmune conditions.
  • Hollander and others have focused on affecting the microbiome using a medicalized parasite, Trichuris suis ova (TSO-the eggs of a porcine whipworm). Trichuris suis ova is safe in humans, does not multiply in the host, is not transmittable by contact, and is cleared from the system spontaneously.  It works by balancing the inflammatory response to increase its survival. This balance in our system has shown some success in autoimmune diseases such as Crohn’s disease.
  • His group has been carrying out a small study of TSO in 10 high-functioning adults with ASD for 3 months and have found a potential benefit.
  • In another interesting study, researchers studied 10 children with ASD who were known to improve when they had fevers.  The children spent alternate days soaking in a hot tub at 102°F (to mimic fever) or at 98°F (control condition), showing improvements on the hot tub days.  It is believed that upping the body temp releases anti-inflammatory signals that positively affect behavior.

All of this information is a bit to swallow at once.  However, the real take home message is that inflammation is very bad for the brain, whether it is related to one of the three conditions covered here or another one like migraines, epilepsy or dementia.

Brain health is all-encompassing.  If you have no conditions it is still just as important to keep your brain healthy today for tomorrow’s brain health.  Leading an anti-inflammatory lifestyle is critical.  While the full nature of an anti-inflammatory lifestyle is beyond the scope of this article, you can better believe it involves exercise, stress management and a plant-based diet high in healthy fats.

 

Natural Cures for Depression: Prediabetes and Your Brain

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I’ll agree that getting someone in the deep throes of depression to exercise is not likely to happen.  But that does NOT mean that natural cures for depression won’t work.

Motivation is not high on the list of character traits of a person with depression.  For this reason exercise, which is arguably the most powerful tool available for improving depression, is not going to happen.

But, what I cannot accept, is that other lifestyle choices that don’t require motivation, but rather require the right choices, cannot be implemented.  The right lifestyle choices, largely dietary, are a conscious decision made most often at the grocery store.  Anyone can choose to buy a bag of potato chips or choose to buy vegetables or nuts.  These decisions will clearly have an impact on brain health.

Many will snort in derision at the idea that diet can impact brain health and subsequently depression.  To these people–how can you possibly think that the foods and nutrients that you put into your body are NOT going to affect your brain?  It’s not like the brain is isolated from every other organ system; rancid processed hydrogenated oil, aspartame, FD&C red dye, that brominated vegetable oil, mercury present in the high fructose corn syrup; they are ALL going to touch the cells in your brain.  These toxic compounds will insinuate themselves into the very machinery of your neurons and interrupt function.

Does this sound like diet does not have an impact on brain function?  To think otherwise tells me that you have too many of these compounds in your life already.

As I was reviewing all the research that went into my Depression Risk Factors: Beat it Before it Starts, Fight it Once it Does eBook, I was reminded of just how powerful healthy fats such as DHA and EPA (fish oils) are in depression.  And this is not information from Reader’s Digest–it is from medical studies supporting the benefit of heathy fats on depression.

All of this leads us to this particular study.  In it, researchers looked at the what happened to depression scores (using the Beck Depression Inventory) in 55 prediabetic patients who followed one of two low-calorie diets (30% fewer calories) for 6 months.  Here are the details:

  1. Both diets improved self-perceived depression.
  2. Those who ate more omega-3-fatty acids had lower depressive symptoms at baseline.
  3. Those who increased their dietary folate had better improvement in depression.
  4. Those with a greater decrease in oxidative stress (as measured by malondialdehyde levels) also had better improvement in depressive symptoms.

Back to the individual depressed person who does not have the motivation to exercise and does not believe that dietary changes can have an impact on depression.  You can no longer hide behind the belief that dietary changes are pointless.  Dietary changes do not require effort, they require a decision.

Make that decision now and follow these changes for 3 months and see how you feel.  If (when?) the changes help your brain, use this window of time to add in exercise.  Dietary changes and exercise all the long-term tools to help your brain.

 

Does Your Diet Depress You?

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When it comes to depression, our society relies heavy on drugs for an answer.  Even counseling is a late effort.  Maybe primary care physicians should not be the first choice in this realm.

Drugs first, counseling second, lifestyle never.  I’d probably suggest a revision.

When patients come into my office who are on antidepressants, I always ask if they help.  While I do get a few who say they couldn’t survive without them, the vast majority give me a sheepish shrug and admit that they’re not really sure.  The real test, however, is always beyond the 3 month mark, when the massively strong placebo effect begins to wane and you’re left with the true benefits (or lack thereof) of the antidepressant medication.

When it comes to healthy lifestyles, supplements and depression, the research is solid and continues to accumulate (feel free to check out my eBook on Depression Risk Factors by clicking here).  While St. John’s wort tops the list as the supplement that comes to mind with depression, omega-3 fatty acids are really the heavy hitter.

This particular study adds weight to this fact.  In it, researchers looked at the relationship between depressive scores (as measured by the 20-item Center for Epidemiologic Studies–Depression Scale, aka the CES-D).  A CES-D score of 16 or more was suggestive of elevated depressive symptoms (EDS).   Here’s what they found:

  1. EDS prevalence was 18.1% in men and 25.6% in women.
  2. In women, those with the highest dietary intake of omega 3 fatty acids had a 49% lower risk of EDS.
  3. Those with the greatest omega 3 to omega 6 fatty acid ratios had an impressive 53% lower risk of EDS.
  4. For the somatic CES-D subscales (measuring things like sleep problems, sadness and fatigue), higher intakes of omega–3 fatty acids led to lower scores.

Clearly, higher intakes of omega 3 fatty acids (fatty fish, flaxseed, nuts, seeds, chia seeds) and a lower intake of omega 6 fatty acids (oils like corn, sunflower, peanut, safflower and cottonseed) are very good for the brain and will lower you risk of depression.

The biggest concern and problem with depressed people is compliance.  Sure—they all know that exercise is really good for their brains, but few have the motivation to pull off a regular exercise routine.  But increasing your omega 3 to omega 6 ratio doesn’t require motivation, merely a desire.  Depressed patients are still eating.  But McDonalds is not going to cut it.

 

Can Supplements for Depression Beat Medication?

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Most cases of depression are treated with antidepressants in medicine today. But when talking natural depression treatments, St John’s Wort pops up first.

Certainly St. John’s Wort has a pretty good track history when it comes to battling depression, but are there any other supplements that can help?

Before I answer that, let’s cover a little bit on depression first.  Too often we think of it as some kind of “chemical imbalance,” despite the fact that there is absolutely no proof that any such entity exists.  Personally, I think the idea of an imbalance was fostered by the drug companies to increase the acceptance of medication designed to correct such an imbalance.  I mean really–do you think you were built with a shortage of Prosac?  Maybe at your moment of conception the gene that makes Paxil just didn’t make it?

Since we inherently know that this can’t be true, what goes wrong?

Well, there’s a couple of solid theories.  First and foremost is having healthy brain cells so that messages that are supposed to get out and into the cell get to where they are going.  A diet filled with unhealthy fats and devoid of healthy fats is going to leave your brain cells unable to effectively  communicate with its neighbors.  This is why there are numerous studies supporting dietary changes and omega 3 fats on depression have been published.  For a full review, feel free to check out my Depression Risk Factors eBook that can be found by clicking here.

Another bad situation for the brain is inflammation.  Anytime inflammation runs amok (unlike the controlled inflammation associated with something like a sprained ankle) the blood vessels suffer.  Once the blood vessels become inflamed the next stage is worsening brain health.  If your brain cells can’t get the nutrients they need, the same problem with communication mentioned above is going to occur.

Based on this information, what if we used a natural anti-inflammatory to treat depression, a brain cell based problem that is affected by inflammation?  You of course know where I’m going with this one.  In this particular study, researchers compared the natural anti-inflammatory curcumin (which is the most powerful compound found in the spice turmeric) to the popular antidepressant of the SSRI class fluoxetine (Prosac).  Here’s the details:

  1. 60 patients with MAJOR DEPRESSIVE DISORDER (important–this is not run of the mill gloomy that we’re talking about here).
  2. They were give fluoxetine (20 mg) and curcumin (1000 mg) individually or in combination for 6 weeks.
  3. Response was rated using the Hamilton Depression Rating Scale, 17-item version (HAM-D17).
  4.  The response was highest in the combination group (77.8%) than in the fluoxetine (64.7%) and the curcumin (62.5%) groups.
  5. However,  the overall change in HAM-D17 score at the end of six weeks was comparable in all three groups.

Overall, the response to curcumin was equivalent to that of Prosac.  That’s where the similarities end.  The curcumin supplements were well tolerated (which we know that upwards of 38% of patients taking SSRIs experience side effects).  In addition, SSRI are linked to poor bone health and osteoporosis as well as the development of weight gain and diabetes.  Curcumin, on the other hand, has almost the opposite effects.

Seems like a good-brainer to me (get it?  Not a “no-brainer,” but a “good??”  Never mind….).  Anyway…let this be a reminder to avoid the high-fructose corn syrup ketchup and overload your food with mustard.

 

Retroviral RNA in the CSF and brains of individuals with schizophrenia – (05-10-01)

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Retroviral RNA in the CSF and brains of individuals with schizophrenia

Just thought I would throw this article into the mix. Psychiatrists and counsellors today give little credence to the idea that physiology places a role in mental health. Granted, I am biased because of my studies, but I feel that physiology may indeed be the major player in many forms of mental health. Which would, of course, mean that any patient with a mental health problem, be it depression, anxiety or schizophrenia, would benefit greatly if not entirely from nutritional and lifestyle modification.

PNAS — Abstracts: Karlsson et al. 98 (8): 4634

Read entire article here

Depression in medical illness – (11-29-00)

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Depression in medical illness

This is a very interesting article outlining the interactions between the immune system and our mental health. Chronic infections and chronic immune stimulation can actually produce depression in patients. This depression can then, in turn, lead to additional physical complaints. This may be why certain antidepressants actually lower complaints in certain patients with syndromes such as fibromyalgia. The drugs do not actually get to the cause of the original complaint (the immune activation) but do help with the secondary effects of the depression. Unfortunately, without controlling the underlying immune activation, any therapy will not be very effective.

wjm — Yirmiya 173 (5): 333

Read entire article here

Teenage Depression Treatment w/ Drugs? 3 Things You Need to Know

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Somewhere along the way someone decided that teenage depression treatment using antidepressants was ok.  I understand that there are challenges and there may actually be a time and place for medicating our kids for psychological problems.

But certainly not at the rate we are medicating them today.  These drugs affect the way your brain functions.  YOUR BRAIN.  Yes–the center of who you or your child is.  YOUR BRAIN.

Any antidepressant drug is going to fundamentally change the way that an enzyme involved in a pathway in the brain performs.  And unless we choose to fool ourselves, we really have no idea whatsoever how our brains function.  Messing around in a developing brain just sounds like a bad idea.  But just how bad?  This particular article looks at just how much anti-depressants may effect a developing child’s brain.

First, a brief primer on the amygdala.

The amygdala is a region of the brain that is thought to be responsible for things like fear conditioning and the long term processing of memory.  Since it is responsible for fear conditioning, what do you think might happen if we blocked the action of receptors in the amygdala with antidepressants?  Of course you know where I’m going with this.

While this study was done on rats, the implications are pretty scary.  Basically, chronic use of antidepressants lowered the number of receptors on a certain region of the amygdala that receive the neurotransmitter NMDA.

Behaviorally, the chronic antidepressant rats lost the ability to learn fears needed to protect themselves.   We cannot directly transfer the results of this study to teenage depression treatment using antidepressants, but it should raise concern over just what we are doing to our kids’ brains when drugs that effect the neurotransmitters in the brain are given during a time of incredible brain development.

Further, consider the concerns over the tragedies that seem to occur at higher rates here in the US than other countries.  We like to vacation in Mexico, and yet we hear all the time about how dangerous it is in Mexico for tourists.  Do these people mean to say that in Mexico, with a much lower antidepressant use that the US, we hear stories of random teenagers shooting up schools, malls and movie theaters, killing absolutely innocent bystanders?

The answer is, of course, no.  The US clearly dominates the world in these types of random shootings.  At the same time, the US has a much higher (and climbing) rate of antidepressants use over other countries.  Now, we learn from this study that chronic antidepressant use has some type of effect on learning fear for self preservation.  To think that these thinks are NOT connected is wishful thinking.

If antidepressants seem to be a very bad idea for teenage depression treatment, what are some other options?  Here are some very powerful tools to help heal the brain:

  1. Exercise is likely the most powerful teenage depression treatment that we know of.
  2. Increase intake of healthier fats like wild caught fish, nuts and olive oil.
  3. Stress reduction via meditation, deep breathing, or tools such as the Resperate.

While there are never any promises, these simple steps can begin a process of healing the brain to get it to develop and function properly.

 

St John’s wort and imipramine for treating depression – (10-05-00)

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St John’s wort and imipramine for treating depression

The studies keep piling up demonstrating the effects of St John’s wort with better tolerability. Now, add exercise, dietary changes and essential fatty acids and I think almost all cases of mild to moderate depression could be better handle using natural methods.

Read entire article here