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September 23, 2014

Food As Medicine
4

The 4 Myths of Depression

With the recent passing of Robin Williams, we are once again face to face with the harsh realities of mental illness. It brings many feelings to the surface as another great talent, who has touched so many of us with his super-human acting abilities, follows an all-to-common path.

I like to think that with  great tragedy comes great opportunity. An opportunity to learn from the situation and use it as a tool to help ourselves and others avoid walking down a similar path.

The Taboo of Mental Illness

When you break an arm, you can see it. There was an event with a story; there’s a cast that people can write on. But when there’s mental illness, it is hidden. You can’t see a feeling. People feel alone and isolated. And when they share their feelings, many don’t know what to do or say. There’s nowhere to write “get well soon”.

Since mental illness is such a taboo subject, naturally, there are many myths associated with it. I’d like to attempt to bring to the forefront some common myths, and more importantly the truths about mental illness, specifically depression.

Myth 1: Depression is a Single Illness

Our current system attempts to create protocols; a set of specific characteristics that lead to a diagnosis and ultimately a treatment. The problem with this is that the current method looks at downstream effects of upstream issues. Consider the following examples.

One of the most accepted theories (in the medical community) around depression is that there is a serotonin deficiency. Serotonin is the neurotransmitter that makes us feel happy and blissful, and essentially, not depressed. However, if people are deficient, where does serotonin come from so we can fix the deficiency?

One of the first questions I consider with my clients is, are they getting enough protein? You might be thinking, what does protein have to do with serotonin. Serotonin is actually made from protein. Protein is made up of amino acids, and there is a specific amino acid called tryptophan which converts into serotonin. So if my client is protein deficient, they simply cannot make the neurotransmitters they need for proper nervous system function.

Thyroid function has also been linked to depression. Small decreases in thyroid function and subsequently thyroid hormone, have been linked to depressive symptoms. 1 2

Another possible cause of depression is toxic overload. Our nervous system is predominantly made up of fat; and heavy metals, solvents, pesticides, herbicides, and many other chemicals have an affinity for fatty tissue. Many psychological symptoms can occur with toxicity. 3 4 5.

Blood sugar levels can play a role is our mood as well. There have been multiple studies showing hypoglycemia to be common in depressed individuals. 6 7 This is one reason why I stress to parents, they ensure they are controlling the blood sugar levels of their children.

Various vitamins and minerals have also been linked to depression including folic acid 8, vitamin B12 9, vitamin B6 10, vitamin D 11, zinc 12, selenium 13, and chromium 14.

Myth 2: Antidepressants Are The Best Treatment for Depression

In a very detailed analysis published in the British Medical Journal, two experts concluded “that selective serotonin reuptake inhibitors [i.e. Prozac, Celexa] do not have a clinically meaningful advantage over placebo” and “have not been convincingly shown to affect the long term outcome of depression or suicide rates.” 15. The research shows that antidepressants should really only be considered in severely depressed patients. 

The politics behind the research and why placebo-controlled trials are sometimes misleading are detailed in Dr. Peter Breggin’s landmark book, Talking Back to Prozac: What Doctors Aren’t Telling You About Today’s Most Controversial DrugOne of the issues with the research is that Eli Lilly, the manufacturer of Prozac, ran 10 clinical trials, and 6 of these trials showed no benefit over a placebo. Four studies showed a positive effect, but there were only 286 subjects in total in these studies. If you combine the results of all of these studies, the numbers show that placebo and drugs were equally beneficial. One problem is that the FDA requires at least two studies with positive results, but places no limit on the number of studies without beneficial results.

Myth 3: Antidepressants are Safe

Whenever taking a drug, the risks and benefits need to be taken into account. When it comes to antidepressants, there are many side effects including nausea (20%), headaches (20%), anxiety and nervousness (15%), insomnia (14%), drowsiness (12%), diarrhea (12%),  as well as dry mouth, loss of appetite, reduced sex drive, sweating, tremors, and rash.

But the most disconcerning effect associated with taking antidepressants is it’s increased risk of suicide and violent behaviour. In fact, compared with placebos, selective serotonin reuptake inhibitors at least double the risk of suicidal thinking. 16 If you just look to the news, kids who have shot up schools, and celebrities who have taken their own life, have commonly been on these drugs.

In 2004 the FDA finally issued a “black box warning” on all antidepressant drugs mentioning the risk of suicidal thoughts. This action is just shy of taking a drug off the market.

Myth 4: Drugs Are the Only Option

There are many theories as to why people develop depression and subsequently what the best treatment options are. But there are certain things that are one-hundred percent only going to help anyone’s metal health. Here is a short list:

  • Eat a whole foods diet with many vegetables
  • Move daily (the best exercise is the one you’ll do)
  • Spend time in nature
  • Expose yourself to full-spectrum lighting
  • Hang out with people who energize you (avoid energy-vampires)
  • Learn about how your mind works by studying the work of Wayne Dyer, Mark Waldman, Byron Katie, Eckart Tolle, and many others.
  • Meditate and/or do deep breathing daily
  • Smile, even when you don’t feel like it

Life is about emotion. It’s a journey riddled with highs and lows, successes and failures, life and death. It is the natural course of being human. It is normal to be sad, even depressed sometimes. But if it becomes pathological, meaning it affects your quality of life and health over the long term, step back, determine what new skills you require, what nutrients you need, what activities you should embark on, or find someone who can help you find these things. Happiness is our birthright.

Mental Health and Neurology

 

References:

  1. Gold M. Pottash A, Extein I. Hypothyroidism and depression, evidence from complete thyroid function evaluation. JAMA. 1981;245:1919-1922.
  2. Joffe R. Roy-Byrne P, Udhe T, et al. Thyroid function and effective illness: a reappraisal. Biological Psychiatry. 1984;19:1685–1691.
  3. Schottenfeld RS, Cullen MR. Organic affective illness associated with lead intoxication. The American Journal of Psychiatry. 1984;141:1423-1426.
  4. Rutter M, Russell-Jones R, eds. Lead versus health: sources and affects of low level lead exposure. New York: John Wiley, 1983.
  5. Seaton A, Jellinek EH, Kenedy P. Major neurological disease and occupational exposure to organic solvents. Quarterly Journal of medicine. 1992;305:707-712.
  6. Hadji-Georgopoulos A, Schmidt MI, Margolis S, et al. Elevated hypoglycaemic index and late hyperinsulinism in symptomatic postprandial hypoglycaemia. The Journal of Clinical Endocrinology and Metab. 1980;50:371-376.
  7. Fabrykant M. The problem functional hyperinsulinism on functional hypoglycaemia attributed to nervous causes. 1. Laboratory and clinical correlations. Metabolism 1955;4:469-479.
  8. Kivela SL, Pahkala K, Eronen A. Depression in the aged: relation to folate and vitamins C and B12. Biological Psychiatry. 1989;26:210-213.
  9. Zucker D. Livingston R, Nakra R, et al. B12 deficiency and psychiatric disorders: case report and literature review. Biological Psychiatry. 1981;16:197-205
  10. Russ C, Hendricks T, Chrisley B, et al. Vitamin B6 status on depressed and obsessive-compulsive patients. Nutrition Reports International. 1983; 27:867-873
  11. Harms LR, Burne TH, Eyles DW, McGrath JJ. Vitamin D and the brain. Best Practice and Research: Clinical Endocrinology and Metabolism. 2011; 25(4):657-669.
  12. Nowak G. Schlegel-Zawadzka M. Alterations in serum and brain trace element levels after antidepressant treatment. Part 1 Zinc. Biological Trace Element Research. 1999;67:85-92.
  13. Sher L. Role of Selenium depletion in the etiopathogenesis of depression in patient with alcoholism. Medical Hypothesis. 2002;59:330-333.
  14. Davidson JR, Abraham K, Connor KM, et al. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biological Psychiatry. 2003;53:261-264
  15. J. Moncrieff and I. Kirsch. Efficacy of antidepressants in adults. BMJ 331 (2005):155-157
  16. D Fergusson, S. Doucette, K.C. Glass, et al. Association between suicide attempts and selective serotonin reuptake inhibitors: systemic review of randomized controlled trials. BMJ 2005; 330(7488):396.