Saturday, April 25, 2009

DEPRESSION - A NUTRITIONAL DISORDER

Article written by :
Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr


Site from which it is taken:
http://www.hypoglycemia.asn.au/articles/depression_disorder.html


If you ever wonder why so many people are suffering from ‘treatment resistant’ depression it is because mainstream medicine and psychology can offer only ‘palliative’ remedies. They treat symptoms only and not causes.
Drug therapy can only suppress the symptoms of depression, but does nothing to address the underlying biochemical abnormality that is responsible for depression. Once a patient is on the drug band wagon, they usually go on the merry-go-round from one drug to another for maybe the rest of their lives. Several studies have shown that drug therapy and/or psychotherapy may leave about 60 per cent of patients with treatment resistant depression.

Similarly, mainstream psychologists believe that talk therapy can alleviate the symptoms of depression. They assume that our irrational thoughts, unpleasant childhood experiences or ‘bad parents’ - hidden in a mythical ‘subconscious mind’ - have caused us to be depressed. They have us believe that by changing our attitudes and beliefs (for instance by RCBT) we can overcome the underlying biochemical disorder. They truly believe that psychology is a question of ‘mind-over-matter’. We only have to bring these ‘unconscious’ thoughts into consciousness and voila we become better. Many psychologists assume that depression is caused by cognitive processes, such as a low self-esteem, making the mistake of confusing symptoms with causes. This is ‘palliative treatment’ without addressing the underlying biochemical disorder.

True, when we experience a stressful situation in life - such as divorce, bereavement, rejection by a loved-one or any other trauma - stress hormones interfere with the synthesis of our feel-good neurotransmitters and we become depressed. This is called ‘environmental’ depression, where a person is fully aware of the external source of stress. Here the production of stress hormones helps us to find a solution. See Strickland PL et als. (2002). Sometimes such person can be helped by changing their coping skills or lack of self-esteem that could be at the root of their problems.

And, when the source of stress is removed people soon start to produce the happy hormones again and life resumes.

Unfortunately, many depressed people do not fall into that category, because after the removal of the external trauma, they continue to feel depressed and often cannot understand why, which brings them into the hands of a therapist. This may explain the development of Post Traumatic Stress Disorder, when a person fails to produce serotonin following a traumatic experience in a person’s life, long after the event. See PTSD and Hypoglycemia.

The majority of people seeking advice and information at this web site are people with ‘endogenous’ depression; that is to say that their depression is due primarily to a chemical imbalance in the brain. Mainstream medicine and psychology often fail to help these people, because they have no proper explanation as to the causes ‘endogenous’ depression. Consequently, they are not in a position to help depressed people.

Thus we need a different interpretation of endogenous depression as an alternative to the prevailing narrow drugs and/or psychotherapy model: AND which is based on scientific knowledge.

I will propose the psycho-nutritional model which says that depression - and for that matter any other non-psychotic mental illness - is a disease of energy production.

For the brain to change one molecule into another - as in the conversion of tryptophan into serotonin - it needs a disproportionate amount of biological energy called ATP. That energy is derived from the sugars in our food in the form of glucose. It is transformed into biological energy as a result of a complex biochemical pathway, called glycolysis.

The brain although 2 per cent of the body requires about 60-70 percent of all available energy, whether we are asleep or awake. A normal healthy cell requires about 2 million molecules of energy (ATP) per second to fuel biochemical reactions inside the cell. This is all derived from glucose in our food. See here.

Thus if the brain is deprived of that energy, it cannot synthesize the feel-good neurotransmitters such as serotonin, norepinephrine, dopamine or acetylcholine, to make us feel happy and relaxed when we normally should. One immediate consequence is that the body is inundated with stress hormones, which will undermine one’s self-esteem. This is often mistakenly interpreted to mean that a negative self-image is the cause of depression.

Without serotonin the body cannot produce melatonin - the sleeping neuro-chemical that makes us sleep - and so we see that depression is usually associated with insomnia. Because serotonin is also associated with the appetite mechanism, depression is often accompanied with weight problems. Unabsorbed sugars in the diet are stored in the body as fat cells, hence the association between depression and obesity. See also: Connection between obesity and depression. Not only energy, but a host of other nutrients are required to bring about these biochemical reactions in the brain. They could well be deficient.

If the universal source of energy is derived from glucose in our food, one may wonder why it is, that in a high sugar consuming society in the Western world, people would suffer from energy starvation? Could this be responsible for the exponential increase in depression and mental illness?

Excessive sugar consumption, when converted to glucose, can expose the body to free radical attack upon the immune system and DNA. Glucose is easily oxidized into peroxides and other toxins. The body has a defense mechanism against excess sugar consumption: it shuts down receptors for insulin that controls the amount of glucose (and other nutrients) getting across cell membranes into cells. This is called Insulin Resistance, which may result in hypoglycemic symptoms. There are many studies showing a significant association between depression and insulin resistance. See here.

With insulin resistance blood sugar levels tend to rise, triggering more release of insulin - called hyperinsulinism - and this may provoke a sudden descent in blood sugar level called hypoglycemia. Thus the brain tends to be exposed to wildly fluctuating blood sugar levels, responsible for many ‘psychological’ symptoms. See graph here.

When the brain is starved of energy it could lead to the death of brain cells in a matter of minutes. In reaction to this threat, the brain triggers the release of stress hormones - such as adrenaline and cortisol - that function to convert sugar stores in the body (glycogen and amino acids) back into glucose so as to feed the brain again.

But these stress hormones, generated within the body are also responsible for the varied symptoms of mental illness, from depression, anxiety attacks, phobias, insomnia, compulsive behaviours and thoughts, alcoholism, drug addiction, hypochondria, PTSD, OCD and so on and on.

Thus hypoglycemia is characterized by unstable blood sugar levels feeding the brain, causing excess stress hormones to flood the system.

The non-drug treatment for hypoglycemia is the adoption of the Hypoglycemic Diet - a virtual panacea for depression - which is a natural diet, but specifically designed to regulate blood sugar levels, stress hormones and insulin levels. One should not be surprised to find that he medico-pharmaceutical industrial complex would be strenuously opposed to the treatment of mood disorders without resort to drugs, and that it pays doctors to be ignorant of nutritional medicine.

Thus depression is in fact a NUTRITIONAL DISORDER.

This concept is difficult to accepts for those who have believed for so many years that mental illnesses is one of ‘mind over matter’. This perception is still held by the majority of practitioners in the field. But scientific truth is not very democratic and is not determined by majority rule.

This disorder can be medically tested with a special Glucose Tolerance Test for Hypoglycemia (GTTH) designed by Dr George Samra of Kogarah (Australia) and as described at our web site at:

“Testing for Hypoglycemia and How your Doctor can help”.

We also have a paper-and-pencil test called the NBI that can indicate a metabolic disorder if you score high on that test. Another home test can be found at: The Hypo Quizz.

The scientific basis of this new nutritional approach is supported by numerous scientific studies, that have shown a significant association between Depression and Insulin Resistance.
Treatment
The first step in treatment is going on a hypoglycemic diet, with the appropriate supplements such as B-complex vitamins including vitamin B3 (niacin), B6 (Pyridoxine), B12 (ask your doctor for injections) and folic acid, zinc, magnesium, chromium picolinate, cinnamon, glycerine, high doses of EPA fishoil, Rhodiola rosea (Amoryn), Seredyn, Try out Olive Leaf Extract, Coconut Oil and others. Experiment with combining the Hypoglycemic Diet with Herbal Remedies for Mood Disorders, such as Camu-Camu, Damiana, Ginseng, Hops, Kanna (reduces cravings for cigarettes), Lavender, Passion Flower, Rhodiola, St John's Wort, Vervain, with the help of a herbalist or a health care professional. Remember herbal remedies may interact with psychotropic medications. Generally, herbal remedies and AD medications do not mix.

Follow this up with a thorough assessment of possible allergies and food sensitivities by systematically recording a food diary as per Finding your Allergies. If possible have a hair analysis done to detect abnormal mineral levels.

If you are presently on medication for any mood disorder, the best strategy is to remain on any medication and prepare your body to produce the right neurotransmitters and hormones by nutritional therapy. This should be done in consultation with your doctor. This may take some time (perhaps up to a year), but as soon as you start to feel better you could then gradually withdraw from your medication, under doctor’s supervision, whilst being on the hypoglycemic and anti-allergenic diet or other nutritional therapy. (See also here) If you strike any problem It is suggested that you be referred to a Nutritional Doctor, Clinical Nutritionist or Nutritional Psychologist. See: Looking for Nutritional Therapists.

Thus patients do have a choice, if mainstream medicine and psychology have failed to help them.

Please discuss with your therapist.

Reference
“An active cell requires more than 2 million ATP molecules per second. The store of ATP in a human body is sufficient to satisfy a person's needs for only a few seconds, therefore, the store needs to be continuously replenished.” Source


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