Dealing With Depression

Last week I discussed two neurotransmitters (hormones) in the brain that are related to addiction and depression.  These hormones are dopamine which is associated with our sense of reward and pleasure and serotonin which is associated with general happiness and feeling good.  I also referenced that depression and its traditional treatment is associated with maintaining higher levels of serotonin but I made mention of the Toronto study that determined the deepest levels of depression are linked to very low levels of dopamine.  This week, I’d like to finish the discussion and cover treatment options for these difficult and potentially devastating conditions.

The standard modern treatment for depression has been the prescription of what are called SSRIs or serotonin inhibitors.  These drugs function to block the reabsorption of serotonin in an attempt to keep the levels of this “happy hormone” high in the brain tissue.  This method makes sense and in some instances can be very effective.  This has been the accepted approach to depression since the early 1980’s.  However, with more aggressive marketing and wider usage, the drugs came under scrutiny in the year 2000 as medical research and case study made a link between the use of SSRIs with aggression, suicidal tendencies, and violent behavior especially in children and teens.  In fact, in 2003, the British government banned the use of several of the drugs in citizens under the age of 18.  The FDA followed in 2004 by placing a black-box warning on the drugs alerting parents to watch for any signs of these behaviors.  Over the years they’ve expanded these warnings to include side effects of increased risk of bone fractures, sexual dysfunction, panic attacks, mania, cognitive disorders and loss of contact with reality, and increased feelings of depression and anxiety!  I remember when all of this was coming out in the medical literature and I’ve always wondered what the mechanism was that could make the drugs helpful to some people but dangerously harmful to others.  In researching this article, the aforementioned Toronto study of 2005 provided my answer.  Because our brains and chemistry are all different, some of the SSRI drugs on some of the people result in a deficit of dopamine some of the time.  The study showed in the bad reactions the drugs seemed to “hijack” the dopamine transporters causing levels to plummet.  As I mentioned last week, everything we do is tied to dopamine and this lack is the major cause of addictive behavior and the deepest depression. 

One of the best seminar courses I ever attended was about the stress response and how it related to brain chemistry including these two potent neurotransmitters.  As it turns out, we are supposed to maintain normal levels of serotonin and dopamine through healthy lifestyle habits such as adequate sleep, physical exercise, loving relationships, positive thoughts and even the vitamins and minerals we receive from fruits and vegetables.  So if you’re looking to prevent depression and addiction this is your best strategy – place your focus on health and happiness.  However, if you’re already dealing with these conditions, I still recommend the lifestyle approach, but I recognize that it may take more as the subconscious and hormonal patterns are already established.  If you’re using the SSRIs, just be aware of the side effects and don’t settle until you find one that is agreeable as there are several different options.  I also need to mention that you should not try to go off these on your own – have your doctor or pharmacist help you wean off them safely.  Even though it’s not as popular as it used to be, a qualified counselor can help you work through these problems and eventually uncover the underlying cause of your depression or anxiety which the drugs will never do.

Dissecting Depression

With the passing of Robin Williams this past week, there has been a raised awareness regarding addiction and depression.  While I’m not going to pretend to be an expert on either of these subjects, I do know a few things and I was able to research some material that I believed would be of interest to anyone because even if you don’t deal with these ailments yourself, you most certainly know someone who does.

When it comes to the chemistry of the brain, it turns out that addiction and depression are very closely related.  In the past I wrote a piece on two neurotransmitters in the brain that account for much of our behavior, our habits, and our motivation.  These chemicals are dopamine which is often referred to as the “reward hormone”, and serotonin which is often referred to as the “happy hormone”.  I’ve heard speakers present that everything we do is tied to dopamine as it gives us a feel-good sense of reward that is tied to motivation and pleasure but also deeply tied to addiction.  In rat studies where dopamine was shut off, as the rats were dropped into water, they neglected to swim as if they just lacked the will to survive!  Likewise, your ability to be happy is thought to be directly linked to how much serotonin is being released. Serotonin has a profound effect on mood and anxiety -- high levels of it, or sensitivity to it, are associated with serenity and optimism.  Low levels of either of these hormones and especially both have been proven to cause depression.  One of the biggest problems we face is that numerous chemicals including caffeine and sugar and nearly all recreational drugs including alcohol will stimulate a very strong dopamine response and can also impact serotonin.  This leaves us wanting these chemicals more and more, but it also can deplete our dopamine levels leaving us short.  This is the very nature of addiction.  Dopamine gives us a very strong emotional response that we want more of.  Unfortunately this hormone does not last long in our system.  The stronger drugs like cocaine, heroin, and ecstasy are thought to completely deplete our dopamine stores creating a highly addictive tendency even on the first use.  Obviously, this reaction is tied to addictive behaviors but a 2005 University of Toronto study has shown that any kind of dopamine dysfunction is associated with the deepest levels of depression

So that was the bad news.  One of the concepts I teach in our “Think Well” workshop is that except in very rare cases, we were not born with a lack of happiness or sense of reward.  The stress, anxiety, or depression we experience is a learned response from what we eat and drink, how we move, and how we think.  As we practice these habits and emotions more often, we become more efficient at expressing them in part from the response of these neurotransmitters.  This phenomenon is referred to as neural plasticity; meaning that our brains are pliable and learn from repetition.  The good news of this is that our brain patterns and even the chemistry of these hormones can be relearned by practicing feelings of love, happiness, and gratitude.  It takes time and diligence but it can be done.  This is also why counseling and talking about our stresses in order to resolve the root of the problem is important.  Unfortunately, most people don’t do this and the standard of care for addiction, stress, anxiety and depressions are a couple classes of drugs that come with their own host of side effects and their own impacts on serotonin and dopamine.  Please check in next week when I share these effects and discuss some other natural strategies of relieving stress and depression before it gets too advanced.

Starting a Program

You’ve likely heard by now that sitting is considered the new smoking; meaning that the health detriments of prolonged sitting day in and day out are just as dangerous if not worse than smoking cigarettes.  I recently read a report that two hours of continuous sitting will undo the benefits of 20 minutes of exercise.  This is just more evidence that we need to get up and get moving and get out of our seats at home and at the office.  Obviously any form of exercise is better than none at all, but what type of exercise should you be doing to gain the greatest return on investment for you overall health and wellness?

As I’ve reported before, the best exercise programs include dimensions for strength, cardiovascular, as well as balance, coordination, and flexibility.  Most people simply don’t do this.  The weight lifters are often lacking the flexibility and cardiovascular components.  The walkers/runners are often lacking the strength and flexibility.  The yoga enthusiasts could do better with strength and cardio.  Again, this is not to downplay any of these forms of exercise as they’re all equally great in their own right; they’re simply incomplete by themselves.  The standard recommendations that are most widely accepted are to do strength training twice per week where you work on all the major muscle groups at least once each week.  Try to make your strength training as “functional” as possible where you are performing common, real-life movements with resistance rather than isolated muscle training.  A personal trainer can help you with this.  In addition to strength, cardiovascular training three times per week is the most commonly accepted schedule.  In order to get the greatest health benefits and weight loss out of your cardio work, practice what is referred to as HIIT or high intensity interval training.  This type of training is so important on many levels and it is where I’d recommend getting started if you’re just getting back into exercise.  The advantages of this training include insulin regulation, maximized growth hormone, but also time management.  Through HIIT training you can get a better workout in just 20 minutes than what you would otherwise do in an hour on a treadmill or bike with a steady heart rate.  Again, a trainer can provide different options for HIIT.  In regard to flexibility and coordination, it’s a good practice to include 10 minutes of this at the end of every workout.  This practice will relieve stress off your muscles and joints that can lead to injury but more importantly, working on balance will help prevent dangerous falls as we age.

What I’ve just described is the type of workouts provided in our 8 Weeks to Wellness program.  The doctors who designed this program took the latest science and research and put it into practice.  In addition to this, our trainers focus on core strength and posture to retrain the posture patterns that cause much of the back and hip as well as neck and shoulder problems that people suffer from.  We’re proud to announce that we have two new trainers in the office (Brittani Groff and Kelly Culp) doing this work and their anxious to help – they’re so anxious that we’re offering one free workout through the month of August to anyone who responds to this article.