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.

Organic or Not

 

Two years ago a study released by Stanford University questioned the value of purchasing and consuming organic foods.  Is it really worth the extra expense to purchase a brown banana that goes bad twice as fast?  Stanford concluded that the nutrient levels found in conventional vegetables are actually very similar to that of the organically grown variety.  Other studies dispute these findings, but even if Stanford has it correct, there are other important advantages to purchasing organic you should know about.

There have been 343 studies looking at the advocacy of organic vegetables over the last couple decades.  All these studies agree on a couple of things.  First it is well recognize that organic fruits and vegetables contain anywhere from 18-69 percent more antioxidants than conventionally grown foods.  These antioxidants are known to reduce the risk of numerous chronic diseases and in particular several varieties of cancer.  Antioxidants are also linked to how quickly you age by reducing how quickly you oxidize or degenerate.  Think of this process similar to rusting.  This alone would justify the expense for eating organically, but there’s another important reason.  Studies agree that organic foods have fewer toxins and pesticide residues.  In fact, the difference in the levels of cadmium alone is thought to be on average 48% less.  Cadmium is a toxic metal that is known to be linked to numerous concerns.  Likewise, the levels of pesticide residues are found to be four times higher in conventional fruits and vegetables than in their organic counterparts.  These pesticides kill off the bad bugs that would eat away at the crops, but they also kill off the good bugs that should be found in healthy soil and should be passed onto the fruits and vegetables.  These are the probiotics that promote a healthy digestion and immune system and serve to reduce overall inflammation in the body.  The other bigger problem with the pesticides is that they too have been linked to different cancers and they are directly related to thyroid problems as I reported on a few weeks ago.  The thyroid maintains your metabolism and energy level and when it starts malfunctioning, this leads to many health problems but also increased weight particularly around the hips and thighs.

While the experts will still argue about the nutritional value of organic over conventional, I hope this other information makes a strong enough case to choose organic.  In my experience with thousands of clients, most of us simply need to eat more fruits and vegetables more regularly.  If you truly are looking for the very best source, then you’ll want to do your own homegrown organic vegetables or find a good source through a farmers’ market.  This takes more work and time, but these sources have been shown to have the highest levels of nutrition and probiotic levels as long as the grower is well trained in organic methods.

Sound Sleep

The psychology textbooks will teach you that there are four stages of sleep.  This is true, but when it comes to health and vitality, there are two levels that are highly restorative.  These are the deep sleep level and the rapid eye movement (REM) level of sleep.  Sleep experts like to refer to these levels similar to nourishment where deep sleep is like water and REM sleep is like food for the mind.  In the end you need both!  While required amounts of sleep vary from person-to-person, most experts agree that if you’re getting less than seven hours per night, you simply are not getting enough of these deeper levels of sleep.  For this article, I found some new data on why getting the proper amount and the proper type of sleep is so important.

To prevent sleep deprivation and the host of health problems it accompanies, we should commit to at least seven hours of sleep per night.  In general, you should look at your energy levels through the day.  If your energy is steady and consistent you’re probably doing o.k.  The next question is how deep is your sleep?  It turns out dreaming is very important and it occurs in the latter third of our sleep time within that REM stage.  It generally takes 4-5 hours to get into this level.  Research has proven that dreaming is tied to our memory and our ability to learn from the information that we’ve acquired over the last few days.  When we dream, the hippocampus portion of the brain becomes very active.  This part of the brain is known to convert short-term memory into long–term memory.  Think of this as downloading recent information that you’ve learned or experienced onto your hard-drive.  When you’re not getting into this deepest level of sleep your memory will suffer and you stop adding to who you are.

I find that many people simply have trouble sleeping.  Many times this is due to pain or discomfort and many times it is due to a chronic level of subconscious stress.  Fortunately for me, one of the most common “side-effects” of chiropractic adjustments to remove stress from the nervous system is . . . better sleep.  If you are someone who has trouble sleeping, you will want to make certain your sleep area is dark, quiet, and cool.  For many people, the electromagnetic fields created by cell phones, TV, alarm clocks, and electric blankets will mess with your energy and deter proper sleep.  Try to move these devices away from your bed.  Likewise, the blue light that comes from television, computers and phones will suppress melatonin production.  Melatonin is important for sleep, but it also has potent anti-inflammatory and anti-cancer benefits.  For these reasons, you should try to shut down all electronics for about an hour before sleep.

In the end, most sleep problems are not the result of inadequate sleepiness, but are due to excessive wakefulness.  Most people are simply running too hard and are revved up due to stress and stimulants.  Find some habit after you unplug the electronics to slow your system down!  As I’ve reported numerous times, meditation and yoga can be very effective for slowing your brain down and calming the stress hormones.  Go to the internet or YouTube and find guided meditations.  Even if you just listen to these before going to sleep, your results will often be improved.

A Double Cross

As a chiropractor, neck pain, headaches, and shoulder pain or tension are some of the most common complaints that walk through the doors.  While spinal adjustments are usually very effective at providing relief for these symptoms, just like with any health problem, when you go back to the very same lifestyle habits or routines that were the root cause of the problem to begin with, the pain or ailment often returns.  When it comes to spinal or muscular pain, the root cause is often very simple – our posture and daily activity alter the alignment, balance, and function of our spine as well as the muscles that move and support our spine.  In recent decades, we have become world–class sitters and the posture we assume during prolonged hours of sitting becomes the regular posture of our spines.  In the upper back and neck, this postural distortion is known as Upper-Crossed Syndrome.

In Upper-Crossed Syndrome (UCS), tightness of the upper shoulder or trapezius muscles on the back side “crosses” with tightness of the chest muscles on the front side from sitting with rounded shoulders.  Likewise, weakness of the front neck muscles crosses with weakness of the middle back muscles as a result of not using these muscles when we sit. This pattern of imbalance creates joint dysfunction, particularly in the neck and upper back.  Think of this phenomenon literally as a tug-of-war on the muscles and internal structures.  This imbalance and stress on the spine correlates with the primary areas of spinal misalignment or subluxation, disc degeneration, and arthritic change we commonly see in the spine as we age.  These postural changes seen in UCS, include forward head posture, tension up the back side of the neck, loss of curvature in the neck and an increased curvature or “humping” in the upper back resulting in “winging” of the shoulders.  In addition to neck and upper back pain, these postural changes are known to cause numerous problems and excessive wear-and-tear in the shoulder joints.  While this postural change is very common, it is also completely preventable and usually reversible.

Think of what your neck, upper back, and shoulders look like when you sit at a computer, drive in a car, or relax on the couch.  The head is forward and bent, and the upper back and shoulders are rounded.  The good news is that when you work to reverse this posture, the syndrome and the pain associated with it can be reversed as well.  In this case you simply need to perform stretches and exercises to move the head backward to bring the ears over the shoulders.  Similarly you need to perform stretches to open up the chest and exercises to strengthen the shoulder blades and bring the upper back into extension.  In most cases, it may take several months to reverse these changes, but for someone suffering from chronic upper back, shoulder, neck pain, and tension headaches the work is worth the effort.  Reversing these postural distortions is also the key to getting the longest lasting results with your chiropractic care by addressing the root cause of these particular spinal problems.  If you’ve been dealing with these problems, I encourage you to get with a chiropractor who incorporates this work or simply look up Upper-Crossed Syndrome to learn more about the appropriate exercises.  

A Thyroid Thing

Thyroid disease has quickly become one of the most common health problems faced by Americans.  An underactive thyroid gland is known as hypothyroidism and is thought to afflict anywhere between 10-40% of Americans.  However, I’ve heard experts say they believe that subclinical hypothyroid is present in nearly 80% of women in the U.S.  This means they have signs and symptoms and are headed toward full blown thyroid disease but are not to the point that it would be diagnosed by blood tests.  Depending on the source, there are multiple causes for thyroid gland dysfunction, but the good news is there are a few things you can do to prevent or even reverse damage to this vital gland.

The thyroid gland can go either overactive or underactive, and both conditions are a problem, but the majority of all the thyroid problems are on the underactive or hypo-side of things.  Hypothyroid is classified by numerous symptoms including: increased weight, fatigue, ringing in the ears, dry skin, course hair, constipation, sensitivity to the cold, morning headaches, frequent urination, slow pulse, hair loss, inability to sweat, and a general lack of get-up-and-go.  Blood testing is the standard for diagnosis, but many times in the early phases of dysfunction these tests will come back as false negatives while the problem is still progressing.  This is particularly true when only the basic blood thyroid hormones are checked and not the full panel.  Many people believe that one of the reasons for dysfunction of the gland is related to the chloride and fluoride in our drinking water and eating brominated flour.  The thinking on this is that these elements are known to displace iodine in your body and the two basic thyroid hormones responsible for your metabolism are made largely of iodine.  Similarly, we do not get much iodine in our diets particularly in this part of the country.  This has been known for nearly a century and was classified as the Great Lakes Effect because culturally, the Midwest simply does not eat as much ocean-caught seafood that is rich in iodine.  Another cause of the dysfunction is toxicity.  Part of this is thought to be from pesticides as I reported on a few weeks ago, but other research shows that heavy metals such as cadmium, lead, mercury mess with thyroid function as well. 

If you’re already dealing with thyroid problems, I would check your blood iodine levels and look to supplement with iodine, but I would also get with a doctor who checks for heavy metals and is able to perform chelation to detoxify and remove these metals.  You do not want to attempt this on your own – look for a doctor of Integrative Medicine to assist with this process.  If you’re just looking to avoid thyroid problems or worry due to a family history, I’d do a regular detoxification at least once per year, I’d still check my iodine levels and I would recommend sticking to a whole food diet while maintaining adequate levels of exercise and practicing some form of stress reduction technique such as meditation or yoga as, like with everything else, lifestyle factors play a role in thyroid function too!