America is finally realizing that depression is a serious concern. Of course, the pharmaceutical companies have known for years that there’s money to be made, but now society is on full alert. It’s taken a few miss-steps with celebrities, but the message is clear; those suffering from depression aren’t just having the “blues”, they are suffering, and in a big way.
Treatment for depression has varied through the years, but the overwhelming first choice by traditional doctors and patients alike are anti-depressant drugs. Meds like Zoloft, Paxil and Prozac are the second most prescribed drugs and now one in every ten people over 12 years old are on them. Unfortunately, the research shows that they’re just barely better than placebo for mild and moderate depression and so this leaves us with the question: What can we do to help these people? Well, this is one of those times where the best approach is to get back to finding the underlying cause.
The most recent studies are showing now that the previous theory of “chemistry imbalance” is out of date and simply inaccurate. This has always been a questionable theory because most of the brain chemicals – or neurotransmitters have opposite affects in different parts of the brain. This has led to treatments that help one symptom and worsen others. The psychiatrists I talk to feel that it’s a real crap shoot finding the right drug, and many times the “right drug” can never be found.
This leads us to the more current theory of depression based on inflammation. Most researches feel this is more accurate and aligns more with what we see in our practices every day.
So where does this inflammation come from? Well, there are several options like the joints or the skin but the overwhelming origin of inflammation is from the gut. This is because of two things. One, there is enough surface area there to fill an entire tennis court – so there’s lots of area for inflammation, and two, there are no pain nerve endings on the gut wall so inflammation can run rampant for years without you realizing the severity of the problem. Essentially, we just put up with the other symptoms like diarrhea, constipation, bloating and gas.
There is actually a name for this theory – The inflammatory cytokine model of depression. It basically works like this. Your intestines may have a more bad bacteria than good bacteria, there could be yeast overgrowth, you may have some other condition like gluten sensitivity or even a parasitic infection. These problems cause irritation and inflammation in the walls of the intestine that are triggered by the large but local specialized immune system. This inflammation produces messenger cytokines that enter the blood and travel to the brain. Once there, they can affect the frontal lobe to cause depression or affect the hypothalamus to affect the hormones that control our stress response and anxiety. Either way, our emotions will be in turmoil.
Our standard American diet and life style is full of inflammatory factors like reduced sleep, and lack of exercise but the insults that come from our diets are unprecedented. We eat an enormous amount of carbohydrates in the form of gluten, grains, and sugar that are so refined that they are absorbed very high in the intestines promoting even more inflammation. These products lack the natural fermentable fiber that feed the good bacteria, and so add to the inflammatory scenario. Of course you probably know that gluten can cause serious problems to the intestines but it can also causes nerve damage in the brain and spinal cord, and serious skin conditions even if you have the less serious form of gluten sensitivity. We also consume an extraordinary level of highly refined, industrial seed oils that have high levels of bad fats like omega 6’s. These oils from commercial foods found in boxes and bags increase inflammation and lead to depression and other mental health disorders.
And finally, some of the pesticides used on industrially grown grains may contribute to intestinal permeability or leaky gut increasing inflammation. Chemicals and preservatives found in highly processed and refined foods like artificial flavors, colorings, etc., have also been linked to behavioral problems and hyperactivity in children, and they may also cause food allergy and inflammatory reactions that affect brain function.
It’s hard to imagine, but a huge amount of information is gathered in the gut in the 500 million neurons that comprise the body’s “second brain” or “enteric nervous system” that travel up to the brain through the bi-directional Vagus nerve. Unfortunately, that’s not all that travels up to the brain. The inflammation and other toxic chemicals like the protein synuclein that causes Parkinson’s can travel up as well, damaging the brain causing anxiety, depression and chronic brain degeneration. In fact, recent research shows that the wrong microbes in the gut can distort personality increase stress and degrade cognition.
So where do we go from here? Well, it’s obviously important to heal the problems in the gut. But to do that, you have to know what’s wrong. That’s where the recent advances in gut testing comes in. This can specifically identify any parasites, bacterial imbalance or measure inflammation.
There are many other directions testing might take depending on the patient, like micronutrient evaluation or adrenal – cortisol or allergic food sensitivity that can affect mood as well. Once you know where your particular inflammation is coming from, it gets much easier to treat. For instance, if testing shows that the origin of your inflammation is from bacterial overgrowth in the small intestine, this can be successfully treated and cured. This is the case with most of the testing outcomes.
But I’ll have to say that an anti-inflammatory diet is the fundamental backbone of all of the treatments to control inflammation. Practically all of my patients find that it has the largest transformative effect even when considering pro-biotics, pre-biotics, short chain fatty acids and anti-microbials. So make sure you are working with a doctor that understands the importance of gut testing, and inflammation when you are trying to control depression and anxiety.
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