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FREE CONSULTATION If you would like to schedule a 15 minute phone consultation at no charge with us to determine how we can help you, call 480-240-2600. If you want to send us a brief description of the issue you would like help with, email info@Arizona AdvancedMedicine.com      An Alphabet Of Good Health In A Sick World |
Depression and AnxietyDepression can range anywhere from "the world is grey today" to "the world is intolerable today and I want out." The only emotion is greyness and sadness, and it feels as though there is no hope for the future. When depression is combined with anxiety – a constant feeling of agitation, where nothing ever settles down, the nerves are always on edge – it is even more difficult to deal with, because there is never a time of quiet. For those who have anxiety, having to perform at work, going shopping, cooking breakfast, reading the newspaper – almost anything can stop them in their tracks.Depression affects approximately 10-15% of our population in any given year, and up to 20% of the population as a whole, some time in their lifetime. Three times more women than men are diagnosed with depression. Average duration of illness is 10 years. It is estimated that 15-20% of older adults suffer from depression.[2] Many symptoms of depression are associated with things which we are "supposed to" be able to control – mood swings, focus on self, concentration, ability to experience pleasure. "Just pull yourself together!" "Get over it!" Once a person has been treated successfully, and has experienced remission of symptoms (one hardly dares say cure), it becomes quite clear that they were in fact incapable of "pulling themselves together" prior to the treatment. Standard allopathic treatment for depression used to involve cognitive/behavioral therapy – let's sit on the couch and talk. Increasingly in these days of HMOs, standard allopathic treatment comes from the prescription pad – antidepressants, anticonvulsants, anxiolytics (anti-anxiety agents), stimulants, and other psychotropic (mind-changing) pharmaceuticals. Drugs sometimes calm the anxiety, sometimes they merely make people feel brain fogged. Depression drugs have a track record of giving about a 50 percent decrease in symptoms. Many patients have experienced that over time their anti-depressant doesn't seem to work anymore and they have to switch to an ever stronger cocktail of pharmaceuticals. If you are way low on serotonin – the hormone that is a master neurotransmitter – the drugs may not work much at all. Up to 20% of patients fail to respond to any form of therapy for depression. Dr. David Rubinow, in an excellent editorial in the New England Journal of Medicine in 2006[3], talks about the National Institutes of Health funded trials which were also reported in the same issue, and laments that at least half the patients treated for depression with standard antidepressant medication continue to have symptoms of depression despite treatment. 75% of the patients in those studies had suffered from depression for 15 years or more, and over half of them waited for over a year before receiving their first treatment. Findings from the Women's Health Initiative Study revealed that post-menopausal women taking antidepressants were 45 per cent more likely to suffer a stroke than those of the same age not on the medicines. The research also found that overall death rates were 32 per cent higher in women on the drugs.[2a] Because therapy is so ineffective and the condition so prevalent, it is reasonable to look for more effective alternative therapies. Depression can be caused by many things. If it has a spiritual basis, then acupuncture and hypnosis can be helpful. A sudden spiritual awakening is enough to lift the veil – but those awakenings are hard to orchestrate. More often, depression and anxiety have an organic cause. You may have very poor neural function, meaning your brain doesn't work very well because some wires are crossed or don't even exist.[4] Your neurotransmitters could be misfiring because of low levels of serotonin and dopamine[5] – your brain functions like a truck running on two cylinders instead of eight. For some people, food allergies trigger the blues. For others, a body burden of heavy metals inhibits neural functions to the point nothing works and you feel depressed. Other physiologic factors implicated in depression include low levels of Vitamin D[6], hormonal imbalance[7], head injury[8], vitamin deficiency[9], and fatty acid deficiency[10,11].  A five-year study involving 3,500 people showed that people who eat a diet high in processed food increase their chances of depression. Conversely, those who avoided processed food and instead ate a healthy amount of vegetables, fruit and fish, or what is known as the Mediterranean diet, actually lowered their risk of depression.[11a]We can start by looking at hormone levels because they affect all the neurotransmitters. Then we look to see if there is merit in desensitizing environmental allergies with smart testing and homeopathy, removing heavy metals with chelation, and identifying food allergies. Is there any exercise in the picture? The January 2005 issue of the American Journal of Preventive Medicine reported a study on the effects of exercise and found comparable results from studies in which patients with mild to moderate depression were treated with antidepressants. "The effect you find using aerobic exercise alone in treating clinical depression is similar to what you find with antidepressant medications," said Dr. Madhukar Trivedi, a study author and professor of psychiatry and director of UT Southwestern's mood disorders research program. "The key is the intensity of the exercise and continuing it for 30 to 35 minutes per day. It's not for the faint of heart." How are the vitamin D levels? How is the omega 3/omega 6 balance in the diet? Vitamin D, the "sunshine vitamin" and fish oils with omega-3 oils have been found to provide some benefit. Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults.[13] Consumption of omega-3 fats is especially low in the United States, and we have one of the highest depression rates in the world. Dr. Joseph Hibbeln of the National Institutes of Health has shown that higher national consumption of fish for a nation equates with lower rates of depression.[14] What are the sleep patterns? The body does most of its healing as we sleep so adequate sleep is important too.
Then it is time to go to work on the brain. The frontal lobe is key to depression because it isn't usually working right. Your right frontal lobe looks at the big picture and puts the past and the future in perspective. When the frontal lobes are not working well, it is harder for people to cope. You get slow or garbled transmission of impulses to the limbic system in the brain. This is often the source of the fight or flight response in the brain. The anxiety makes you want to run away, and depression makes you want to freeze.You are quivering between the proverbial rock and the hard place. We all have different reactions to dysfunctional transmission of nerve impulses. If we look at the temperaments as described in Chinese Medicine:
The brain operates on a use it or lose it principal. Blood brings oxygen and the basic nutrient, glucose, to all parts of the brain. The more blood flow you have, the more oxygen and glucose you will have on board and the more neural connections you can make. The less blood flow you have, the less processing power you have. HEG feedback is a simple way to increase blood flow to the frontal lobes of the brain. This is the area where you do "executive functions" like paying attention to details and remembering them, organizing, strategizing, and planning. HEG feedback is combined with exercises using special sounds and pictures to exercise the brain on different levels. After about 20 HEG sessions, a person achieves permanent gains in brain function. HEG is proving to be much more rapidly successful than the older style of qEEG feedback training. Using HEG feedback, you can literally increase the processing speed of the brain. This has proven to be beneficial not only for depression and anxiety, but also for ADHD, memory loss, and more. It works so well because brain malfunction is usually a processing issue. We can give a patient more serotonin for example, but odds are the brain wouldn't know what to do with it. Incapacitating anxiety is one of the most difficult things to deal with on any level. The anxiety becomes a global state of being. It can relate to misinterpretation of physical signals like falling blood sugar. Depending upon the personality, that can advance to a state where everything triggers anxiety. Looking at things energetically can help. Sometimes things are hidden in the energetics of our body. There can be a latent reason for the anxiety that has become an integral component of the person and the ego. A skilled energetic healer can sometimes see what is going on behind the scenes and help bring it to the surface so the conscious mind can deal with it and get rid of it. Hypnosis is another option for getting at the root cause. "Just pull yourself together!" isn't a realistic demand of someone with depression and anxiety. Solving depression is not as easy as tackling any one thing. We have found a combination of therapies to be most effective in the treatment of depression, particularly when depression is associated with incapacitating anxiety, including HEG biofeedback, nutritional and dietary counseling, supplements, auditory and vestibular processing training, audio-visual entrainment (AVE), cognitive and memory training, as well as counseling and hypnosis. Together, these modalities have had remarkable effect in helping people overcome their depression and return to life – all within the space of about 20 sessions of treatment.
[1] Murphy JM, Olivier DC et al. Incidence of depression and anxiety: the Stirling County Study. Am J Publ Hlth 78; 5 534-540. [2] Gallo JJ, Lebowitz BD. The Epidemiology of Common Late-life mental disorders in the Community: Themes for the New Century. Psychiatric Services 50:1158–1166, 1999. [2a] J Smoller, MD et al; Antidepressant Use and Risk of Incident Cardiovascular Morbidity and Mortality Among Postmenopausal Women in the Women's Health Initiative Study, Arch Intern Medicine, 2009;169(22):2128-2139. See also: http://www.psychologytoday.com/blog/charting-the-depths/201001/the-womens-health-initiative-study-firebell-in-the-night-0 [3] Rubinow DR. Treatment Strategies after SSRI Failure – Good News and Bad News. NEJM 354.12:1305-07 (March 23, 2006). [4] Papakostas G. Dopaminergic-based pharmacotherapies for depression. European Neuropsychopharmacology , Volume 16 , Issue 6 , Pages 391 - 402. [5] Mayberg HS. Modulating limbic-cortical circuits in depression: targets of antidepressant treatments. Semin Clin Neuropsychiatry 2002;7:255-268. [6] Gloth FM 3rd, Alam W, et al. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging. 1999;3(1):5-7. [7] Walf AA, Frye CA. A Review and Update of Mechanisms of Estrogen in the Hippocampus and Amygdala for Anxiety and Depression Behavior. Neuropsychopharmacology (2006) 31, 1097 - 1111. [8] Jorge RE, Robinson RG et al. Major Depression Following Traumatic Brain Injury. Arch Gen Psychiatry. 2004;61:42-50. [9] Morris MS, Fava M. Depression and folate status in the US Population. Psychother Psychosom. 2003 Mar-Apr;72(2):80-7. [10] Hibbeln JR, Salem N. Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy. AJCN, Vol 62, 1-9. [11] Puri BK, Counsell SJ et al. Eicosapentaenoic acid in treatment-resistant depression associated with symptom remission, structural brain changes and reduced neuronal phospholipid turnover. Int J Clin Pract. 2001 Oct;55(8):560-3. [11a] T Akbaraly, E Brunner, et al; Depression link to processed food, British Journal of Psychiatry, February 2009, 195: 408-413) [12] Walf AA, Frye CA. A Review and Update of Mechanisms of Estrogen in the Hippocampus and Amygdala for Anxiety and Depression Behavior. Neuropsychopharmacology (2006) 31, 1097 - 1111. [13] C.H Wilkins, Vitamin D Deficiency Is Associated With Low Mood and Worse Cognitive Performance in Older Adults, Am J Geriatr Psychiatry 14:1032-1040, December 2006. [14] Hibbeln JR. Fish consumption and major depression. Lancet 1998; 351: 1213. |
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