Why Don’t My Antidepressants Work?

Mood Disorders Are Common… but whats the Root Cause?

Anxiety and depression are crippling problems for the American healthcare system because of the sheer number of people who suffer from these conditions. 30 million combined people have been diagnosed with some sort of variant of anxiety or depression. This is staggering considering the inefficiency of the mental health system, which is not prepared to handle that many diagnoses. So perhaps rather than focus on how to temporarily treat these mental disorders with medications, we should focus on why these diagnoses are sky rocketing? Why are so many of us anxious for no reason at all? Why do many of us feel as though we have lost the joy of life? Moreover, why do so many of us complain that the prescription medications don’t work or bring us back to feeling like ourselves?

Anxiety and depression are usually multifactorial,  meaning they have many causes. What baffles many is that their prescription medications like selective serotonin reuptake inhibitors (SSRIs) fail to bring them back to baseline and leave them feeling numb. The secret is that the problem is often not a neurotransmitter imbalance, but an INFLAMMATION PROBLEM. That being said, gut inflammation leads to brain inflammation. Nutritional imbalances can lead to brain inflammation. In fact, any systemic inflammation can lead to brain inflammation. Adults with bipolar disorder are commonly seen swinging from one emotional extreme to the next. This is due to transient inflammation within neuroendocrine immune cells in the brain rather than severely fluctuating neurotransmitters as previously thought. (1)

A study published last year showed that microglial cells, your nervous system’s immune cells) have rampant inflammation in disorders like schizophrenia and depression. No wonder drugs like Prozac or Lexapro, used in depression, only partially work for so many patients.

Its often hard to pinpoint without a personalized consult, but here are my top tips for getting to the root cause of your mood disorder. I want to stress that you do not have to live like this! Please never stop your medication without consulting your doctor first

A diet poor in fruits, veggies, healthy fats and clean protein-if this is you, be prepared to change your diet!

There was a time not too long ago where I did not value the benefit of a holistic lifestyle. I ate convenience food, which included diet soft drinks, microwavable dinners and boxed foods. I took birth control pills that affected the action of my natural hormones. I drank tap water, which often contains endocrine disrupting chemicals. I stayed up late when I had to get up early and drank wine. Then felt exhausted in the mornings but kept pushing my adrenals with a few cups of coffee. I was REALLY stressed out and pretty unhappy with my tedious career choice. Everything in my life was promoting inflammation. What ended up happening was that all of this compounded and lead to severe free-floating anxiety. It made me irritable and reactive. However, during that time, I was unaware of the fact that the cheese I loved may be contributing to my brain fog. And I’m sure there are many of us that have not made this connection. Mood disorders don’t affect everyone-some people chronically living the preformentioned lifestyle may end up with an autoimmune condition or cancer, but my genes predisposed me to mood disorders.

Our guts are connected to our brains via the housekeeping and calming nerve in our body, known as the vagus nerve. Indulging in a bag of chips that contain preservatives and fillers feed pathogenic bacteria in the gut that then send signals up this nerve to the brain. These bacteria have been proven to shape our moods, cravings and overall immunity. If we are helping to promote the growth of pathogenic bacteria in the gut, then our thoughts and focus will be affected as well.(1)

The majority of our serotonin, melatonin and immune cells are housed in the gut. This means that if we are not feeding harmonious bacteria, then our happiness, sleep and ability to fight infections will all be impaired. Inflammation of the gut leads to irritation of the microglial, or immune cells of the brain and disruption in neuro immune signaling is indicated in recent studies to play a large role in many mood conditions.

Aim to eat organic fruits, vegetables, whole grains like quinoa or brown rice and clean meats (if you eat them). This means free range, grass fed, no antibiotics or hormones. I can’t express how many of my patients resolve their lingering mood disorders by changing their diet alone.

Exercising-whatever calls to you-this is a great stress reliever and can release “happy” neurotransmitters

We all know exercise is good for us, but sometimes I don’t think everyone realizes just how good. When we build up a sweat, your body recognizes this as a moment of stress. As your blood pressure increases and your respirations uptick, your brain releases a protein called BDNF, or brain derived neurotropic factor, to protect you from the stress. This protein is protective and can even repair neurons and act as a reset switch. Not only that, but your brain also releases endorphins, or feel-good hormones, when exercising. The purpose of this is to lessen the discomfort associated with exercise. It can acutally become addictive, but the good news is that for the most part, it is a healthy addiction. This is why we feel so calm and focused after exercise. Daily exercise can prove to be REAL medicine for a mood disorder.

Herbs and Minerals That Help the Happiness Factor 

Due to diet and lifestyle, many of us are drained, nutritionally deprived and stressed to the max. Throughout my career, I’ve witnessed the power of herbs and minerals on one’s mental state. Many conventional medicines, especially for anxiety, are habit forming and have risks like withdrawal seizures if not weaned off properly. Thats why I always try to supplement naturally before trying other avenues (I’m partial to my own Stress Master that contains many of the herbs listed below).

 

Fave herbs/Minerals/Compounds for Anxiety:

Ashwagandha

Holy basil or Tulsi

Rhodiola Rosea

Chamomile

Passionflower

CBD, cannabinoids, the non-psychoactive part of the marijuana plant

Skullcap

Magnesium (magnesium glycinate is the most absorbable)

L-theanine

Gotu Kola

Beta Glucans

 

Fave herbs/Minerals/Compounds for Depression: 

SAM-e

St Johns Wort

5-HTP

Ginseng

Vitamin D

Curcumin/Turmeric

Omega 3 Fatty Acids

Probiotics

Low dose naltrexone is also useful for depression and autoimmune disorders. Please be sure to consult your trusted healthcare professional before trying to self diagnose or cure.

Genetic Testing

This is an avenue that I encourage many patients to follow. Rather than simply offer herbs or medications by trial and error, genetic testing for mutations can provide the missing links or keys in mental health.

One of my favorite genetic tests is the SNP test by Great Plains lab (it however requires a prescription). If you’re looking for something you can order easily, then 23 and me is a good choice. It tests multiple genes and scans for mutatations throughout the genome. It can tell you if youre at risk for Alzheimers or prone to panic attacks. The OAT (organic acid test), also by Great Plains lab, is excellent as it measures neurotransmitter by-products in the urine. This tells us what neurotransmitters have too much or too little activity and can target specific therapy for the patient. If you have tried everything else, then this is definitely something you don’t want to exclude.

Heres the skinny on the best SNPs/mutations to look out for on tests.

  1. Stat4-normally codes for proteins that activate TH1 immunity but a mutation here codes for an aggressive inflammation response instead
  2. TNF (tumor necrosis factor)-cytokine or cell communicator that codes for T and B cell activation. A mutation means T cell overactivation that leads to mood disorders through brain inflammation.
  3. CTLA4-cytotoxic T lymphocyte associated protein-4-downregulates the immune system when needed. A mutation means that you have chronic inflammation as the immune system is too overactive.
  4. MTHFR-40% of the population has a mutation in one or both of these genes. These patients cannot methylate or activate B vitamins and methylation is used in thousands of processes in our bodies. This causes a propensity towards depression and anxiety.
  5. COMT or MAO mutations-this means that the enzyme that breaks down certain neurotransmitters is slow, so there are higher levels of adrenaline throughout the body that these patients are not able to rid themselves of. This can lead to severe anxiety and behavioral issues.

Lifestyle Changes and Lab Checks

Tempering your exposure to EMF from computers and cell phones can help moods as well. Have you ever looked at the informational insert that comes with cell phones? They directly warn about the dangers of continuous EMF and low level radiation. On May 21, 2011, the International Agency for Research on Cancer (IARC), a committee of 27 scientists from 14 different countries working on behalf of the World Health Organization (WHO), concluded that exposure to cell phone radiation is a “possible carcinogen” and classified it into the 2B category. This is the same category as the pesticide DDT, burning coal and dry cleaning chemicals, just to name a few. Be sure to put blue screens from computers and phones away at night. Practice good sleep hygiene.

If you still cannot sleep and are suffering from racing thoughts and mood swings, ask your healthcare provider to check your sex hormones (refer to my blog on hormones), your salivary cortisol levels to screen for adrenal fatigue and your vitamin D levels. These are crucial labs when dealing with mood disorders.

On top of diet and exercise changes, incorporating these lifestyle changes and checking on lab values can help to treat chronic depression and anxiety.

Addressing Emotional and Spiritual Wounds

Stress and trauma are inherently tied into our wellbeing. If you were abused or mistreated as a child and have not thoroughly processed the truama, it can reveal itself through disease or mood disorders. Autoimmune disorders nearly always have a traumatic event that proceeded the onset of the symptoms. Heart attacks can even occur due to a severe heartbreak, like the death of a loved one. Many mood disorders have root in trauma, emotional wounds, childhood abuse and unprocessed emotions. Be sure to let yourself grieve, mourn and cry over these events if this sounds like you. Even journaling can help with releasing suppressed emotions and pains.

Final Word

Treating mood disorders takes a multilevel approach. Don’t give up just because one thing didnt work for you. You can take control of your life by taking action in areas that need TLC, but be honest and ask for help when you need it. You are becoming your own best doctor!

Dr Jess

 

REFERENCES:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701682/
  2. http://neuroscienceresearch.wustl.edu/userfiles/file/Gut_brain%20axis%20How%20the%20microbiome%20influences%20anxiety%20and%20depression_Tran%20%20%20.pdf
  3. https://articles.mercola.com/sites/articles/archive/2011/06/18/finally-experts-admit-cellphones-are-a-carcinogen.aspx

 

 

Dr. Jess (MD)

Dr. Jess (Dr. Jessica Peatross) is a western trained medical doctor who began her journey into healing in 2009.

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3 replies
  1. Noah A Ford
    Noah A Ford says:

    You mentioned several genetic test that were available. But nothing about who would read or interpret the test to let you know what the results are and what to do with the results. Like who tells me that I need more of this or less of that?

    Reply
  2. Daniel S Lennox
    Daniel S Lennox says:

    Hi All, I just want to ask if anyone ever tried using medical cannabis as an alternative meds? I have read many articles about medical marijuana and how it can help you in terms of chronic pain, bone injuries, eating disorder/anorexia, anxiety disorders and panic attacks, inflammation, even cancer and a lot more. Like this article about a marijuana strain from:http://www.ilovegrowingmarijuana.com/cherry-pie/ . Cbd and thc are also new to me and I don’t even smoke. If this is true I cant find any solid conclusive evidence that speaks to its efficacy. Any personal experience or testimonial would be highly appreciated. Thanks

    Reply

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