First Do No Harm

Depression ― The Latest Findings

In the past we’ve talked about a connection between Nutrition and Depression, and since then it seems that science has backed us up on this. Since few studies showed this connection, and when we first started looking for the connection, one of the first things we found at WebMd was: “The biggest myth of all is that food has any connection to behavior," says Steven Pliszka, MD, professor of psychiatry, University of Texas Health Science Center at San Antonio.

Our response, both then and now is: “Actually, the biggest myth of all is that physicians know anything about nutrition.”

Since our publishing the article referenced above (in the late nineties), much more research has gone into the factors behind depression, what doesn’t seem to work, and some creative solutions.

And we will now present them to you.

The Nutritional Factor

The University of Las Palmas in the Canary Islands performed a cohort study of 15,093 people who were “healthy” at the start of the study, and followed them for 10 years.

During the course of the study, 10% were diagnosed with depression (or was prescribed anti-depressants). Researchers noted a very strong correlation between diet and depression. It seems that those following a Mediterranean type diet or a similar diet rich in fruits and veggies, even with a moderate alcohol intake, reduced their risk of depression. And even more noteworthy was that following that kind of diet religiously did not provide any more protection over those who occasionally followed it. [Source: BMC Medicine, 2015; 13: doi: 10.1186/s12916-015-0428-y]

We must also keep in mind that, as published here years ago, that some 80 to 90% of our serotonin is created in our gut.

Researchers at McMaster University in Ontario modified the gut bacteria of mice (using antibiotics) and discovered a host emotional and behavioral changes had been produced.

In our article Nutrition and Depression we talked about vitamin B-12; that among the first symptoms of a B-12 deficiency is depression. Well, there’s a doctor in England who’s been treating depression and a host of illnesses with B-12 injections. In fact, Dr Joseph Chandy has successfully treated hundreds of patients with B-12 injections even when their B-12 blood serum levels were considered normal by the UK medical establishment.

So, they slapped his wrists and forced him to stop treating patients with this therapy demanding that randomized double blind placebo testing take place first. Chandy argued that he’d documented all of his results. With a bit of media exposure, Chandy’s persistence won out and he’s back to treating his patients (get this) at his own expense. Yup; he pays for the shots.

It is estimated that 80% of the population is B-12 deficient. One problem, especially for the English/Irish/Scottish is their lack of intrinsic factor which helps one’s body assimilate B-12 from their food intake. Additionally, Chandy criticized the blood testing methods used in the UK because there are two types of B-12: human-inactive and human-active and results grouped these two together.

From my research, I’m convinced that methylcobalamin is the best form of B-12 and taking it in a sublingual lozenge (thus avoiding the digestive tract) is the best way to take it.

Chandy reports that his treatment has been successful in everything from premature hair loss to Multiple Sclerosis, to mental disorders, especially depression. [UK Doctor Treats Various Illnesses Successfully with Vitamin B12 Injections]

Inflammation

Sugar shouldn’t be classified as food. It should be classified as a drug. We’ve known for decades the harm its been doing to us, but now, with medicine finally accepting that most illness is the result of inflammation, we also know that one of the culprits behind our inflammation is sugar. Sugar is inflammatory.

Not only that, but a diet high in sugar and fat, America’s preferred choice of suicide, changes the mixture of gut bacteria in such a way as to produce an imbalance that leads to even further inflammation, especially of the brain, and, according to researchers at the Louisiana Sate University, can lead to depression and other psychiatric disorders. [Gut Bacteria Protect Your Mental Health]

Researchers in Ireland discovered that a bacterial deficit in early-life caused an irreversible serotonin deficit through adulthood. [The microbiome-gut-brain axis during early life regulates the hippocampal serotonergic system in a sex-dependent manner.]

And sugar substitutes, those man-made sugar substitutes seem to be even worse than sugar itself, sugar is bad enough.

We prospectively evaluated the consumption of various types of beverages assessed in 1995-1996 in relation to self-reported depression diagnosis after 2000 among 263,923 participants of the NIH-AARP Diet and Health Study…. Finally, compared to nondrinkers, drinking coffee or tea without any sweetener was associated with a lower risk for depression, adding artificial sweeteners, but not sugar or honey, was associated with higher risks. Frequent consumption of sweetened beverages, especially diet drinks, may increase depression risk among older adults, whereas coffee consumption may lower the risk. [Sweetened beverages, coffee, and tea and depression risk among older US adults.]

The overall results:

  • People who drank 4 or more diet sodas per day were 31% more likely to suffer depression.

  • People who drank 4 or more regular sodas per day were 22% more likely to suffer depression.

  • People who drank 4 or more cans of diet fruit drinks per day were 51% more likely to suffer depression.

  • People who drank 4 or more cups of coffee per day were 10% LESS likely to suffer depression than non coffee drinkers.

Keep in mind that the study involved the elderly, but the scientists felt that these results could easily be translated to cover most age groups. [Study Finds Linkage between Diet Drinks and Depression]

From What Doctors Don’t Tell You, we discovered a very worrying connection between diet, inflammation, and behavioral problems (including depression).

Thus far, the discoveries have been based on tests with laboratory mice, but the results are nonetheless worrying. Gut microbioma from mice given a high-fat diet were transplanted into other mice, which were monitored for any changes to their behaviour and cognition.

They quickly developed behavioural problems, including anxiety, impaired memory, and repetitive actions. The mice also showed signs of gut permeability and had markers of inflammation, including signs of inflammation in the brain.

(Source: Biological Psychiatry, 2015; 77(7): 607)

Omega-3 EFAs (essential fatty acids) are known to both fight inflammation and depression and more studies have come to lite proving that. Even an old study from the American Journal of Clinical Nutrition [2009; 89: 641-51] followed a group of women between the ages of 40 and 55. They were given either one gram of marine-based omega-3 or a placebo consisting of sunflower oil.

The experimental group reported significant improvement in mental distress and mild depression while the control group reported no changes. Also, as has been pointed out at this site, hot flashes were less of a problem taking omega-3s.

The connection between inflammation and depression is not new, but it seems to finally be getting some attention. In 2009, this study: A potential role for pro-inflammatory cytokines in regulating synaptic plasticity in major depressive disorder was released showing conclusively that several pro-inflammatory cytokines “have been found to be significantly increased in patients with MDD (major depressive disorder).

Just released in December of 2015 is a study that What Doctors Don’t Tell You published as: Low omega-3 levels could be the cause of bipolar disorder (and the drugs could be making it worse).

It seems the type of omega-3s needed are both fish and plant based. In fact the researcher found that both omega-3 and omega-6 levels were low in people with bipolar disorder. Supplementing with these oils helps, and the drugs they’ve been prescribed seem to make things even worse because they interfere with the body’s ability to process fats. In fact WDDTY reports:

Earlier studies had found that omega-3 didn`t help alleviate bipolar symptoms, but this could have been because the patient was still taking the medication, which may have blocked the body`s ability to process the fatty acids properly.

If depression is a problem, then may I suggest you look over a paper that we worked on for quite a few years called Chronic Inflammation, and also check out Cardia-7 which is my latest discovery to fight inflammation fast and make our bodies more sensitive to insulin.

Epigenetics

Genetics is the science that once taught us that the way we were born, with that genetic makeup, determined our longevity and our overall health. Epigenetics is a new science that tells us that your genetic makeup does not determine our fate. The Linus Pauling Institute has promulgated that diet and lifestyle override genetic disposition, but first there was Dr Bruce Lipton who bridged the gap between "science and spirit" in the early nineties, when he discovered that what we think and believe affects our cells at a genetic level. He is considered the father of epigeneitics.  

What we think and how we think can activate or suppress our genes and these changes can not only become permanent, they can be passed down to our offspring.

One of the things that can turn off (suppress) inflammatory genes is meditation. In a 2013 study study that took place on different continents, researchers found that meditation could suppress the inflammatory genes RIPK2 and COX2, "as well as histone deactylase genes, among experienced practitioners of mindfulness meditation in comparison with a control group." The article (in the above link) ends, quoting Dr Lipton: "Taking care of your health is a lifestyle problem. You can do something about lifestyle."

In 2014, JAMA published a study that showed that meditation outperformed drugs in reducing depression and anxiety, so significantly that the "placebo effect" or "wishful thinking" could be ruled out completely. Participants meditated for 40 minutes a day every day for eight weeks.

Even if you're in a group situation meditating, another study published in the British Journal of Psychiatry that considered two groups, one doing standard traditional talk therapy and another doing eight weeks of group meditation and declared a tie. The meditation worked just as well as the therapy.

A side benefit to meditation is that you'll lose far less gray matter as you age than those who don't.

What Doesn’t Seem To Be Working

As pointed out directly above, drugs seem to make bipolar disorder even worse, and now you’re going to learn that there are therapies for depression that are more successful than drugs, and that drugs again could be making things worse.

For years we’ve been told that depression is caused by a “chemical imbalance.” I’ve often responded to professionals telling me this by asking, “Which chemicals are those, exactly?”

The response is usually a blank stare.

The entire theory, which has been very profitable even if unsubstantiated, is based upon the “fact” that serotonin can “strengthen” communication between brain cells. This theory launched a multi-billion dollar industry of SSRI (Selective Serotonin Reuptake Inhibitor) drugs that stop nerve cells from reabsorbing serotonin, hopefully causing more brain cell activity. Again, this has never been proven and most studies have shown them to work in the beginning for a short period and then nothing. If your friends or yourself have ever been on these, I’m sure you know all about going back to your doctor to “readjust your meds.” Named drugs of this type are Zoloft, Celexa, and Prozac.

In 2013, Nature Neuroscience [doi: 10.1038/nn.3355] published a study from the University of Maryland School of Medicine that refutes the whole SSRI theory. According to Professor Scott M Thompson, and we’re paraphrasing, “Depression has more to do with brain cell activity, and especially excitatory connections. Normal activity is reduced in the depressed person, and it affects the ability to concentrate, remember and make decisions.” And instead of prescribing drugs that supposedly “strengthen” communication between cells, we should be developing drugs that promote “better” communication between brain cells.” [Depression not caused by 'chemical imbalance', researchers confirm]

Besides, “Taking a drug almost doubles your risk of suffering a relapse,” according to researchers at McMaster University who performed a meta-analysis of studies that monitored the effectiveness of anti-depressants. [Anti-depressants double the risk of another bout of depression]

The British Medical Journal just last year published a study showing that people on SSRIs increase their risk of becoming bipolar by 34%.

And still more studies are finding adverse side effects that seem to fly under the radar. Swiss doctors found SSRIs boost your risk of fractures and lower bone density. One study showed an increased risk of 72%. German scientists found an increased risk of gastrointestinal bleeding, which can put you into a dangerous position if you're also using aspirin or taking blood thinners. Then there's the risk of bleeding profusely should you have surgery. The Archives of Internal Medicine in 2013 pointed out that people taking SSRIs who went into surgery were much more likely to suffer complications and death . . . this latter one we want to avoid at all costs.

One of the problems, at least as I see it, is that depression is automatically treated as a disease when, as many psychologists will admit, it appears, at times, to be a very natural and even beneficial process that people go through to cope with stress, loss, and pain.

Chronic depression, on the other hand, is something quite different and appears to have a nutritional basis, though we can never rule out a physical anomaly in a small percentage of cases.

However are doctors qualified to diagnose accurately clinical depression? And did you know that depression can be handed down?

We can thank those lucky stars that there are people willing to experiment with alternatives to drug therapy, especially when deaths (suicides) while using drug therapies are enough to send you into depression. One such therapy is the old standby, Talk Therapy.

JAMA reported (in 2009) publishes a study in which 317 teens between the ages of 13 and 17 who had either had a history of depression or were showing early signs were given CBT (cognitive behavioral therapy) with the results being significantly better than any drug therapy at preventing depression and in reducing its symptoms.

However, there was a group that did not respond to CBT, and they had at least one parent who suffered from depression.

Depression…an inheritance that will never be taxed. [Doctors discover something better than drugs for depression]

And far too often a physician will reach for the prescription pad rather than schedule a second appointment to make sure of the diagnosis. Lancet, in 2009 published a meta-analysis of 41 trials into depression diagnoses and discovered that more than a third of patients prescribed anti-depressants (which can be dangerous at times, leading to, you guessed it, depression) who were misdiagnosed as being clinically depressed.

The British Medical Journal published a very simple yet amazingly insightful study out of New Zealand in which doctors came up with two key questions that could identify up to 96% of all cases of depression: [numbers]

  • During the past month, have you often been bothered by feeling down, depressed, or hopeless?
  • During the past month, have you often been bothered by little interest or pleasure in doing things?

This turned out to be a remarkable success and even if you ask yourself these two questions, you’ll know if you might need to talk to a counselor.

Doctors are driven, cajoled, and incentivized to prescribe antidepressant drugs. From 1995 to 2005, prescriptions for these pills doubled. Out of the 27 million Americans diagnosed with depression, only 19% were offered any form of therapy other than drugs.

Researchers from Northwestern University Feinberg School of Medicine say that because medicine has an oversimplified view of the causes of depression (chemical imbalance, stress), drugs just don’t work, are over prescribed, and never get to the true causes of depression.

Another study out of UT Southwestern Medical Center  concluded the same thing. This $83 billion a year drug business isn’t helping at all and that doctors have to start taking a more holistic approach to depression.

In 2013, researcher from Bern University in Switzerland assessed seven different non drug therapies for depression and most were at least as good as drug therapy with a few producing even better results than drug therapy. Since drugs come with so many and often horrid side effects, shouldn’t physicians be investigating these first rather than reaching for the prescription pad? What ever happened to “Do no harm?”

Depression Can Make You Sick

One thing doctors notice right away is that depressed people are not healthy people. Depression can affect our immune systems, and if inflammation can lead to depression, well, it’s been known to lead to heart disease, cancer, diabetes, and a host of other illnesses.

Many heart specialists learn early on in their career that depression is one of the early signs of heart disease. It also makes heart problems worse if untreated. In this article, Depression: Why it can lead to a heart attack, you’ll read:

But nobody has been sure why this is. To find out, researchers from the VA Medical Center in San Francisco tracked 1,017 patients with heart disease for nearly five years.

Those who were depressed were also 50 per cent more likely to suffer further heart problems, such as a heart attack or stroke.

But when researchers looked at lifestyle issues, such as exercise, the association went away. In other words, depression didn't cause heart problems, and heart problems didn't cause depression - but both were symptoms of a poor lifestyle, and lack of exercise.

Nobody knows why. You see, the hardest thing in medicine is proving cause. It’s so difficult that we’ve got drugs for everything just in case we’ve missed the actual cause, and in this case, as in others we’ve talked about in the past, this is one of those “chicken or egg” problems. Which came first?

And we also know, positive people live longer. This is simply a fact. However, the positiveness must be organic and not imposed. There are people who are positive simply because they are scared to death to have one negative thought.

Treating Depression

Now that we’ve seen how NOT to treat depression (and perhaps get a second opinion) and have offered a few suggestions, let’s really get into what helps.

Family and friends help. However, they must be supportive. If they’re not, who needs them. A family can pass on its dysfunction for generations. As one therapist put it, we are all victims of victims of victims etcetera.

Here is our article (one last time, I promise) on Nutrition and Depression and here is our article on Chronic Inflammation.

Find a therapist willing to treat you as a human being, rather than a customer. Find one willing to think outside the box.

Find a physician who will keep you from being a statistic, for after a review of all published and unpublished date, Profession Gotzsche of the University of Copenhagen (and a researcher with the Cochrane Collaboration) concluded that after cancer and then heart disease, psychiatric drugs were the third major killer in our Western world.

Suicide rates for people on antidepressants are 15 times higher, according to Dr Gotzsche, than “official figures suggest.” Don’t end up a statistic.

The Nordic Cochrane Centre is and independent review board that re-examined 70 drug studies (paid for by the manufacturers) that involved nearly 19,000 teens under 18 years old and discovered that they were twice as likely to commit suicide while using SSRIs than people the same ages using nothing.

And there is a lot you can do on your own, keeping in mind that when you’re depressed, the last thing you’re probably going to do is something you really need to do. It’s a crazy, downward cycle.

So, get a friend to help. That’s right. Someone to go walking with. Someone who won’t put up with your “bullshit” and who’s willing to drag your ass outside.

I had a friend who was diagnosed as clinically depressed. I taught her tennis. And in all the time I knew her, she never looked as happy as she did when we played tennis. However, eventually she decided she liked her depression more than tennis. I had to give up. You can’t pull people out of their ruts day after day after day.

There is one ubiquitous rule in life and that is: we love our little ruts.

If you can step outside your rut, you can beat this.

So, it’s up to you to take control. Get out and walk a minimum of 30 minutes a day. You can break that into two walks of 15 minutes.

Being in nature helps fight depression. Exercise helps. Getting the bright light of day helps.

In fact, for those of you with Seasonal Affected Disorder, a bright light works better than Prozac, almost twice as effective. [JAMA Psychiatry, 2015; doi: 10.1001/jamapsychiatry.2015.223]

And how about starting to forgive your enemies? And forgiving yourself. Studies show that a little forgiveness goes a long way in healing and preventing, but apparently especially in women.

Helping Others

In our article on Nutrition & Depression, I posted something of interest:

You CANNOT possibly be depressed while helping another human being.

Recently I received an email from someone telling me I should be ashamed of posting such bull. Obviously this person "thought" he was helping others and it didn't cure his "attitude."

I wrote back that the studies showed that the person must be doing this from the heart, or it did nothing.

He wrote back in ALL CAPS berating me up, down, and sideways.

Apparently I'd hit a nerve

The studies are in. When you are helping others from the heart, your depression and anxiety leave you, at least temporarily. The studies also show that too much volunteering does the exact obvious, so keep it simple. If you're doing it for yourself, you get no benefits. Just getting out into the community, talking to and interacting with your fellow human beings boosts your "happy" chemicals.

 

 

As you can see from everything presented here, you can do more to help yourself than all the drugs in the world. Yes, you have to be pro-active, and that can be hard when you’re down, but if you think about it, doing nothing isn’t going to help at all and can only make things worse.

Future Updates

If you check back, we'll be posting any and all new research published on either depression or on antidepressants. In fact, just as we're about to publish this article in our newsletter, we've already received our first update.

Two Antidepressants In Pregnant Women Connected To Birth Defects

The British Medical Journal published a study (July) that is finally getting attention that showed that pregnant women taking paroxetine or fluoxetine early in pregnancy, raise the risk of certain birth defects 2 to 3.5 times that of women not taking these SSRIs. Women taking them later in their pregnancies, the second or third trimesters, nearly double their chances of their babies having autism.


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