Cure for Anxiety and Depression
If you have been unsuccessful in your battle against depression and your attempts to improve mental health, you are not alone. At least 40 percent of all alcoholics in the United States are affected. I say "at least" because our Health Recovery Center study found that almost two-thirds of our clients are seriously depressed at entry. In fact, most alcoholics I have treated suffered from depression.
It is tempting to pin the blame for hopelessness and despair on external events that can be triggered by alcoholism such as the deterioration of a marriage or the loss of a job. To be sure some of the depression alcoholics report is a result of the negative course life can take when you drink too much. You will be relieved to learn that this type of situational depression is self-limiting and will pass as your life begins to improve. Counseling or group therapy can be of enormous value here.
But most depression among alcoholics runs much deeper than the situational variety I have just described. Depression, like the other emotional problems, often has biochemical roots that stem from the destructive effect of alcohol on the chemistry of the brain. Research has verified the relationship between biochemistry and depression. Autopsies of people who have committed suicide have revealed biochemical disruptions that are unique to suicidal depression. On these pages you will learn to recognize the warning signs of this tragedy in the making.
No amount of counseling or psychotherapy by mental health treatment centers can produce a cure for depression for people who suffer from biochemically-induced depression. I learned this the hard way, watching my son fight the deep sadness and feelings of hopelessness that descended upon him as his depression worsened. The counseling he received was excellent, but words have no power to reverse the biochemical disruption caused by alcoholism and drugs. In fact, therapy's focus on the failures and unhappy external events in the lives of seriously depressed people only creates more misery for them.
My search for an explanation for Rob's suicide led me to research studies that confirmed the connections between brain biochemistry and depression and offered methods of repair that work far more reliably than any form of talk therapy. I learned that there is no single biochemical glitch that explains all depression. At HRC, we treat 14 different sources of depression that affect alcoholics. On these pages you will learn which may underlie your depression (in some cases, two or more may be to blame). You will also learn how to overcome your particular chemical problem or problems. Your depression or anxiety cure depends on the replacement of key missing nutrients. It may require further changes in your diet, or you may need drug treatment to correct a medical condition, like hypothyroidism, that can precipitate depression. Before you take a look at our formulas used as a cure for anxiety and depression, you'll of' course, have to confirm that you are depressed. Then you can evaluate the severity of your case.
Before You Can Improve Your Mental Health, You Must First Recognize If You Are Depressed?
Although two-thirds of the clients at HRC are severely depressed when they enter the program, many do not realize they are affected. Men, in particular, are inclined to attribute the feelings induced by depression to other causes. Some blame their inability to handle stress well. Others reject being labeled depressed because of the social stigma often unjustly attached to this condition. Some are simply so overwhelmed by alcoholic symptoms that their depression is masked. Even so, depression is not difficult to spot if you know that certain behaviors are red flags to the condition:
- Withdrawal from activity, isolating yourself
- Continual fatigue, lethargy
- Lack of motivation, boredom, loss of interest in life
- Feeling helpless, immobilized
- Sleeping too much; using sleep to escape reality
- Insomnia, particularly early morning insomnia (waking early and being unable to get back to sleep)
- Lack of response to good news
- Loss of appetite or binge eating
- Ongoing anxiety
- Silent and unresponsive around people
- An "I don't care" attitude
- Easily upset or angered, lashing out at others
- Inability to concentrate
- Listening to mood music persistently
- Self-destructive behavior (including promiscuity)
- Suicidal thoughts or plans
How to Tell if Your Depression Is Psychological
Biochemical depression has certain symptoms that distinguish it from the depression stemming from negative life events. You have reason to suspect that you are biochemically depressed if any of the markers listed below describes your depression:
- You have been depressed for a long time despite changes in your life
- Talk therapy has little or no effect; in fact, psychological probing-- questions like "Why do you hate your father?"--leave you as confused as Alice at the Mad Hatter's tea party
- You don't react to good news
- You awaken very early in the morning and can't get back to sleep
- You cannot trace the onset of your depression to any event in your life
- Your moods may swing between depression and elation over a period of months in a regular rhythm (this suggests bipolar, or manic-depressive, disorder)
- Heavy drinking makes your depression worse
How Serious Is Your Depression?
As important as identifying the cause of your depression is determining the depth of your feelings. If you often have suicidal thoughts, please confide in your physician and a close friend or relative. You will recover, but in your present state you need the support of someone you trust. Share this information and together do the detective work needed to discover what is responsible for your continued depression.
The Seven Kinds of Alcoholic Depression
As I noted earlier, at HRC we have identified seven sources of biochemical depression affecting alcoholics:
- Neurotransmitter depletion
- Unavailability of prostaglandin E1
- Vitamin/mineral deficiency
- Food and chemical allergies
- Candida-related complex.
Where do you fit in? Let's begin with the most likely biochemical scenario.
Neurotransmitter Depletion and Depression
In earlier reading of this website you became acquainted with neurotransmitters-the natural chemicals that facilitate communication between brain cells. These substances govern our emotions, memory, moods, behavior, sleep, and learning abilities. Neurotransmitters are manufactured in the brain from the amino acids we extract from foods and their supply is entirely dependent on the presence of these precursor amino acids.
Alcohol destroys these essential precursor amino acids, which is probably why alcoholics seem so emotionally muddled and depressed. Without adequate amino-acid conversion, neurotransmitters are no longer produced in sufficient amounts; this deficiency causes "emotional" symptoms, including depression.
The two major neurotransmitters involved in preventing depression are serotonin (converted from the amino acid L-tryptophan) and norepinephrine (converted from the amino acids L-phenylalanine and L-tyrosine). You can resupply these vital neurotransmitters and reverse depression by taking daily amino-acid supplements.
Your symptoms will determine which amino acid you will take for depression: tryptophan if your symptoms are sleeplessness, anxiety or irritability; L-tyrosine or L-phenylalanine if your symptoms a lethargy, fatigue, sleeping too much, or feelings of immobility.
Tryptophan to Serotonin
The amino acid tryptophan, found in large amounts in milk and turkey, is the nutrient needed to form serotonin, which controls moods, sleep, sex drive, appetite, and pain threshold. Eating disorders and violent behavior have also been traced to serotonin depletion. Replacing serotonin can lift depression and end insomnia. In one notable study, a medical researcher in Holland demonstrated that a combination of tryptophan (2 grams nightly) and vitamin B6 (125 milligrams three times a day) could restore patients with anxiety-type depression to normal in four weeks. Depression accompanied by anxiety and sleep disturbances is most likely to respond to tryptophan.
New research (1997) from McGill University in Montreal has found that men produce 52 percent more serotonin than do women. This in-formation seems to explain why more women than men appear to experience a shortage of this critical chemical that modulates moods and so are more likely to suffer from depression and/or eating disorders.
Until the U.S. Food and Drug Administration prohibited the manufacture and sale of tryptophan in the United States in the fall of 1989, we used it for ten years at HRC without any ill effects. This amino acid has also been widely used in England and Canada. In 1989, however, a number of deaths and illnesses in the United States were traced to batches of tryptophan manufactured in Japan. In response, the FDA removed tryptophan from the U.S. market. The FDA has finally allowed this essential amino acid to be restored to baby food and also has made it available by prescription only. Unfortunately, the price of it has now quadrupled.
Tryptophan is now available at Bio-Recovery
Tryptophan is not a drug. It is an essential amino acid much needed to support life and sanity. In an interesting coincidence, Prozac made its first appearance within days of the ban on tryptophan. Now there is a whole family of serotonin-stimulating drugs, but none of them can create more serotonin; they can only speed its firing into the brain and partially block the reuptake into the neurotransmitters, and so the low levels of serotonin in those neurotransmitters are slowly becoming even more depleted.
At HRC almost everyone comes into our program taking one of the serotonin-firing antidepressants (Zoloft, Paxil, Desyrel, Serzone). Our physician switches them to the natural serotonin precursor, tryptophan, which promptly restores the missing serotonin levels. Usually the firing mechanism works fine; the problem was that it simply has had very little serotonin to fire.
Here are the guidelines for substituting tryptophan for a serotonin enhancing drug:
- Tryptophan alone will not be converted to serotonin. To insure that it is properly used, you must also take vitamin C and vitamin B6 (Table 25, Seven Weeks to Sobriety).
- Tryptophan is converted to niacin before its final conversion into serotonin. If your body is deficient in niacin, the tryptophan you take will supply you with niacin, not serotonin. For this reason, it is a good idea to take a B-complex vitamin daily. This will give you both vitamin B6 and niacin and allow the tryptophan to be converted to serotonin.
- Inositol changes into a substance that regulates serotonin's effectiveness within nerve cells. A recent (1997) study confirms its effectiveness with depression. Therefore, we include inositol in this formula.
Of all the amino acids, tryptophan is least able to cross the blood-brain barrier. It must pass this biological hurdle in order to be converted to serotonin. You can give it a nudge by taking it in fruit juice. This will trigger insulin release, which will assist the tryptophan across the blood-brain barrier. Always take your tryptophan on an empty stomach.
Safety and Side Effects
Orthomolecular physicians have safely used tryptophan in doses of one to six grams daily. Since it is not stored in the body, it cannot accumulate to toxic levels. However, taking high doses of tryptophan can produce some side effects:
- Drowsiness the next morning
- Bizarre or strange dreams (rare)
- Increased blood pressure in persons over sixty who already have high blood pressure
- Aggressiveness (this rare side effect can occur in the absence of sufficient supplies of the nutrients needed for normal conversion of tryptophan to serotonin)
Who Should Not Take Tryptophan:
- Anyone who takes an MAO (monoamine oxidase) inhibitor for depression; do not take tryptophan until ten days after giving up MAO inhibitors
- Anyone with severe liver disease (a damaged liver cannot properly metabolize tryptophan)
- Pregnant women (you may be able to take five hundred to thousand milligrams of tryptophan, but only with the approval and supervision of your physician)
The reasons for the potential risks of 5-HT were brought to our attention by Steven B Harris, M.D. He explained that: 5-Hydroxytryptophan (5-HT) is one step closer to serotonin than tryptophan. The sequence is as follows.
Tryptophan > 5-Hydroxytryptophan > Serotonin
Based on the above metabolic sequence it would appear desirable to use 5-HT instead of tryptophan since 5-HT more readily converts to serotonin. Serotonin is a neurotransmitter that is often deficient in the brains of depressed people. Boosting serotonin can alleviate depression in some people and reduce carbohydrate cravings in others, thus inducing weight loss.
Here's why 5-HT will not work for most Americans, and could be lethal to some people: The blood-brain barrier does not allow significant absorption of serotonin from the blood. The brain does have a large neutral amino acid pump that freely allows tryptophan and 5-HT into the brain for conversion into serotonin. The process by which 5-H is converted into serotonin is called decarboxylation. If decarboxylation occurs before 5-HT is absorbed by the brain, than blood levels of serotonin will elevate significantly, but very little serotonin will enter the brain.
When Europeans take 5-HT, they are often prescribed the dopa decarboxylase inhibitor carbidopa that prevents 5-HT from being converted into serotonin until it reaches the brain. Americans do not take carbidopa with 5-HT and the result is possible serotonin overload in the blood, with virtually no serotonin reaching the brain. We will describe later the dangers of overloading the blood with serotonin. Americans taking 5-HT are more vulnerable to blood serotonin overload because, unlike most Europeans who are vitamin deficient, Americans who use 5-HT usually take large doses of vitamin B6 as well. Vitamin B6 rapidly converts 5-HT into serotonin before it can reach the brain. Even when combined with carbidopa, high levels of vitamin B6 will break through the carbidopa barrier and insure that 5-HT converts into serotonin in the blood before the it can reach the brain.
The multiple health benefits of vitamin B6 are too important, we believe, to recommend that people avoid taking vitamin B6 just to enable them to try using 5-HT to boost brain serotonin levels. This may be difficult anyway without also taking carbidopa, which is available in the US only as a prescription drug. At the very best, those who take vitamin B6 with 5-HT are probably wasting their money. Unfortunately, high serotonin in the blood in not benign. Anyone suffering from heart disease should avoid 5-HT because the elevation in blood serotonin could cause coronary artery spasm an/or abnormal platelet aggregation, which are risk factors for sudden death heart attack.
Here is the real frightening aspect of serotonin overload, as described by Dr. Harris: "Serotonin causes not only harmless flushing and diarrhea, but people with serotonin secreting tumors (hindgut carcinoids) also have problems with fibrosis of the endocardium and valves of their right hearts with can cause heart failure. The effect can also be seen with dietary intake of only modest amounts of serotonin, and there has actually been described in the medical literature, a tribe of South Sea islanders with right heart fibrosis as a result of eating green banana mush, which poisons them with its serotonin content" Dr. Harris goes on to state that people who ingest several hundred milligrams a day of 5-HT with B6 and without a decarboxylase inhibitor would expect to see urinary excretion of a serotonin metabolite in the same range as a person with a serotonin secreting tumor.
Based upon Dr. Harris' report the Foundation had its analysts conduct an extensive review of the medical literature and have come to the following preliminary conclusions:
1) For 5-HT to boost serotonin levels in the brain it is necessary to: a)Take 50 mg of carbidopa before each 5-HT dose. Carbidopa is a prescription drug. b)Limit vitamin B6 supplementation to a small dose taken at least six hours before or after 5-HT carbidopa dosing. c) Have a urinary test to measure a metabolite of serotonin called 5-hydroxy indoleacetic acid (5-HIAA) on a regular basis. As long as 5-HIAA levels are normal, than 5-HT intake would be safe.
2) Those with existing cardiovascular disease, including atrial fibrillation, coronary artery disease, congestive heart failure, cardiomyopathy, valvular disease or pulmonary hypertension may want to avoid 5-HT completely. One Foundation analyst felt that 81 mg a day of aspirin and 500 mg a day of magnesium would reduce the risk of 5-HT inducing a heart attack.
3)The effects of 5-HT by itself elevating blood serotonin levels are extremely individualistic. Some people may not experience any blood serotonin increase, while others could suffer from a lethal serotonin peripheral overload.
4) Despite the potential dangers of 5-HT, most FDA-approved drugs to treat depression and obesity appear to be more toxic.
5) At the time of this printing, we have not been able to verify whether 5-HT induced serotonin overload would cause fibrosis of the aortic valve and destruction of the heart muscle. Based on the potential health risks of ingesting 5-HIT, Bio Recovery has decided not to offer it tat this time. we encourage anyone seeking to use 5-HT to follow strictly the above protocol for safe 5-HT supplementation. We'll post further evidence regarding 5-HTP as soon as it becomes available. This warning applies only to 5-hydroxy tryptophan (5-HT), not tryptophan itself. Published studies show that tryptophan does not readily convert into serotonin in the blood, but that 5-HT does, since 5-HT can convert directly into serotonin while tryptophan has to go through one additional metabolic step which protects against blood serotonin overload.
Tryptophan is now available at Bio-Recovery
This extract is preferred by nearly 76 percent of German physician to treat depression and anxiety. A recent meta-analysis of its effectiveness was published in the British Medical Journal in 1996 Twenty-three double blind studies involving 1,757 patients were analyzed. St.John's Wort proved significantly superior to placebos an as effective as Prozac and other standard antidepressant drugs. The big advantage of using Hypericum instead of antidepressant drugs is its safety and lack of side effects. St.John's Wort works by inhibiting serotonin reuptake just like the many new antidepressant drugs, and without any loss of libido or any violent outbursts, nausea, anxiety or nervousness.
The standard dose is 300 milligrams three times daily between meals.
WARNING: Do not use St.-John's-Wort if you are currently taking an antidepressant drug prescription. First see your doctor about discontinuing your drug.
Do not combine the HRC Formula for Depression Due to Serotonin Depletion with St.John's Wort. Consider St.John's Wort as alternative after you have reloaded your serotonin neurotransmitters but are still depressed. In most alcoholics the serotonin firing mechanism is fine, but alcohol has so depleted the neurotransmitter's supply that there's nothing much to fire. Reloading via the Formula for Depression Due to Serotonin Depletion is usually enough.
If you are still depressed after three weeks on the formula, you can use St.John's Wort to block serotonin from leaving the brain so that it naturally recycles back through the neurotransmitter. This creates a lot of extra serotonin in your brain. If alter four weeks on St.John's Wort you still do not get relief, trust me, your depression is not caused by serotonin depletion.
Tyrosine to Norepinephrine
The amino acid tyrosine, found in large amounts in meats and cheeses, has an amazing effect on depression. A number of studies have found that it can succeed where antidepressant drugs fail.
In the brain, tyrosine is converted into the neurotransmitter norepinephrine, which has been described as the brain's version of adrenaline line. You can appreciate the power of norepinephrine when you realize that the high produced by cocaine comes from the drug' ability to activate norepinephrine while inhibiting serotonin. This chemical reaction causes the brain to race until the supply of norepinephrine is depleted. The crash leaves addicts exhausted, depressed, extremely irritable, and craving more cocaine. Large doses of tyrosine can reduce withdrawal symptoms and prevent serious depression among cocaine addicts.
We have used tyrosine at the Health Recovery Center for the past few years with no adverse effects. The usual dose is three to six grams per day, taken on an empty stomach. You must take vitamins B6 and to facilitate conversion of tyrosine to norepinephrine.
L-Phenylalanine to Norepinephrine
As an alternative to tyrosine, you can take the amino acid L-phenylalanine, which also can be converted into norepinephrine. number of studies have confirmed L-phenylalanine's amazing anti-depressant effects. In one, this potent ammo acid was found as effective an antidepressant as the drug imipramine (Tofranil).
L-phenylalanine has one important advantage over tyrosine treating depression. It can be converted to a substance called 2-phenylethylamine, or 2-PEA. Low brain levels of 2-PEA are responsible for some depression (before it converts to tyrosine, which the converts to norepinephrine).
If you are affected, L-phenylalanine will be better for you than tyrosine. The only way to find out is by trial and error. I recommend that you start by taking L-phenylalanine. If you find that it makes your thoughts rush (an effect that is often described as the brain "racing" you don't need 2-PEA and should switch to tyrosine. The only other disadvantage to taking L-phenylalanine is its slight potential for raising blood pressure. There is also some evidence that excess L-phenylalanine can cause headaches, insomnia, and irritability. For these reasons, it is Important to start with a low dose.
L-phenylalanine doses can range from 500 milligrams to 1,500 milligrams daily taken on an empty stomach. Overdose symptoms & headaches, insomnia, and irritability.
Who Should Not Take Tyrosine or L-Phenylalanine:
- Anyone with high blood pressure should avoid phenylalanine or take very low doses (one hundred milligrams) at first and monitor blood pressure as dosage is increased
- No one taking an MAO inhibitor for depression should take either tyrosine or L-phenylalanine
- No one with severe liver damage should take any amino acid
- Do not take any amino acids during pregnancy except with the approval and supervision of your physician
- No one with PKU (phenylketonuria) should use L-phenylalanine
- No one with schizophrenia should take either amino acid (except with a physician's approval and under his or her supervision)
- No one with an overactive thyroid or malignant melanoma should take either amino acid
- If you are being treated for any serious illness, consult you doctor before taking these amino acids
Unavailability of Prostaglandin E and Depression
Another biochemical cause of depression is a genetic inability to manufacture enough prostaglandin E1 (PGE1), an important brain metabolite derived from essential fatty acids. The problem is the result of an inborn deficiency in omega-6 essential fatty acid (EFA). Alcohol stimulates temporary production of PGE1 and lifts the depression. If you have been depressed since childhood, your introduction to alcohol was probably nothing short of miraculous. But this relief is short-lived. When you stop drinking, PGE1 levels fall again and depression returns. To banish it, you turn again to alcohol. Thus a deadly spiral begins toward alcoholism.
During the last fifteen years, researchers have learned to restore normal PGE1 levels in alcoholics and eliminate both the depression and the need to drink for relief. A substance called gamma-Linolenic acid (GLA) is easily converted to PGE1. I have seen some amazing recoveries from depression within three weeks of GLA treatment.
Take the case of Colleen, a high school English teacher. Colleen described her childhood and teenage years as withdrawn and lonely "I can't remember not being depressed," she told me. In college, she drank alcohol for the first time and received the shock of her young life. Her world brightened in a way she had never before experienced. She felt different. Friendly. Happy. The effects lingered into the next day and then gloom closed in again. After experiencing the dramatic lift in her spirits, she was convinced that she had discovered a magic elixir in alcohol. In a short time she was drinking a few beers every day. The alcohol never failed to banish her depression.
As her college years passed, Colleen's alcohol consumption escalated. She needed to drink more and more to get the lift she sought. She also began to experience deep depressions in the days following heavy drinking. After college, she began teaching high school English. Controlling her depression with alcohol became a real balancing act. Eventually, her drinking came to the attention of her peers and her students. Colleen was appalled at the idea that she was a problem drinker. She decided to prove she could live without alcohol.
The next ten years were some of the most miserable of her life. She joined AA and sought psychiatric help for her severe depression Sadly, no antidepressant drug relieved her misery. It was hard to keep teaching, hard to keep living. Her depression had reached the suicidal stage when she reasoned that alcohol could put an end to her despair. Her decision to resume drinking didn't take much reflection. Predictably, her alcohol intake began to escalate rapidly. This time, no one sympathized. Her principal ordered her to treatment. Three weeks after completing an inpatient program, she was back at work and drinking again to medicate her depression. A second round of treatment left her temporarily dry and depressed. Colleen was on a merry-go-round she couldn't get off. When she called the Health Recovery Center, she was crying: "I have alienated everyone because I won't stay sober; but being drunk feels better than being depressed."
I often think someone up there does watch over people; it seems more than coincidence that Colleen found her way to one of the only treatment centers in the country that would run tests and restore her chemistry to normal. Within three weeks, her depression had vanished. She no longer needed nor craved alcohol.
Colleen's was a classic case of chronic depression caused by too little PGE1. Although alcohol blocks production of additional amounts of this metabolite, its active effect is to enhance what little is available in the brain. Eventually, a no-win situation develops and alcohol becomes the only way to prevent depression. The solution, of course, is to provide the brain with the PGE1 needed to reverse the depression. The illustration below shows how essential fatty acids are converted into PGE1 and other brain metabolites. If your body can't do this normally, you can correct the problem by taking gamma-linolenic acid (GLA). The formula for EFA deficient depression (Table 27, Seven Weeks to Sobriety) includes three supportive nutrients in addition to GLA: Zinc and magnesium needed for formation of gamma-linolenic acid (GLA); vitamin B6, for metabolism of cis-linolenic acid; and vitamin C, to increase production of PGE1. When you take GLA and its cofactors, depression magically lifts and won't return as long as you continue to take the formula. Colleen now uses this natural substance daily instead of alcohol, and her world has brightened up permanently.
Conversion of Essential Fatty Acids to PGE1
From D. Horrobin et al., 'Possible Role of Prostaglandin E1 in Affective Disorders and in Alcoholism, "British Medical Journal 1 (June 1980): 1363-66.
- Step 1 blocked by Trans-polyunsaturates
- High-carbohydrate and high-fat diets
- Saturated fats
- Lack of insulin
- Step 2 blocked by Opioids
Do You Have an EFA Deficiency?
In his book Essential Fatty Acids and Immunity in Mental Health, Charles Bates, Ph.D., provides a list of factors that suggest an essential fatty acid deficiency:
- Ancestry that is one-quarter or more Celtic Irish, Scandinavian, Native American, Welsh, or Scottish
- A tendency to abuse alcohol or feel that it affects you differently from others; trouble with alcohol in your teenage years
- Anxiety or depression during hangovers
- Depression among close relatives
- A family history of alcoholism, depression, suicide, schizophrenia, or other mental illness, religious fanaticism, or fanatical teetotaling
- Depression that persists while you are abstinent from alcohol
- A personal or family history of Crohn's disease, hepatic cirrhosis, cystic fibrosis, Sjogren-Larsson syndrome, atopic eczema
- A personal or family history of ulcerative colitis, irritable bowel syndrome, premenstrual syndrome, scleroderma, diabetes, or benign breast disease
- Experiencing an emotional lilt from certain foods or vitamins
- Winter depressions that lighten in the spring
Vitamin and Mineral Deficiency and Depression
The effect of nutritional deficiencies on brain chemistry can cause depression, anger, listlessness, and paranoia. Unfortunately, the connection between depression and vitamin and mineral deficiencies is often missed. At Johns Hopkins University, sixty-nine cases of scurvy (total vitamin C depletion) were discovered at autopsy, and yet the disease had not been diagnosed before death in 91 percent of these patients.
One of the most dramatic cases of vitamin and mineral deficiencies I have seen involved a man I'll call Paul. He had been arrested four times for drunken driving but continued to drink daily. His probation officer brought him to the Health Recovery Center. The three of us had to decide if an outpatient program would be proper for someone as depressed as Paul. The court had just ordered him back to treatment; judging by the miserable look on his face, it was the last place he wanted to be.
Paul was thirty, divorced, and living alone. He rarely ate more than one meal a day, usually fast food or junk food. He lived on coffee, cigarettes, and beer. Paul confided that he was probably going to lose his sales job because he could no longer motivate himself. He blamed all of his troubles on depression. There were so many aspects of his lifestyle that suggested a real depletion of the natural chemicals he needed to recover from alcoholism and depression that I urged Paul to let us work with him.
Two days later, after receiving his B-complex shots, Paul remarked that we must have injected him with an amphetamine. The effect of restoring these life-giving substances was dramatic. He also made many lifestyle changes that contributed to his recovery, but one of the most important was the replacement of certain key natural substances that helped relieve his depression.
The B-Complex Vitamins
The B-complex vitamins are essential to mental and emotional well-being. They cannot be stored in our bodies, so we depend entirely on our daily diet to supply them. B vitamins are destroyed by alcohol, refined sugars, nicotine, and caffeine-the very substances that most alcoholics consume almost to the exclusion of everything else. Small wonder that deficiencies develop.
Here's a rundown of recent findings about the relationship of B-complex vitamins to depression:
- Vitamin B (thiamine): Deficiencies trigger depression and irritability and can cause neurological and cardiac disorders among alcoholics.
- Vitamin B2 (riboflavin): In 1982 an article published in the British Journal of Psychiatry reported that every one of 172 successive patients admitted to a British psychiatric hospital for treatment of depression was deficient in B2.
- Vitamin B3 (niacin): Depletion causes anxiety, depression, apprehension, and fatigue.
- Vitamin B5 (pantothenic acid): Symptoms of deficiency are fatigue, chronic stress, and depression. Vitamin B5 is needed for hormone formation and the uptake of amino acids and the brain chemical acetylcholine, which combine to prevent certain types of depression.
- Vitamin B6 (pyridoxine): Deficiency can disrupt formation of neurotransmitters. Vitamin B6 is a coenzyme needed for conversion of tryptophan to serotonin and phenylalanine and tyrosine to norepinephrine. I have discussed the relationships of these neurotransmitters to depression earlier in this chapter.
- Vitamin B12: Deficiency will cause depression.
- Folic acid: Deficiency is a common cause of depression.
Continuing vitamin C deficiency causes chronic depression, fatigue, and vague ill health.
Deficiencies in a number of minerals can also cause depression. If this is at the root of your problem, you should already be on the road to recovery; your adjusted nutrient plan contains sufficient amounts of all the minerals necessary to overcome any deficiencies. But I would like you to familiarize yourself with the minerals that can underlie depression so you can better understand the rationale for taking large doses of so many supplements.
- Magnesium: Symptoms of deficiency include confusion, apathy, loss of appetite, weakness, and insomnia.
- Calcium: Depletion affects the central nervous system. Low levels of calcium cause nervousness, apprehension, irritability, and numbness.
- Zinc: Inadequacies result in apathy, lack of appetite, and lethargy When zinc is low, copper in the body can increase to toxic levels, resulting in paranoia and fearfulness.
- Iron: Depression is often a symptom of chronic iron deficiency. Other symptoms include general weakness, listlessness, exhaustion, lack of appetite, and headaches.
- Manganese: This metal is needed for proper use of the B-complex vitamins and vitamin C. Since it also plays a role in amino-acid formation, a deficiency may contribute to depression stemming from low levels of the neurotransmitters serotonin and norepinephrine. Manganese also helps stabilize blood sugar and prevent hypoglycemic mood swings.
- Potassium: Depletion is frequently associated with depression, fearfulness, weakness, and fatigue. A 1981 study found that depressed patients were more likely than controls to have decreased intracellular potassium. Decreased brain levels of potassium have also been found on autopsies of suicides. You can boost your potassium intake by using one teaspoon of Morton's Lite-Salt every day.
The Safety of Supplements
Vitamin C and the B-complex vitamins discussed above are all water soluble. This means that they can't accumulate in your body or be stored for future use. Amounts above and beyond your current nutritional needs are dumped into your urine. As a result, there is no danger of overdose.
Unlike water soluble vitamins, minerals can be stored in your tissues. Refer to Table 24, Seven Weeks to Sobriety for the RDAs and therapeutic treatment levels. Do not exceed the recommended therapeutic doses, since accumulation of minerals in the body can be dangerous.
Hypothyroidism and Depression
The stress showed on Mary's face as she described how weary and depressed she felt. Her husband and children demanded too much of her, and she drank to escape the pressures and responsibilities. Mary had been in our program for two weeks. She was now alcohol-free and making lifestyle changes. Still, she had very little energy and didn't seem to be recovering very fast.
As we talked, she inadvertently offered several clues to the source of her problem. She complained that even on her restricted diet she simply couldn't lose weight. Exercise was out of the question. She was just too tired, even though she slept up to ten hours a night. She was wearing a heavy sweater even though it was a warm spring day. She said she had a hard time keeping warm and was very susceptible to catching colds. By the end of our session, I had heard enough to refer her to our physician for a thyroid test.
Symptoms of hypothyroidism (low thyroid function) include
- Mental sluggishness
- Poor memory
- Low sex drive
- Brittle hair
- Dry skin
- Puffiness around the eyes
- Cold hands and feet
- Sleeping more than eight hours a night]
- Susceptibility to colds and infections
Researchers speculate that hypothyroidism causes depression because there is an insufficient supply of oxygen to the brain, since people with low thyroid function do not use oxygen efficiently. Linus Pauling contends that all depression could be eliminated if brain cells received sufficient oxygen.
If you have any of the symptoms listed above, you can test yourself for hypothyroidism with a procedure first described in the Journal of the American Medical Association by thyroid expert Broda Barnes, M.D. The test could not be simpler; People with low thyroid function have lower than normal body temperatures because they are not burning up as much food as they should. All you have to do for this test is determine whether your body temperature is lower than normal.
Use a digital or basal thermometer, not a fever thermometer. The basal type is commonly used by women trying to get pregnant -or trying to avoid pregnancy- to determine when ovulation occurs on the basis of an increase in body temperature. Basal thermometers are available in most drugstores.
Upon waking, place the thermometer snugly under your armpit for ten minutes. if it registers below 97.8 degrees and if you have symptoms of hypothyroidism, you probably need thyroid hormone.
This home test can give you a fix on your thyroid status. If you haven't yet been tested, you can ask your doctor to check further. The usual laboratory tests for thyroid (T3, T4, and TSH) do no always tell the whole story. But a new test, the fluorescence activated microsphere assay (available from ImmunoDiagnostic Laboratories in San Leandro, California) will often reveal abnormalities less sophisticated tests miss.
In Mary's case, standard lab tests indicated low-normal thyroid function, but her morning temperature never rose above 96.9 degrees. We treated her with Armour Thyroid, a prescription drug. It relieved her depression and eliminated her mental sluggishness and fatigue. She also lost weight.
If your home thyroid test shows that your temperature is consistently below 97.8 degrees, see your physician to discuss treatment. If the doctor wants more information on your testing method, refer him or her to Dr. Barnes's book Hypothyroidism: The Unsuspected Illness. Another useful book is Solving the Puzzle of Illness by Steven Langer, M.D.
Dr. Barnes has published more than a hundred papers and several books on the role of the thyroid gland in human health. He treats thyroid disorders with natural desiccated thyroid (bovine or pork) rather than synthetic thyroid preparations. The advantage of natural thyroid over synthetic is that all thyroid hormones are replaced with the natural product, whereas synthetics have not yet been able to duplicate nature completely and do not affect two troublesome symptoms of hypothyroidism, dry skin and water retention.
Hypoglycemia and Depression
In his studies of twelve-hundred hypoglycemic patients, Stephen Gyland, M.D. found that 86 percent were depressed. More recently, positron emission tomography (PET) scans have verified that glucose metabolism is often reduced in the brains of patients suffering from depression.
The symptoms of hypoglycemia and depression (below) is based on Dr. Gyland's work. It is no accident that both conditions are so common among alcoholics. If hypoglycemia underlies your depression, you should begin to notice an improvement soon after you adopt the hypoglycemic diet recommended in Chapter 7, Seven Weeks to Sobriety.
Food and Chemical Allergies and Depression
The connection between food allergies and depression was a revelation to me. I was treating a young woman who was both alcoholic and depressed. I expected to find some food or chemical sensitivities because she had a terrible withdrawal hangover when she stopped drinking, indicating an allergic/addicted response to alcohol. But I was not prepared for the Jekyll and Hyde changes that I witnessed. By the end of a week-long modified fast, Carol was feeling much better.
Her depression was gone and her energy had returned. Then she tested wheat. Within two hours she crashed. Crying over the telephone, she told me she was too depressed to continue the program. The next day she apologized. We were both grateful to find a major trigger to her depression.
After her severe reaction, I expected Carol to avoid wheat religiously. At the time, I didn't understand the addiction aspect of the allergic/addicted response. Carol had enormous cravings for breads and pasta, so her resolve lasted only a few days. Then she succumbed to temptation and ate pizza for lunch. An hour later, she arrived at her treatment group sobbing inconsolably while the others groped for emotional explanations for her behavior. After her wheat reaction wore off, her depression again lifted.
Wheat is not the only substance capable of triggering a maladaptive reaction within the brains and nervous systems of sensitive people. Alcohol, certain foods (particularly the grains from which alcohol is made), and many chemicals (particularly hydrocarbon-based products like gasoline and paints) can also cause reactions. Food addiction keeps us coming back for more of certain foods. We love the Initial mild highs they provide as they lift us out of our withdrawal state. We don't understand that the downside of this addiction is depression, anxiety, and mental confusion, the result of the inevitable withdrawal in the nervous system and the brain.
If you are an allergic/addicted alcoholic, consider the possibility that substances other than alcohol may be affecting your brain and causing depression. In Chapter 11 of Seven weeks To Sobriety you'll learn how to identify and eliminate these culprits.
Candida-Related Complex and Depression
During the last five years, we have seen a steady parade of clients who are fighting an internal war with an overgrowth of a common intestinal yeast called Candida albicans. I can usually tell on the basis of a first interview who is a probable candidate for treatment of candida-related complex (CRC). People suffering from this problem appear depressed, tired, anxious, and so spacey that they can't follow what I'm saying. They tell me they continually crave sugar as well as alcohol, and they have telltale signs of yeast invasion throughout their bodies. Their immune systems are so depressed that most foods cause bloating and produce allergic/addictive responses. If you suffer from CRC, your depression won't lift until these yeast colonizers are brought under control.
In Chapter 11, Seven Weeks to Sobriety you'll find a full discussion of CRC and its symptoms, as well as an explanation for why some people are particular susceptible to this yeast. There is also a description of the tests and treatment for CRC.
Suicide and Depression
Before we leave the subject of depression, I want to discuss a painful subject: Suicide, the final solution to depression. If your life, like mine, has been seared by the suicide of a family member, you may find the answers you have been seeking. And if you have been trying to cope with overwhelming depression and are plagued with thoughts of suicide, you will find a welcome warning that can help you avert tragedy.
Over the years, I've learned that alcoholics often conceal the fact that family members have taken their own lives. But if I tell them about my son's suicide, the truth comes rushing out: "My father shot himself" or "Several times, my mother took a deliberate overdose of pills" or "My son hung himself." The pain of these tragic deaths is often compounded by a family code of silence. Often, those touched by the tragedy are tormented by guilt. They can't stop wondering whether they could have done anything to prevent the suicide, whether they missed warning signs that tragedy was approaching. Recent scientific findings provide some of the answers to these agonizing questions and offer comfort and insight.
Most people experience some major disappointment or stress in the course of life, but suicide is rarely the outcome. And, there is no good evidence suggesting that most depression predates alcoholism or that any personality traits underlie alcoholism. Indeed, researchers have so far failed to find genetically transmitted depression among most alcoholics. Instead, studies suggest that the prolonged use of alcohol causes biochemical changes in the brain associated with depression and suicide. The most striking of these findings (from the National Institute of Mental Health) shows that the neurotransmitter serotonin is almost depleted in all the brains of suicides examined during autopsies.
Since alcoholism causes the destruction of tryptophan and other precursor amino acids needed for production of the antidepressant neurotransmitters, it's not surprising that many alcoholics are prone to depression and even suicide. As I have explained earlier in this chapter, alcohol can also precipitate depression by destroying a number of the natural chemicals, including
- The neurotransmitter norepinephrine, formed from the amino acids phenylalanine and tyrosine
- Essential fatty acids needed to form brain metabolites, including prostaglandin E1 (PGE1)
- B vitamins, which supply the brain's energy and maintain mental and emotional balance
- Trace elements and enzymes that govern the body's hormonal balance
A cerebral allergic reaction to alcohol or other substances can cause suicidal depression. You'll find a full discussion of this effect in Chapter 11, Seven Weeks to Sobriety. High levels of toxins from candida albicans overgrowth can also affect the brain and central nervous system and induce suicidal depression. Alcoholism promotes both proliferation of candida and escalation of cerebral allergies.
Since alcohol can inflict so much biochemical damage on the brain and nervous system, it should not be surprising that many alcoholics attempt suicide. One recent study found that up to 40 percent of all alcoholics try to take their own lives at least once; another study found that 25 percent of the deaths of treated alcoholics were suicides.
If you feel that you or someone close to you is a suicide risk, please read chapter ten of Seven Weeks to Sobriety carefully and make the changes recommended to restore normal balance and banish depression once and for all.
Where Do You Fit In?
Now that you are familiar with the various problems that can underlie depression, it's time to determine what to do about the one(s) responsible for your own bleak state of mind. Here are the options. Check all the categories that apply to you:
- Restoring the neurotransmitters serotonin and norepinephrine (formulas found in chapter 10, Seven Weeks to Sobriety)
- Replacing essential fatty acids to create PGE1 (formulas found in chapter 10, Seven Weeks to Sobriety )
- Restoring key vitamins and minerals (review the list of vitamins and minerals found in chapter 10, Seven Weeks to Sobriety)
- Treating hypothyroidism (consult your physician)
- Correcting hypoglycemia (review Chapter 7, Seven Weeks to Sobriety)
- Avoiding foods/chemicals responsible for cerebral allergy/addiction (see Chapter 11, Seven Weeks to Sobriety)
- Treating candida-related complex (see Chapter 11, Seven Weeks to Sobriety)
Don't be surprised if you fit several of these seven categories. Heavy alcohol use wreaks havoc on your biochemical balance. But with the HRC repair program you can restore your health. In some cases you'll need a physician's help. I can't overemphasize the importance of expert medical advice when you are dealing with depression, especially if it is severe. It is equally important to choose a doctor attuned to your special needs.
Orthomolecular MDs are experts in both allopathic and nutritional science who treat disorders at the cellular level with biological weapons-nutrients that nature has provided in her own system of defense for millions of years. An orthomolecular psychiatrist or physician can help you address the following problems:
- Restoration of neurotransmitter levels via amino-acid therapy
- Hypoglycemia testing and treatment
- Vitamin, mineral, and essential fatty acid testing and restoration
- Thyroid testing and treatment
For a list of orthomolecular physicians in your area, contact the Journal of Orthomolecular Medicine, 16 Florence Avenue, North York, Ontario M2N 1E9, Canada (416) 733-2117. (This group supplies names of orthomolecular physicians in Canada and the U.S.)
A clinical ecologist will be able to test you for food and chemical allergies and candida-related complex. For a list of such physicians in your area, contact the American Academy of Environmental Medicine, Box CN 1001-8001, New Hope, PA 18938, (215) 862-4544.
Other places to check to find holistic care Include The American Association of Naturopathic Physicians.
Call 206-298-0125 or link to http://www.naturopathic.org/
Another place to check is The American Holistic Health Association: 714-779-6152, or link to
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Seven Weeks to Sobriety by Joan Mathews Larson, Ph.D. (ISBN 0-449-00259-4) ©1991-2000. All rights reserved. This information may not be reproduced without permission from Villard Books, a division of Random House Inc. and Joan Mathews Larson, Ph.D.
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