Confessions of a renegade psychiatrist

Confessions of a renegade psychiatrist

I felt this sensation in the pit of my stomach – it was a combination of sympathy and anger – listening to Annie tell me, through tears, about her postpartum journey into the world of psychiatry. 

Three separate psychiatrists dismissed me when I expressed concerns about taking an addictive medication like Klonopin.  It's been two years, I can't get off it, I'm on 4 psych meds and I feel worse than I ever did before I started this treatment.

Annie was ushered into the promise-filled halls of psychiatry 3 months after the birth of her first baby when she began to experience racing heart, insomnia, vigilance, irritability, and a host of physical complaints including joint pain and hair loss.  No one did blood work, asked about her diet, or cared about any of the myriad observations about her body and its changes in functioning.  This was a "head-up" intervention. I believe women deserve better.  People deserve better.

Most patients who come to me for treatment of depression and anxiety do so because they want answers.  They want to know WHY they are struggling. The closest they will be offered by their prescribing psychiatrist or primary care doc is some reductionist hand waving about serotonin imbalances.  I think it is time to speak to these patients with respect, truthfulness, and to offer them more than a life-long relationship with a pill (or pills as it will inevitably become over the years).  First, let's review some basics:

Depression is not a serotonin deficiency

Thanks to direct-to-consumer advertising and complicit FDA endorsement of evidence-less claims, the public has been sold an insultingly oversimplified tale about the underlying driver of depression.  Here's how we know depression is not a serotonin deficiency corrected by Zoloft:

  • There has never been a single study, in humans, to validate the theory of low serotonin in depression. Low levels are found in a minority of patients.
  • An antidepressant marketed as Stablon, increases reuptake of serotonin (reducing serotonin activity) and appears to be equally effective as those that decrease it or have no effect on it at all.
  • Manipulation of serotonin levels (depletion or enhancement) do not consistently result in a depressive syndrome.
  • These medications are used to treat an impossibly non-specific and broad array of illnesses from obsessive compulsive disorder to anorexia to premenstrual dysphoria to bipolar depression to irritable bowel syndrome.
  • Antidepressants of all categories seems to work about the same regardless of their presumed mechanism of action with about 73% of the response unrelated to pharmacologic activity.

You might wonder: Well, then how is it that antidepressants are a billion dollar industry and I have all these friends who are so much better on them?  Some pioneering individuals have investigated the data supporting antidepressant efficacy and have made compelling arguments for what is called the "active placebo" effect accounting for "breaking blind" in placebo-controlled trials.  In short, the expectation of relief and subsequent change in symptoms experienced by "responders" is related to perception of side effects. This analysis suggests that antidepressants may only have 10% efficacy above and beyond the placebo effect.  When you also consider the suppression of negative studies (permission of sedatives in trials, replacement of non-responders, and allowance of placebo washout) by pharmaceutical companies, you may start to worry that you have been sold a bill of goods. When inefficacy, long-term risks, increase in suicidality and violent behavior are taken into account, it is a marvel to observe the star-power of these medications.

What is it then? Inflammation!

Inflammation is a buzzword, and a 41 million+ Google hit for a reason:  it appears to underlie just about every chronic disease plaguing Americans today. A contribution of genetic vulnerabilities likely determines who develops heart disease or cancer or obsessive compulsive disorder, but many researchers are convinced that depression may have a significant inflammatory component. Just as a fever is one of your immune system's mechanism for eradicating intruders, suppressing a fever, in no way, serves to resolve the underlying infection or to support the body's return to balance.  Similarly, suppressing symptoms of depression does not achieve rebalancing, and will likely result in the Whack-a-Mole phenomenon of shifting symptoms, and protracted resolution.

There appears to be a specific subset of non-responders to medication who have measurable markers of inflammation as explored in this study. We know that medications such as interferon given to patients with Hepatitis result in significant levels of depression and even suicide, and we know that anti-inflammatory agents such as infliximab or even aspirin can result in resolution of symptoms. Investigators like Miller and Raison have discussed, in a series of wonderful papers, the conceptualization of depression as "sickness behavior" with accompanying social withdrawal, fatigue, loss of appetite, decreased mobility. Recent meta-analyses have identified at least 24 studies which have correlated levels of inflammatory cytokines like CRP, IL6, and TNFalpha with states of depression.

What drives inflammation?

What causes inflammation in the body that can affect the brain? This is the subject of an excellent book, and, it turns out the list is long, but these are the contributors that I see most commonly in my practice:

Sugar

It's in almost every packaged food. Seriously. Look for it and you will find it. It may come with different labels – cane sugar, crystalline fructose, high fructose corn syrup – but it's all sugar. The way the body handles fructose and glucose is different; however, which may account for why fructose is 7x more likely to result in glycation end products or sticky protein clumps that cause inflammation. In addition to the above mood and anxiety rollercoaster, sugar causes changes in our cell membranes, in our arteries, our immune systems, our hormones, and our gut as I discuss here.

Food intolerances

Gluten, soy, and corn have been identified as allergenic foods and a leading speculation as to how these foods became and are becoming more allergenic is the nature of their processing, hybridization, and genetic modification rendering them unrecognizable to our immune systems and vehicles of unwelcome information.  Gluten (and processed dairy), when incompletely digested, result in peptides that, once through the gut barrier can stimulate the brain and immune system in inflammatory ways.

Autoimmunity

The epidemic incidence of autoimmune disorders in this country is a direct reflection of environmental assault on our system.  The body's ability to determine self from other starts with the gut and our host defenses there. Unfortunately, it doesn't end there because autoimmune disorders typically have psychiatric manifestations.  This makes sense – the body's immune system is misfiring, and the immune cells of the brain (called microglia) are following suit.  Beyond rampant inflammation, autoimmune disorders such as Hashimoto's thyroiditis (more here) also result in symptoms related to damage to tissues.  Low or erratic thyroid function can cause anxiety, depression, flattened mood, cloudy thinking, metabolism changes, and fatigue.  Sometimes even the presence of immune system misfiring can predict depression as was noted in this recent study where women with thyroid autoantibodies in pregnancy went on to develop postpartum depression.

Before you see a psychiatrist

Diet

Do a 30-day diet overhaul. If you feel committed to the cure, eliminate these provocative foods: corn, soy, legumes, dairy, grains. What do you eat? You'll eat pastured/organic meats, wild fish, eggs, fruit, vegetables, and nuts/seeds. If this is not revolutionary, then you may be someone for whom nightshade vegetables, nuts, or eggs are inflammatory. If that seems entirely overwhelming, then start with dairy and gluten. If that is too much, then gluten is my top pick.

Coconut oil

Introduce 1-2 tablespoons of virgin coconut oil to give your brain an easy source of fuel that does not require significant digestion. When your brain is inflamed and your sugar is out of balance, your brain cells end up starving for nutrients to make energy. This can be an effective shortcut.

Turmeric

I use this spice in therapeutic doses, but it has recently been demonstrated to be as effective as Prozac (I will discuss in a future post!). If you cook with it, use pepper and oil (red palm, coconut, olive oil, ghee) for enhanced absorption. 

Fermented foods

Naturally fermented foods like sauerkraut, kimchi, and pickles as well as kefir and yogurt if you are dairy tolerant are a source of beneficial bacteria that can retrain the gut to protect you from unwanted pathogens. A recent study demonstrated that these bacteria can, indeed, affect brain function.

Detox your environment

Here's an important way to call off the dogs of your immune system. Give it less stimulation.

  • Filter air and water
  • Purchase products free of known carcinogens and endocrine disruptors such as parabens, TEA, fragrance (pthalates), sodium lauryl/laureth sulfate, triclosan
  • Eat organic produce, pastured meat/dairy
  • Make your own cleaning products from household vinegar, baking soda, tea tree oil, or purchase similarly simple products
  • Avoid eating or drinking from heated plastics
  • Avoid cell phone use
  • Avoid processed foods and sugar, consume low-mercury fish
  • Carefully consider risks and benefits of any elective medical interventions

Promote healing messages

I have developed an appreciation of the body's ability to work towards balance when obstacles are removed.  An important obstacle is the stress response that is activated by many of the above factors as well as perceptions of busy-ness, lack of downtime and community support, and trauma.  Take 10-20 minutes a day (or even 2!) to promote the relaxation response by breathing in with a count of 6 and breathing out with a count of 6.  Imagine the air flowing in and out through your heart and cultivate a feeling of gratitude. The benefits of this practice have been well-studied by Heartmath Institute.

Psychiatry has long suffered from pseudoscience and propaganda. From an embarrassing history of pathologizing human behavior, applying crude "treatments", and imposing beliefs about societal welfare on vulnerable populations, we haven't come very far in the past century. Incidence of mental illness is rising, partly from changes in diagnostic criteria, commercializing mental illness, collusion between doctors and patients around the "quick fix", and partly because our bodies and minds are crying out in protest about this toxic world we live in. Take control of your body to heal your mind – take back your health and bear witness to the power of a lifestyle renaissance.

Republished from GreenMedInfo
Written by Dr. Kelly Brogan, M.D.

Dr. Brogan is allopathically and holistically trained in the care of women at all stages of the reproductive cycle experiencing mood and anxiety symptoms, including premenstrual dysphoria (PMDD), pregnancy and postpartum symptomatology, as well as menopause-related illness.

You can learn more about Dr. Brogan at www.kellybroganmd.com, and connect with her on Facebook.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of The Watchers or its staff.

Tags: depression

Comments

Benjamin 6 years ago

I had severe depression for years then I was diagnosed with bipolar. I have not had any symptoms for a year now because I stopped taking psychiatric drugs and read a book on optimum nutrition and changed my diet. "Primal Body, Primal Mind" by Nora Gedgaudas. http://www.primalbody-primalmind.com/about-nora-gedgaudas/Then I read a book on psychology and changed my thinking patterns. "A New Earth" by Eckhart Tolle. http://www.eckharttolle.com/ Then I saw this video on the biology of depression that explained more: http://www.openculture.com/2009/12/sapolsky_breaks_down_depression.html The root cause of my problem was not that I had a lack of olanzapine in my brain; it was the starch, glucose, and fructose in my diet, without enzymes present, that caused glycation to leech out the minerals from the cells in my endocrine system (plus other contaminants inhibiting function). As a result, my thyroid glands produced deficient levels of glucocorticord hormones in my brain and the synapses on my neurons malfunctioned chronically. Therefore this condition manifested in the symptoms of depression and bipolar. Now this is only part of the puzzle. My pain body kept my psyche in a state of learned helplessness and because my cerebral cortex was sending a chemical message to my brain stem, that tricked the rest of the brain into going along with negative thoughts that lead to a constant state of "fight or flight" and then my feelings would reflect my thoughts and this caused a positive feedback loop that was exacerbated by having an unnatural compound inhibiting the function of the receptors on my brain cells (olanzapine, lithium, risperidone). This video explains how the majority of studies on these drugs with negative results are not published to give a false sense of validity to them, making them seem safe, but they are not: http://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe.html This artical proves my point even further:http://blogs.naturalnews.com/four-antipsychotic-medications-still-prescribed-even-though-found-to-be-ineffective-and-dangerous/ The final pieces to this puzzle are having sufficient exercise and social activity. This is not easy to do when the common side effects of drugs are lethargy and zombification. Besides, antidepressants act only as placebos in the vast majority of people. http://tv.naturalnews.com/v.asp?v=7d3eeeba499205441c60c65cba1067cb In this video Echkart goes into detail about the ego and effective thinking protocals: https://www.youtube.com/watch?v=M00VLswZdyc The following is the information you should be relaying to your patients, not forcing them to do toxic drugs out of fear from being incarcerated at an insane asylum. Eat lots of these foods rich in minerals: Good fats - Great sources of fats include sesame seeds, chia seeds, avocado, olive oil, seaweed, almonds, walnuts, sunflower seeds, spirulina, and pumpkin seeds. Fish and wild game also provides your body with Omega-3, Omega-6 and Omega-9 oils. These oils are fats that directly affect cognitive function, cellular function and kidney function, all the things under the control of the endocrine system. Every cell in your body requires EFA's except the red blood cells that need glucose to function; however the liver can produce glucose so there is no need for starch or glucose in our diet. Magnesium - http://www.healthaliciousness.com/articles/foods-high-in-magnesium.php You should steam spinach and kale. http://www.whfoods.com/genpage.php?tname=nutrient&dbid=75 Iodine - The mineral iodine is important in forming thyroid hormones. It is an essential nutrient that is involved with growth, development, energy production, and hormone sensitivities. Too much can be a bad thing, so it is better to get it from food instead of supplements. Sea vegetables are the best source for iodine. Try steaming kelp, arame, hiziki, kombu, and wakame. Cranberries, navy beans, and strawberries are also good sources that will be more familiar. Seafood, sea salt, and Himalayan salt are a more natural place to find iodine, unlike table salt that has been stripped of minerals and only contains iodide, an incomplete form of iodine. Selenium - Good sources are: tuna, shrimp, sardines, and salmon. Garlic (also rich in selenium) boosts your immunity, increasing your ability to fight off infection. It also helps regulate blood sugar levels. One or two cloves of garlic a day is recommended. Or eat a smaller amount raw. Selenium, which is nutritionally essential for humans, is a constituent of more than two dozen selenoproteins that play critical roles in reproduction, thyroid hormone metabolism, DNA synthesis, and protection from oxidative damage and infection. Calcium - Calcium keeps nerves healthy and ensures their ability to communicate effectively. Milk, cottage cheese, cheese, leafy greens, dried beans and yogurt are all rich in calcium. Plus, leafy greens like kale, spinach, broccoli, turnip greens, mustard greens, and asparagus. Vitamin B Complex - Directly influences the nervous system’s proper functioning and health and one’s physical and mental performance concerning the nervous system. Found in chicken, fish, eggs, beans, nutritional yeast, and nuts. Vitamin C - Adrenal glands have a very high content of ascorbic acid (vitamin C). This vitamin helps stimulate adrenal glands into producing more of the disease fighting hormone cortin. A continued stressful environment depletes vitamin C reserves and increases the tendency for infection and disease. Good sources of vitamin C include citrus fruits, melons, apricots, strawberries, berries, green vegetables, sweet peppers, and particularly tomatoes. Vitamin D - Get this from mushrooms, eggs, fish, cod liver oil, caviar, and oysters. Or make sure you get cholesterol in your diet so your skin can synthesize vitamin D with exposure to the sun each day. Eat none of these foods: 1) White bread, refined flours. By definition, white bread and refined flours in general are toxic for your body because they have been stripped of virtually all vitamins, minerals, fiber, and other important nutrients. Because of this, the body does not know how to properly digest and assimilate these so-called foods, which can lead to health problems. Refined white flour has also been bleached with chlorine and brominated with bromide, two poisonous chemicals that have been linked to causing thyroid and organ damage. http://drlwilson.com/ARTICLES/BREAD.htm 2) Conventional frozen meals. Most conventionally-prepared frozen meals are loaded with preservatives, processed salt, hydrogenated oils and other artificial ingredients, not to mention the fact that most frozen meals have been heavily pre-cooked, rendering their nutrient content minimal at best (especially after getting microwaved again at home). With the exception of a few truly healthy frozen meal brands such as Amy's and Organic Bistro, most frozen meals are little more than disease in a box, so avoid them in favor of fresh foods. http://www.4us2be.com 3) White rice. Like white bread, white rice has been stripped of most of its nutrients, and separated from the bran and germ, two natural components that make up rice in its brown form. Even so-called "fortified" white rice is nutritionally deficient, as the body still processes this refined food much differently than brown rice, which is absorbed more slowly and does not cause the same spike in blood sugar that white rice does. http://globalnaturopath.com 4) Microwaveable popcorn. This processed food is a favorite among moviegoers and regular snackers alike, but it is one of the unhealthiest foods you can eat. Practically every component of microwaveable popcorn, from the genetically-modified (GM) corn kernels to the processed salt and preservative chemicals used to enhance its flavor, is unhealthy and disease-promoting. On top of this, microwaveable popcorn contains a chemical known as diacetyl that can actually destroy your lungs. If you love popcorn, stick with organic kernels that you can pop yourself in a kettle and douse with healthy ingredients like coconut oil, grass-fed butter, and Himalayan pink salt. http://www.naturalnews.com 5) Factory farm meats and cured meat products with nitrates, nitrites. Deli meats, summer sausage, hot dogs, bacon, and many other meats sold at the grocery store are often loaded with sodium nitrite and other chemical preservatives that have been linked to causing heart disease and cancer. If you eat meat, stick with uncured, nitrite and nitrate-free varieties, and preferably those that come from organic, grass-fed animals. http://www.naturalnews.com/028824_processed_meat_heart_disease.html 6) Most conventional protein, energy bars. By the way they are often marketed, it might seem as though protein and energy bars are a strong addition to a healthy diet. But more often than not, these meal replacements contain processed soy protein, refined sugar, hydrogenated fat, and other harmful additives that contribute to chronic illness. Not all protein and energy bars are bad, of course -- Thunderbird Energetica, Organic Food Bar, Boku Superfood, Vega Sport, PROBAR, and Zing all make healthy protein and energy bars. Just be sure to read the ingredient labels and know what you are buying. 7) Margarine. Hidden in all sorts of processed foods, margarine, a hydrogenated trans-fat oil, is something you will want to avoid at all costs for your health. Contrary to popular belief, butter and saturated fats in general are not unhealthy, especially when they are derived from pastured animals that feed on grass rather than corn and soy. And if animal-based fats are not for you, stick with extra-virgin coconut oil or olive oil rather than margarine. http://www.naturalnews.com/027865_saturated_fat_health.html 8) Soy milk and soy-based meat substitutes. One of the biggest health frauds of modern times, the soy craze is a fad that you will want to skip. Besides the fact that nearly all non-organic soy ingredients are of GM origin, most soy additives are processed using a toxic chemical known as hexane, which is linked to causing birth defects, reproductive problems, and cancer. Soy that has not been fermented is also highly estrogenic, which can throw your natural hormone balance out of whack.http://www.naturalnews.com/026303_soy_protein_hexane.html 9) "Diet" anything. Many so-called "diet" products on the market today contains artificial sweeteners like aspartame (Equal) and sucralose (Splenda), both of which are linked to causing neurological damage, gastrointestinal problems, and endocrine disruption. Many diet products also contain added chemical flavoring agents to take the place of fat and other natural components that have been removed to artificially reduce calorie content. Instead, stick with whole foods that are as close to nature as possible, including high-fat foods grown the way nature intended, and your body will respond surprisingly well. -- May all your moments be super awesomely wonderful for eternity. Be Pro Good - Not Anti Bad.

dawn 6 years ago

Thanks for the awesome article. I know too many people who rely on antidepressants and they don't even help them, yet they keep taking them because the doctor says they will magically help. I think it would have been nice to include a paragraph about the risks of taking psychiatric meds. They are very dangerous to your body and have been proven in many cases (specific drugs) to shorten your lifespan by affecting your heart and other other vital organs, like your liver which has to process the meds. Psychiatric meds are very risky for everyone and only help in 10% of cases so why are they being touted by doctors everywhere as a cure? I went to a psychiatrist for help dealing with post traumatic stress from sexual abuse I experienced as a child. I wanted her to help me cope with the feelings I was having and learn how to move on with my life, she gave me paxil, it made me hear voices. I never heard voices normally, but three doses of paxil made me hear a voice that said "you should just kill yourself, and then you won't keep having this struggle". Luckily I knew that voice was not mine and I immediately stopped taking the medication. When I told my doctor what happened she offered me another medication. I guess that's all psychiatrists are trained to do, match symptoms with medications and gamble with their patients lives. In the meantime I have been on a gluten free diet since age 18 and after a few years of struggling to get the diet to be truly free of gluten I am able to cope. Nothing a doctor did ever helped, I simply removed some of the stresses on my immune system and that made it possible for me to cope and move on. And every time I've eaten gluten since I quit (accidentally I mean) I went through two weeks of emotional upheaval. Gluten makes me feel paranoid. I nearly ended a very loving and supportive relationship because eating a bagel made me question his motives in dating me. Studies have been done on schizophrenics who were put on gluten free diets and something like 30% of them were no longer schizophrenic. So if you have problems with depression or mental instability, do yourself a favour and try a diet change. If it doesn't help, you can go back to your old diet, but if you try a drug you risk permanently affecting parts of your body in ways you'll never know like shortening your lifespan through heart or liver damage. Giving up gluten is hard in the beginning, but if it helps you feel better it gets easier and easier until you laugh at the fact that you ever were afraid to give it up.

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