Bipolar1Blog

Why nutritional psychiatry is the future of mental health treatment

Blueberries

Very interesting and may be so helpful.

Below is a direct quote from the article below. I wonder why we are not told to add vitamin and mineral as well as OTC anti-inflammatory supplementation to out diets and medicine regimen? It would be worth it to try it, if it doesn’t help, ok, but imagine it does help! I am going to ask my psychiatrist about all of these and if they have any adverse reactions with the medications I’m on. That’s would be the best way to go here. Wishing us all the best of physical and mental health.

“It is now known that many mental health conditions are caused by inflammation in the brain which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients from our food such as magnesium, omega-3 fatty acids, probiotics, vitamins and minerals that are all essential for the optimum functioning of our bodies. Recent research has shown that food supplements such as zinc, magnesium, omega 3, and vitamins B and D3 can help improve people’s mood, relieve anxiety and depression and improve the mental capacity of people with Alzheimer’s. Magnesium is one of most important minerals for optimal health, yet many people are lacking in it. One study found that a daily magnesium citrate supplement led to a significant improvement in depression and anxiety, regardless of age, gender or severity of depression. Improvement did not continue when the supplement was stopped. Omega-3 fatty acids are another nutrient that is critical for the development and function of the central nervous system – and a lack has been associated with low mood, cognitive decline and poor comprehension. Research has shown that supplements like zinc, magnesium and vitamins B and D can improve the mental capacity of people with Alzheimer’s. Shutterstock The role of probiotics – the beneficial live bacteria in your digestive system – in improving mental health has also been explored by psychiatrists and nutritionists, who found that taking them daily was associated with a significant reduction in depression and anxiety. Vitamin B complex and zinc are other supplements found to reduce the symptoms of anxiety and depression. Hope for the future? These over-the-counter” supplements are widely available in supermarkets, chemists and online health food stores, although the cost and quality may vary. For people who have not responded to prescription drugs or who cannot tolerate the side effects, nutritional intervention can offer hope for the future. There is currently much debate over the effectiveness of antidepressants. The use of food supplements offer an alternative approach that has the potential to make a significant difference to the mental health of all age groups.”

 

http://theconversation.com/why-nutritional-psychiatry-is-the-future-of-mental-health-treatment-92545

A lack of essential nutrients is known to contribute to the onset of poor mental health in people suffering from anxiety and depression, bipolar disorder, schizophrenia and ADHD. Nutritional psychiatry is a growing discipline that focuses on the use of food and supplements to provide these essential nutrients as part of an integrated or alternative treatment for mental health disorders. But nutritional approaches for these debilitating conditions are not widely accepted by mainstream medicine. Treatment options tend to be limited to official National Institute for Care Excellence (NICE) guidelines which recommend talking therapies and antidepressants. Use of antidepressants Antidepressant use has more than doubled in recent years. In England 64.7m prescriptions were issued for antidepressants in 2016 at a cost of £266.6m. This is an increase of 3.7m on the number of items prescribed in 2015 and more than double than the 31m issued in 2006. A recent Oxford University study found that antidepressants were more effective in treating depression than placebo. The study was led by Dr Andrea Cipriani who claimed that depression is under treated. Cipriani maintains that antidepressants are effective and a further 1m prescriptions should be issued to people in the UK. This approach suggests that poor mental health caused by social conditions is viewed as easily treated by simply dispensing drugs. But antidepressants are shunned by people whom they could help because of the social stigma associated with mental ill-health which leads to discrimination and exclusion. Prescriptions for 64.7m items of antidepressants were dispensed in England in 2016, the highest level recorded by the NHS. Shutterstock More worrying is the increase in the use of antidepressants by children and young people. In Scotland, 5,572 children under 18 were prescribed antidepressants for anxiety and depression in 2016. This figure has more than doubled since 2009/2010. But according to British psychopharmacologist Professor David Healy, 29 clinical trials of antidepressant use in young people found no benefits at all. These trials revealed that instead of relieving symptoms of anxiety and depression, antidepressants caused children and young people to feel suicidal. Healy also challenges their safety and effectiveness in adults. He believes that antidepressants are over-prescribed and that there is little evidence that they are safe for long-term use. Antidepressants are said to create dependency, have unpleasant side effects and cannot be relied upon to always relieve symptoms. Nutrition and poor mental health In developed countries such as the UK we eat a greater variety of foodstuffs than ever before – but it doesn’t follow that we are well nourished. In fact, many people do not eat enough nutrients that are essential for good brain health, opting for a diet of heavily processed food containing artificial additives and sugar. The link between poor mental health and nutritional deficiencies has long been recognised by nutritionists working in the complementary health sector. However, psychiatrists are only now becoming increasingly aware of the benefits of using nutritional approaches to mental health, calling for their peers to support and research this new field of treatment. It is now known that many mental health conditions are caused by inflammation in the brain which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients from our food such as magnesium, omega-3 fatty acids, probiotics, vitamins and minerals that are all essential for the optimum functioning of our bodies. Recent research has shown that food supplements such as zinc, magnesium, omega 3, and vitamins B and D3 can help improve people’s mood, relieve anxiety and depression and improve the mental capacity of people with Alzheimer’s. Magnesium is one of most important minerals for optimal health, yet many people are lacking in it. One study found that a daily magnesium citrate supplement led to a significant improvement in depression and anxiety, regardless of age, gender or severity of depression. Improvement did not continue when the supplement was stopped. Omega-3 fatty acids are another nutrient that is critical for the development and function of the central nervous system – and a lack has been associated with low mood, cognitive decline and poor comprehension. Research has shown that supplements like zinc, magnesium and vitamins B and D can improve the mental capacity of people with Alzheimer’s. Shutterstock The role of probiotics – the beneficial live bacteria in your digestive system – in improving mental health has also been explored by psychiatrists and nutritionists, who found that taking them daily was associated with a significant reduction in depression and anxiety. Vitamin B complex and zinc are other supplements found to reduce the symptoms of anxiety and depression. Hope for the future? These over-the-counter” supplements are widely available in supermarkets, chemists and online health food stores, although the cost and quality may vary. For people who have not responded to prescription drugs or who cannot tolerate the side effects, nutritional intervention can offer hope for the future. There is currently much debate over the effectiveness of antidepressants. The use of food supplements offer an alternative approach that has the potential to make a significant difference to the mental health of all age groups. The emerging scientific evidence suggests that there should be a bigger role for nutritional psychiatry in mental health within conventional health services. If the burden of mental ill health is to be reduced, GPs and psychiatrists need to be aware of the connection between food, inflammation and mental illness. Medical education has traditionally excluded nutritional knowledge and its association with disease. This has led to a situation where very few doctors in the UK have a proper understanding of the importance of nutrition. Nutritional interventions are thought to have little evidence to support their use to prevent or maintain well-being and so are left to dietitians, rather than doctors, to advise on. But as the evidence mounts up, it is time for medical education to take nutrition seriously so that GPs and psychiatrists of the future know as much about its role in good health as they do about anatomy and physiology. The state of our mental health could depend on it.

Beneath the Surface: Exploring Mental Illness.

DSCN0356Mental illness, it’s invisible. There are no bandages, no casts, no crutches, no external wounds. How do you know someone is suffering from one? We, the afflicted, talk about feeling bad, talk about our depression and anxiety woes. You, our friends, look at us with bewildered eyes. You think to yourself “This person is all put together, she has makeup on, is dressed well, there are no signs of illness. I don’t understand.”

It’s not easy to explain mental illness to people who don’t have it. You can’t show them anything that is broken, or any flulike symptoms, or anything visible at all.

The key is listening, trying to understand where your mentally ill friend is coming from, what your mentally ill friend feels like, what they are trying to explain to you. And many will not even explain anything, because of the stigma, because they don’t want to appear “crazy” or abnormal.

Yes it’s confusing. I’ve had bipolar disorder since 1985, and sometimes it’s still confusing for me, so don’t anyone beat themselves over this. Basically the only empirical thing you have to gauge mental illness by is behavior. For example, in mania, people talk a lot, have very high energy, don’t sleep much, may have delusions of grandeur, may have a lot of anxiety. In depression, they have no energy, may sleep a lot, or not, are in a downcast mood, hopeless, and may also have a lot of anxiety. Paradoxically, in hypomania (the stage before going into full blown mania), we can actually get a lot accomplished, we are energetic, focused, not over the edge yet. This might be considered the “industrious” phase of bipolar disorder.

So the way your friend is behaving, a departure from their normal self, is a clue to their mental illness. What they are saying and how they’re saying it is as well. Are they being grandiose, talking non stop, switching from subject to subject (flight of ideas,) these are all clues.

In schizophrenia, people can have auditory hallucinations, where they hear voices, that’s definitely a clue, if they tell you, if they are aware that this is happening and admit to it… Yet most of the time, looking at a mentally ill person, you’d never know anything was wrong at all. It’s all below the surface, in their brain. Just like in a sea, where the water looks still and calm but a savage riptide is flowing under the surface.

Signs and signals, feelings and observations, those are clues to understanding mental illness. Just being an observant and understanding friend who listens and tries to comprehend what is being said and shown to them, that my friends is what is needed to understand the illusive nature of mental illness.

Doug Leddin Interviewed by Samina Raza

DOUG

This brilliant young man, suffered from depression for 12 years. Finally he got so tired of keeping the depression a secret that he decided to tell everyone he knew in one fell swoop, by making a video (below) and posting it on Facebook! The video went viral! He has been asked to speak on talk shows and radio shows in Ireland. He is an eloquent spokesman for people who suffer from depression, or any mental illness. I was fortunate enough to speak with him and recorded this interview.

Samina: Hi Doug, so wonderful to be speaking with you! Just wanted to get your okay. I’m going to post your interview, this interview on my blog bipolar1blog and on the HuffPost blog I am now blogging on. Is that fine?

Doug: Yes. Brilliant!

1) Samina: Great! After suffering from depression for 10 years, what made you make your video and put it on FB?

Doug: I suppose for me, it was a weight off my shoulders. I was living two different lives, and no one knew what I was going through. That alone was hard, having a secret for so long, without your best friends or your extended family to know, that’s a hard thing to do, even my best friend. I just wanted to let everybody know, it scared the hell out of me! I thought it would be easier if I put it on Facebook. I work in social media and marketing, so I thought I’d make a video and put it online. For me, telling everyone was harder than making a video, and putting it on line. It was easy to make the video, tell my story, press post, close the laptop and walk away. So then I told everyone, my friends knew, colleagues I’d met online, everybody, people I’ve met throughout the years, various clubs and teams, everybody! It was an easy way for me to tell everybody. That’s why I did it, I needed to get the weight off my shoulders, I needed to tell everybody, not just a handful of people! It was easier, I felt better that everybody knew, not just my close friends!

Samina: Right, you told the whole world, basically, literally the whole world! Everyone knows now!

Doug: Yeah. Yeah, that’s scary, but it’s also amazing, that message reached everyone! That the message traveled from Ireland to America to Canada, to Australia, wherever, basically everywhere.

Samina: Yes, amazing, everywhere!

Doug: Yes, that people have taken comfort in it, that was a great thing, that it may have helped others. It took one video for four minutes to help somebody else, then that’s amazing as well.

2) Samina: Were you feeling better at the time when you made the video?

Doug: Ummm, no, I’m still on antidepressants everyday. And today I went to see my psychologist. And I’m still with him, I’m seeing him again in two weeks, and two weeks after that. This is a journey for me. I wasn’t feeling better but I was feeling more comfortable and somewhat confident in myself, that I knew that this was the right thing to do for me and it was my next step. It may not be the right thing for other people, but I feel it can’t make it any worse to talk about it, so I hope that’s the case. So I’m not better, the video has made me, maybe, better, and it’s my next step, and I’ve taken that step. Now, I am discovering what my trigger points are that bring me down and being more confident within myself and kind of accepting myself for who I am. I’m so happy I did this because I needed to move forward and help myself.

3) Samina: It’s sometimes the case that young men have a hard time accepting that they are sick because it means admitting weakness. I had a little brother who couldn’t accept that he had bipolar disorder and eventually he got so depressed that he committed suicide. Huge, giant loss in our lives, he was 26 years old. Young men have a difficult time admitting they are sick, or ill, or imperfect. It is a time when you are supposed to be young and strong. Evolution has sort of imprinted that on your brain, society accepts it of you, and now, because of your video, it’s going to make it easier for other young men to come out and talk about their mental health issues and seek help. You’ve become a role model. How does that make you feel?

Doug: Yeah if that happens, that’s amazing! That’s such a hard won feeling. But it’s not just young men,  and you’re right what you say about young men and evolution, we are meant to be young and strong, we are meant to show a strong exterior. It’s not ok to not be ok. I just think women are so much braver than men in this regard, to open up like they do. Their friendships are so much deeper. They get more from their friendships than men, men just don’t talk to other men. I went 12 years without talking. I can’t be the one preaching but… But if it helps men, that’s brilliant!

And regarding your brother, it’s so sad to hear, 26 years old. In Ireland they say and you said it yourself, I don’t like the expression “commit suicide,” you commit a crime, and what your brother was going through, you just don’t know, feeling so much pain, and fear. And it’s just something that, some people refer to it as a selfish act, it’s not! You’re not thinking about anybody else, you can’t think about anybody else! You’re thinking the world will be better without you. It’s just such a horrible place to be! And I just think, as hard as it is, we need to talk about it, because if we talk about it, we’ll find out, it’ll help. It may not help everyone, but it’ll help. I just don’t think it can make it worse.

Samina: Talking definitely helps! All my friends have always known that I have bipolar 1 disorder and like you said, we’ve always talked about it.

Doug: That’s an amazing thing. Such a brave thing!

Samina: Now I have a blog so everyone knows (laughing.)

Doug: My friend, Éanna Walsh,  has a blog about bipolar, I shared it on Facebook. He started blogging without two or three years after being diagnosed, I told him he is so brave!

Samina: Oh good, I’ll have to take a look.

Doug: Yes, my friend’s a great hulking Irish guy, he’s in phenomenal shape, he’s so intelligent, just so brave. It’s so amazing that so many more people around the world, like yourself, are writing about your feelings and putting it out there.

Samina: Yes, you know I never wanted to be the spokesperson for this illness, but that’s just what happened…

Doug: Yes, that’s amazing! I’m not the poster boy or spokesperson for this illness, but if it helps… I just hope this helps.

Samina: I think you are now, you sort of unintentionally made yourself the spokesperson for young men, and it’s a good thing, a very good thing!

4) Samina: You said you’d been suffering from depression for 10 years. Can you tell me how it began? And if you don’t want to answer this one, if it’ll take you to a bad spot, you don’t have to answer it.

Doug: No, I’ve left myself open for the last two weeks. I don’t mind answering any questions, I would have told you if I did. When I was 15, I developed an eating disorder and I lost about 6 stone (84 lbs!!!) in 5-6 months. Then my parents became aware of it, and I went to the doctors and nutritionists, then I went to a psychiatrist, from that point on I started seeing a psychiatrist weekly and found out that this was a little deeper than just an eating disorder. One thing about having body dysmorphia was I was going through something I couldn’t explain. I was in a dark place, I didn’t like myself. I had an amazing family, I had everything I ever needed. I felt really privileged. Plus for me, depression isn’t when things aren’t going fine, it’s when everything is well but I just couldn’t see that. A lot of people said what depression, you’re great at school, or you’ve got great friends and family, and I play sports, and I’m sociable and I’m popular, whatever. But, that doesn’t come into play for a lot of people, it certainly didn’t come into play for me. Just having a hard time, kind of pushing myself into a corner, alone and it’s dark and you just don’t want to get out of bed or meet your friends, it’s just a battle. And the last ten years it just got worse, wondering when you’re in that corner, there’s only one way out. That way will really scares you. But it’s a solution. And I just had to shake myself off, pull myself out of that dark, dark place, and I had a moment that I have to ring my doctor, that I’m not ok anymore.

Samina: Good for you! You realized it! And also when you have the flu and you feel bad, people don’t say: Oh why do you feel bad, you have a beautiful home, you have a beautiful wife/husband/children, you have a wonderful job. Just look at how many wonderful things you have, why do you feel bad? Well it’s because you have the flu! And the same thing goes for when your have depression, you feel bad because you have an illness called depression, all those wonderful things don’t take away the effects of the illness!

5) Samina: It must have been so difficult. How did you cope with it as a teenager? As an adult? Did you have a support system? Did you confide in anyone at all? Were you seeing a doctor? You know you might have even lost weight because you were in a depression, people lose weigh because they don’t have an appetite.

Doug: No, I had an appetite, I just didn’t keep my food down (laughing.) Yes I had the support of my mom, and my dad and my sister. They knew I was feeling depressed, they took me to the doctor. So I had great support. That was amazing to have such great support.

Samina: That’s great, some people don’t have that.

6) Samina: It is being discovered that the immune system may be intimately involved in the development and the continuance of mental illness. Are there any autoimmune illnesses in you or your family?

Doug: Yes. I’ve been diagnosed in 2012 with something called Crohn’s disease.

Samina: Wow! The intestines and your brain are so connected!

Doug: I don’t know much about it, but my father had asthma when he was a child.

7) Samina: What would you say to a young man who is suffering from depression now, but who is afraid to talk about it?

Doug: I’d tell him firstly not to be ashamed, don’t have any kind of shame. It’s ok not to feel ok (!) And if you’re not talking to someone, I’d highly recommend either some family or a friend, or someone they work with or maybe even someone they don’t know that well and see occasionally. Just to talk about it and seeking professional help will help. In America or anywhere where they have health organizations, I just think it is so important for young males and females to talk about it.

8) Samina: How does it feel to be open about your illness, with all your friends and family? How have most people reacted?

Doug: It feels amazing! I don’t regret it for one second! It’s such a weight off my shoulders. Everybody’s reacted so positively! The response has been overwhelming at times, but so heartwarming that I don’t have to hide from my friends and family and can talk to my friends and especially mom and dad. My mom and dad were there for all the 12 years, but now they can kind of see the light at the end of the tunnel is on! Now that everybody knows, we’re not alone anymore. We can help each other and we know what each person is going through. Feel the support and the love.

9) Samina: You have automatically become a mental health advocate, do you realize that?

Doug: (Laughs) No not really! But it’s ok if people see me as that.

Samina: So, where do you go from here? A book? A blog? A movie?

Doug: (Laughing) Yeah, a movie would be great! From here, it’s about me, about getting through this, and getting stronger every single day, and in the meantime. on my journey, being contacted by people doing TV, or speeches, or radio, or speaking on the News. Well that’s amazing because if I can help myself while helping other, well, that’s what I want to do.

10) Samina: Physical exercise, good nutrition, meditation, therapy, good friends, and of course medication all help with depression and mental illness generally. Phew! It’s a full time job! How many of these are you in favor of doing?

Doug: Everyday I take medication, I do a lot of exercise, it helps me, it might help others or it might not, but it definitely helps me! Going for that run, or going to the gym, lifting weights, relieves pressure, or if you’re down or anxious or mad about something, going to the gym and letting off some steam really helps. And medication, for me it helps, but it’s not for everybody, it’s sort of trial and error, some of them affected me badly, some didn’t help me and some did help me. And some people don’t agree with medication at all, But for me it’s definitely helped.

Samina: Yes, medication is good, of course, and yes it may take some trial and error, but the right medication helps a lot!

Doug: And nutrition, if you eat well, you feel well and that’s going to help.

Samina: And do you meditate at all?

Doug: I use an App called Mindfulness, I think it’s called Mindfulness, that’s the name that came to mind, if it’s not, I’ll get back to you. It’s a mediation App, it takes 5 minutes a day, 10 minutes a day, I use it a couple of times a week, and it’s good.

Samina: I use an App called Headspace.

Doug: Oh Headspace, Headspace, Headspace, Headspace, that’s it!!! I don’t know where I got Mindfulness from!

(We laughed and laughed and laughed.)

Samina: And those are all my questions. Would you like to add anything.

Doug: No, I think that covered it all.

Samina: Thank you so much. It was so lovely to talk to you. I’ll post this on my blog, send it to the Huffington Post,  and post it on your Facebook page.

Doug: Cheers, brilliant!

 

Doug’s Facebook Video.

Immune Activity During Pregnancy Tied to Neuronal Defects, Anxiety, and Cognitive Impairments

Apple blossoms

I’m definitely cataloguing this in the Interesting category!

Neurons called Parvalbumin Interneurons in the brains of mice pups were underactive when their mothers had an infection while pregnant, i.e. the mother’s immune systems were ramped up due to the infection. This did not happen to mice whose mothers had no infection during pregnancy. The mice with underactive Parvalbumin Interneurons exhibited more anxiety and struggled with behavioral tests.

Also it was possible to induce these effects (anxiety and difficulty in behavioral tests) in normal mice (no infection in mother while pregnant) by shutting off the Parvalbumin Interneurons.

Parvalbumin Interneurons are neurons which send inhibitory signals to other neurons are much weaker in neurons of mice born to mothers whose immune system had been activated during pregnancy. “Parvalbumin interneurons help coordinate the activity of other cells in the brain, and are thought to be important for memory and cognitive flexibility. Reduced numbers and structural abnormalities in parvalbumin interneurons have been linked to multiple psychiatric disorders…”

https://bbrfoundation.org/brain-matters-discoveries/immune-activity-during-pregnancy-tied-to-neuronal-defects-anxiety-and

Researchers are investigating the possibility that infections during pregnancy increase the likelihood that the fetus will develop into a person who will have mental illness later in life. There is evidence that immune activity in response to maternal infections may increase the offspring’s risk of schizophrenia,bipolar disorder, depression, and anxiety disorders.

In a new animal study led by Christoph Kellendonk, Ph.D., a 2002 and 2008 NARSAD Young Investigator at Columbia University Medical Center, scientists have shown that inhibitory brain cells called parvalbumin interneurons are particularly vulnerable to such maternal immune activation. These cells do not signal as they should in mice whose mothers’ immune systems are activated during pregnancy, the researchers have shown. What’s more, the signaling problems are associated with cognitive impairments and anxiety-like behavior in mice.

Activated immune system in pregnant mice linked to later cognitive impairments in their offspring. Tweet >

The research team, which included Alan Stewart Brown, M.D., M.P.H., a 1993, 1996 Young Investigator, 2000, 2004 Independent Investigator and 2015 Distinguished Investigator, 2013 Young Investigator Sarah E. Canetta, Ph.D. and BBRF Scientific Council Member and 2001, 2003 Young Investigator Joshua A. Gordon, M.D., Ph.D., all at Columbia, published its findings February 2 in the journal Molecular Psychiatry.

Parvalbumin interneurons help coordinate the activity of other cells in the brain, and are thought to be important for memory and cognitive flexibility. Reduced numbers and structural abnormalities in parvalbumin interneurons have been linked to multiple psychiatric disorders, but so far it has been difficult to assess how these abnormalities affect brain function.

In their mouse study, Dr. Kellendonk and colleagues determined that the inhibitory signals that parvalbumin interneurons usually send to target cells are much weaker than usual in mice whose mothers’ immune systems had been active during pregnancy. Those mice struggled with a behavioral test that involved task switching, suggesting certain cognitive impairments, and also exhibited more anxiety than mice whose mothers had no immune activation during pregnancy.

In mice whose mothers did not have activated immune systems during pregnancy, the scientists could provoke the same increase in anxiety and cognitive defects simply by artificially shutting off parvalbumin interneurons, supporting the idea that defects in the cells were responsible for the affected animals’ behavior.

Takeaway: Study in mice identifies brain cells that are vulnerable to a mother’s infection during pregnancy. Reduced signaling from these cells was associated with increased anxiety and cognitive impairments.

Depression is more than a mental disorder: It affects the whole organism

http://www.neuroscientistnews.com/clinical-updates/depression-more-mental-disorder-it-affects-whole-organism
An international team of researchers lead by the University of Granada (UGR) has scientifically proven, for the first time, that depression is more than a mental disorder: it causes important alterations of the oxidative stress, so it should be considered a systemic disease, since it affects the whole organism.

The results of this work, published in the Journal of Clinical Psychiatry, could explain the significant association that depression has with cardiovascular diseases and cancer, and why people suffering from depression die younger. At the same time, this research may help finding new therapeutic targets for the prevention and treatment of depression.
The lead author of this work is Sara Jiménez Fernández, PhD student at the UGR and psychiatrist at the Child and Adolescent Mental Health Unit at Jaén Medical Center (Jaén, Spain). The co-authors are the UGR Psychiatry professors Manuel Gurpegui Fernández de Legaria and Francisco Díaz Atienza, in collaboration, among others, with Christoph Correll from the Zucker Hillside Hospital (New York, USA).
This research is a meta analysis of 29 previous studies which comprise 3961 people, and it is the first detailed work of its kind about what happens in the organism of people suffering from depression. It studies the imbalance between the individual increase of various oxidative stress parameters (especially malondialdehyde, a biomarker to measure the oxidative deterioration of the cell membrane) and the decrease in antioxidant substances (such as uric acid, zinc, and the superoxide dismutase enzyme).
The researchers have managed to prove that, after receiving the usual treatment against depression, the patients’ malondialdehyde levels are significantly reduced, to the point that they are indistinguishable from healthy individuals. At the same time, zinc and uric acid levels increase until reaching normal levels (something that does not occur in the case of the superoxide dismutase enzyme).

Is Depression Just Bad Chemistry?

Hmmm, seems it’s more than that. It’s not just lower levels of Serotonin, like those cute little rock people show us in the commercial for Zoloft. Some antidepressants that decrease Serotonin levels actually help with the symptoms of depression. Seems a lot of areas in the brain, eg. the amygdala, the hypothalamus, the anterior cingulate cortex, all may be of different sizes and activities than in people who do not suffer from depression. Also deep brain stimulation of the subcallosal cingulate gyrus alleviates depression symptoms. Well, it seems the whole thing is much more complicated than little rock people becoming happy and hopping around with little bluebirds… the red bolds are mine.

http://www.scientificamerican.com/article/is-depression-just-bad-chemistry/

A commercial sponsored by Pfizer, the drug company that manufactures the antidepressant Zoloft, asserts, “While the cause [of depression] is unknown, depression may be related to an imbalance of natural chemicals between nerve cells in the brain. Prescription Zoloft works to correct this imbalance.” Using advertisements such as this one, pharmaceutical companies have widely promoted the idea that depression results from a chemical imbalance in the brain.

The general idea is that a deficiency of certain neurotransmitters (chemical messengers) at synapses, or tiny gaps, between neurons interferes with the transmission of nerve impulses, causing or contributing to depression. One of these neurotransmitters, serotonin, has attracted the most attention, but many others, including norepinephrine and dopamine, have also been granted supporting roles in the story.

Much of the general public seems to have accepted the chemical imbalance hypothesis uncritically. For example, in a 2007 survey of 262 undergraduates, psychologist Christopher M. France of Cleveland State University and his colleagues found that 84.7 percent of participants found it “likely” that chemical imbalances cause depression. In reality, however, depression cannot be boiled down to an excess or deficit of any particular chemical or even a suite of chemicals. “Chemical imbalance is sort of last-century thinking. It’s much more complicated than that,” neuroscientist Joseph Coyle of Harvard Medical School was quoted as saying in a blog by National Public Radio’s Alix Spiegel.

Indeed, it is very likely that depression stems from influences other than neurotransmitter abnormalities. Among the problems correlated with the disease are irregularities in brain structure and function, disturbances in neural circuitry, and various psychological contributions, such as life stressors. Of course, all these influences ultimately operate at the level of physiology, but understanding them requires explanations from other vantage points.

Are Your Chemicals out of Balance?
Perhaps the most frequently cited evidence in support of the chemical imbalance hypothesis is the effectiveness of antidepressants, many of which increase the amounts of serotonin and other neurotransmitters at synapses. Zoloft, Prozac and similar selective serotonin reuptake inhibitors (SSRIs) result in such an increase and can often relieve depression, at least when it is severe. As a result, many believe that a deficiency in serotonin and other neurotransmitters causes the disorder. But just because a drug reduces symptoms of a disease does not mean that those symptoms were caused by a chemical problem the drug corrects. Aspirin alleviates headaches, but headaches are not caused by a deficiency of aspirin.

Evidence against the hypothesis comes from the efficacy of a newly developed antidepressant, Stablon (Tianeptine), which decreases levels of serotonin at synapses. Indeed, in different experiments, activation or blockage of certain serotonin receptors has improved or worsened depression symptoms in an unpredictable manner. A further challenge to the chemical imbalance hypothesis is that many depressed people are not helped by SSRIs. In a 2009 review article psychiatrist Michael Gitlin of the University of California, Los Angeles, reported that one third of those treated with antidepressants do not improve, and a significant proportion of the remainder get somewhat better but remain depressed. If antidepressants correct a chemical imbalance that underlies depression, all or most depressed people should get better after taking them. That they do not suggests that we have only barely begun to understand the disorder at a molecular level. As a result, we must consider other, nonchemical leads.

This Is Your Brain on Depression
A possible clue lies in brain structures. Imaging studies have revealed that certain brain areas differ in size between depressed and mentally healthy individuals. For example, the amygdala, which responds to the emotional significance of events, tends to be smaller in depressed people than in those without the disorder. Other emotional regulatory centers that appear to be reduced in volume are the hippocampus, an interior brain region involved in emotional memory, the anterior cingulate cortex, which helps to govern impulse control and empathy, and certain sections of the prefrontal cortex, which plays an important role in emotional regulation. Nevertheless, the effects of these shrinkages on depression, if any, remain an open question.

Neuroimaging studies have revealed that the amygdala, hypothalamus and anterior cingulate cortex are often less active in depressed people. Some parts of the prefrontal cortex also show diminished activity, whereas other regions display the opposite pattern. The subcallosal cingulate gyrus, a region near the anterior cingulate, often shows abnormal activity levels in depressed individuals. These differences may contribute to depression, but if they do, scientists are not sure how.

In 2012 neurosurgeon Andres M. Lozano of the University of Toronto and his associates studied the effects of deep brain stimulation of the subcallosal cingulate gyrus in depressed patients who had not benefited from standard treatments. The intervention led to a significant reduction in symptoms of depression, supporting the idea that a dysfunction in this brain area may be involved in the illness.

Findings also point to a crucial role for psychosocial factors such as stress, especially when it arises from a loss of someone close to you or a failure to meet a major life goal. When someone is under a good deal of stress, a hormone called cortisol is released into the bloodstream by the adrenal glands. Over the short term, cortisol helps humans cope with dangers by mobilizing energy stores for flight or fight. But chronically high cortisol levels can harm some bodily systems. For example, at least in animals, excess cortisol reduces the volume of the hippocampus, which in turn may contribute to depression. Despite such data, we still do not know if stress alters the human brain in ways that can lead to depression.

Seeing the Elephant
Throughout this column, we have described associations between various brain changes and depression. We have not talked about “causes,” because no studies have established a cause-and-effect relation between any brain or psychosocial dysfunction and the disorder. In addition, depression almost certainly does not result from just one change in the brain or environmental factor. A focus on one piece of the depression puzzle—be it brain chemistry, neural networks or stress—is shortsighted.

The tunnel-vision approach is reminiscent of a classic story in which a group of blind men touch an elephant to learn what the animal looks like. Each one feels a different part, such as the trunk or the tusk. The men then compare notes and learn that they are in complete disagreement about the animal’s appearance. To understand the causes of depression, we have to see the entire elephant—that is, we must integrate what we know at multiple scales, from molecules to the mind to the world we live in.

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