Did you know that 1 in 4 women in America are taking a prescription drug for mental health problems?
If you struggle with depressed mood, anxiety or panic attacks, it’s really important to ask “why?” as you are seeking a solution.
As a physician, I was trained to diagnose diseases. Granted, there is some sense of relief for the patient and satisfaction for the doctor to put a label on your condition, but it’s not as helpful as it may seem. In fact, labeling people with specific mental diseases has led to the problematic practice of lumping large groups of patients with similar symptoms into categories and simply prescribing a corresponding prescription drug to the name of the disorder. Unfortunately, in our dysfunctional healthcare system, doctors often lack adequate time with patients AND many physicians are not trained in root cause medicine. As a result, people get placed on pharmaceutical anti-depressant pills without the proper history taking or an adequate functional medical work-up to uncover the underlying biochemical, genetic, environmental, social, occupational, emotional and spiritual root causes of the mood changes.
For example, if you visit your doctor and report that you are feeling down most days, having trouble sleeping, abnormal guilty thoughts, poor concentration, loss of interest in hobbies, fatigue, irritability and change in appetite for two weeks or more, you will likely be diagnosed with major depressive disorder and be given a script for an SSRI (selective serotonin reuptake inhibitor) like Paxil, Prozac, Zoloft or Lexapro. You now have a label and a drug (along with some serious potential side effects), but do you know WHY you are depressed? What is the root cause? Is the root cause being treated by the drug? Probably not.
In order to get the root of your symptoms, we need to go deeper. Are you suffering from the physiological effects of chronic stress from a job you despise? Do you have a hidden food sensitivity that is causing a gut disturbance and generalized inflammation in the body and brain? Are you eating a diet high in processed foods and simply have an omega-three fatty acid or vitamin D deficiency? All of these individual problems can result in the symptoms of depression, but all have different root causes and require individualized treatment.
Your brain and body are not separate. Mental illness affects the entire body, which explains why we tend to suffer with headaches, abdominal pain, diarrhea, constipation, body pain, fatigue, heart palpitations, dizziness and a whole host of other physical symptoms when we are depressed and anxious. Did you know that the reverse is also true? Physical disease can actually cause mental illness. The brain can be inflamed and dysfunctional from a combination of many things. So if you are suffering with anxiety or depression, it’s important to ask the question “why?”
Don’t settle for the outdated explanation of mental illness being a simple chemical imbalance in your brain. This idea has led to the false belief that pharmaceutical drugs designed to modulate neurotransmitters are THE sole answer to mental illness. Please hear me out, I am not condemning the use of drugs to treat mental illness. I recognize that they can be useful and even life-saving in some cases. Yet it is clear that these drugs have not reversed the epidemic of mental illness in our modern world. As more physicians become skilled at seeking out and addressing root causes of brain dysfunction, this old paradigm that emphasizes pharmaceutical drug therapy for mental illness will become obsolete.
Here is a list of 10 root causes to consider if you or a loved one is suffering with symptoms of depression and/or anxiety:
- Sleep Apnea – many people periodically stop breathing during sleep. This deprives the brain of oxygen and sets off a myriad of stressors on the heart and brain leaving one vulnerable to stroke, heart attack, day time sleepiness and depression. Being overweight or using sedating drugs or alcohol before bed can increase your risk. Sleep apnea is an often over-looked contributing factor to mental illness and can be easily treated with weight loss or in some cases the use of a CPAP machine or surgery.
- Anemia – is a condition marked by a deficiency of red blood cells or hemoglobin in the blood. It can have many causes including blood loss from heavy periods, gastrointestinal bleeding, poor diet and vitamin deficiencies to name just a few. Anemia causes fatigue, skin pallor, shortness of breath, dizziness, and heart palpitations. It can be detected by a simple blood test and once the cause is identified it can often be corrected fairly quickly.
- Thyroid Dysfunction – the thyroid is a small butterfly shaped gland that sits on the lower part of the front of your neck. It is an important player in your endocrine system and when working properly it secretes thyroid hormone that regulates bodily functions like your metabolism, digestion and body temperature. The thyroid can become dysfunctional (over or under active) for a variety of reasons: genetics, environmental toxin exposure, gluten sensitivity, micronutrient deficiencies, viral infections, chronic stress etc… The most common cause of under-active or hypothyroidism is an autoimmune condition called Hashimoto’s thyroiditis. It is extremely common and often affects middle aged and older women, but it can strike both sexes and at any age. Hypothyroidism can mimic depression with symptoms of fatigue, low mood, lack of motivation and weight gain. A low functioning thyroid can also cause hair loss, constipation, cold intolerance, hoarse voice, puffiness in the face and swelling/tingling in the extremities. An overactive thyroid is less common and tends to affect women more than men. It can present with severe anxiety, heart palpitations, diarrhea, tremor and weight loss. I recommend checking a full thyroid profile including TSH, free T3, free T4, reverse T3 and thyroid anti-bodies for any one suffering with anxiety or depression.
- PCOS Hormonal Imbalance – Polycystic ovarian syndrome (PCOS) is a very common endocrine condition that affects about 1 in 10 women. Women with PCOS often have insulin resistance, irregular periods, infertility, acne, abnormal weight gain and excessive hair growth on the upper lip, chin, neck, trunk and thighs. The syndrome is associated with a higher risk of cardiometabolic diseases like diabetes, obesity, high blood pressure and hyperlipidemia. PCOS also carries a higher than average risk of depression and anxiety. The symptoms of PCOS can improve with optimizing body composition (i.e. losing body fat and increasing lean muscle mass) and addressing the underlying hormonal and metabolic changes through nutrition, physical training and herbal/nutrient remedies.
- Magnesium Deficiency – Magnesium is known as the “Miracle Mineral,” as it is responsible for over 300 enzymatic reactions in the body. Our modern diet is often deficient in magnesium and we can lose it through sweat, diarrhea and menstruation. Stress can also cause you to burn through a lot of magnesium. Low body magnesium levels will leave you feeling tense, anxious and depressed. When magnesium is repleted it often miraculously restores normal sleep, soothes anxiety, relaxes the muscles, relieves constipation, improves the mood, cures heart palpitations and eases PMS, irritable bowel syndrome and headaches. You can raise your magnesium levels by:
- Eating a whole foods diet rich in green vegetables, nuts, seeds, avocados and legumes.
- Indulge in a small amount of dark chocolate:)
- Minimizing intake of alcohol, coffee, refined sugar, table salt and processed foods.
- Take steps to decrease your stress levels.
- Consult an integrative/functional medicine doctor about checking your RBC magnesium level and the proper use of supplemental magnesium. Use caution as excess magnesium intake by mouth can cause diarrhea.
- Cognitive Distortions – a.k.a. stinkin’ thinkin’ or brain ANTS (automatic negative thoughts) are inaccurate thoughts that perpetuate negative feelings and make us feel badly about ourselves. Here are a few examples:
- Black and white thinking involves putting people and situations in “either/or” categories with no shades of grade. This pattern of thinking does not allow for the complexities of life. For example, if your performance falls short of perfect, you judge yourself as a total failure. This type of polarized thinking with no middle ground can be very damaging to our mental health.
- Overgeneralization is when we come to general conclusions based on a single piece of evidence or an isolated incident. In this cognitive distortion when something bad happens once, we anticipate that it will happen over and over again as a part of a never-ending negative pattern.
- Jumping to conclusions is when we believe that we know exactly what a person is thinking and why they are behaving in certain ways without verifying our impression with the other person. For example, we may believe that someone is upset with us, but not bother to check with them to see if we are correct. This can lead to unnecessary heartbreak.
- Catastrophizing involves the expectation of disaster striking no matter what. You can recognize this cognitive distortion by the “what if ___?” questions or worst case scenario fears that pop up when you think about problems.
- Hypoglycemia – is the medical term for low blood sugar (usually less than 70mg/dL) and can occur in people with and without diabetes. It is an uncommonly recognized cause of anxiety, depression and mood swings. Other symptoms of hypoglycemia include the rapid onset of irritability, anger, sadness, mental confusion, shakiness, heart palpitations, dry mouth, tingling lips, sleepiness, slurred speech and tremor. In very severe cases it can lead to seizures and loss of consciousness. Low blood sugar is common in diabetics, especially those on insulin therapy, but can occur in non-diabetics due to hormonal imbalance, intake of high carbohydrate meals, certain medications, alcohol, stress, eating disorders, pregnancy, disorders of the kidney, heart and liver and certain rare pancreatic tumors. Every cell in your body depends on sugar (glucose) for energy so when the blood sugar drops too low your body sets off a series of chemical alarm signals. This is quite stressful on the body and over time can set you up for developing chronic, degenerative diseases. In many cases, hypoglycemia can be cured with simple dietary changes.
- Drugs – there are many prescription, over the counter, recreational and illicit drugs that can trigger or worsen depression and anxiety including but not limited to:
- Oral contraceptive pills
- Tranquilizers
- Sleeping pills
- Steroids
- Antihistamines
- Antibiotics
- NSAIDS (e.g. ibuprofen)
- Diet pills
- Diuretics
- Pain killers/Opiates
- Anti-hypertensives
- Alcohol
- Marijuana
- Cocaine
- Heroin
- Methamphetamine
- Dysbiosis – the gut and the brain are connected. The digestive tract plays a vital role in our overall health as it helps in the breakdown and absorption of nutrients, elimination on toxins, production of vitamins and forms the frontline of our immune system. One of the main reasons that our gut has such a profound effect on our health has to do with the 100 trillion bacteria (3 pounds worth!) in our gut. Stress, excessive sugar, processed foods, steroids, antibiotics, chemotherapy and PPI drugs like omeprazole can disrupt the normal, healthy balance of these bacteria that make up our intestinal microbiome and allow for an overgrowth of pathogenic yeast. The imbalance, called dysbiosis, is increasingly recognized as having a negative impact on our mental health. Dysbiosis can be diagnosed by history and specialized stool tests. It can be corrected by removing the underlying cause, cleaning up the diet, managing stress and using botanically based anti-microbial therapy, probiotic supplements and medicinal foods.
- Spiritual disconnection – when we are disconnected from Spirit it has far reaching effects on our health: mental, emotional and physical. If we hold onto and carry pride, fear, bitterness or unforgiveness in our hearts, it eats us up from the inside. The anti-dote for all spiritual disconnect is unconditional love. Our best medicine for mental health is to learn how to love ourselves and others and access the source of all true healing. We are spiritual beings with a physical body and pharmaceuticals serve only as a temporary band-aid. Our body, mind and spirit are beautifully and mysteriously interwoven and only God can make complete sense of why we suffer from mental illness. Only He can offer true healing. Please know that in Christ, you are whole and perfect JUST AS YOU ARE, even in the brokenness of anxiety and depression. Mental illness does not signal weak faith, it’s not a character flaw and not a consequence or punishment for personal sin.
Once diagnosed with an anxiety or depressive disorder, most patients struggle with the decision of whether or not to take a pharmaceutical drug for treatment. They desperately want to feel better, but question why they cannot “pull themselves up by the boot straps” or “simply snap out of it.” They often feel badly or guilty about the prospect of taking a mood altering medication. People of faith who are affected by mental illness sometimes have an additional layer of negative feelings and guilt about using a drug for treatment. They may feel that they are somehow failing to trust God for their healing. At times they may even doubt that God is hearing their heart cries for help.
All of these feelings are understandable, but are simply false. If this describes your experience, let me encourage you. God loves you. He hears you. He is working all things out for your good. Miraculous healing may come in a moment or mental illness may be a chronic struggle for you. The brain is an organ just like any other and disease is a sad consequence of our fallen world. It’s OK to take medicine to feel better! Reach out for support. Educate yourself about root causes. Explore natural therapies. Take time to care for your body and soul.
God has not forgotten you. He loves you deeply and is right there with you in your pain.
In the Bible, Jesus assures us that He has overcome the world and that our troubles, however crushing they may seem at the time, are actually light and momentary when viewed through the lens of eternity and His ultimate plan for our lives.
Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid. ~John 14:27 NIV
I wish you success on your transformation journey and invite you to stay tuned for more “Joy Prescriptions” for practical strategies to heal anxiety and depression. I invite you to join the Caring for the Body Community for my latest insights, recipes and encouragement.
Sincerely,
Cynthia Libert, M.D.
