We in the scientific community believe epigenetic forces affect us from our days in utero until the day we die. There are likely many windows during our lifetime when we are sensitive to environmental impacts that can change our biology and have major downstream effects such as symptoms of depression. At the same time, the multitude of neural, immune, and hormonal actions that are controlled by the microbiome—and that in turn command our entire physiology—are susceptible to disruption and adaptation, especially by environmental changes.
One of the most important takeaways from this first chapter is to understand that depression is not about the brain per se. Of course, there are brain events and biochemical reactions occurring when a person feels depressed, but no research has ever established that a particular brain state causes, or even correlates with, depression. Many different physical conditions create psychiatric symptoms but aren’t themselves psychiatric. We think (because our doctors think) that we need to “cure” the brain, but in reality we need to look at the whole body’s ecosystem: intestinal health, hormonal interactions, the immune system and autoimmune disorders, blood sugar balance, and toxicant exposure. And we need natural, evidence-based alternatives to psychiatric medications—treatments that target what’s really awry in our bodies. That means strategic dietary supplementation and noninvasive remedies like light therapy and cranial stimulation, but also smart (i.e., biologically compatible) food protocols and exercise choices, restful sleep, a detoxed environment, and meditation/relaxation practices. The best way to heal our brains is to heal the bodies in which they reside. Or, as I also like to put it, free your mind by healing your whole body. Hence the whole purpose of this book. The potential for lifestyle-based interventions and healing is immense.
When I get asked about the main triggers of depression, I often think of the three types of patients I generally see: the woman with blood sugar issues and nutritional deficiencies due to the standard American diet (high in sugar, low in healthy fats); the individual with a misbehaving thyroid, which plays into all matters of hormones that in turn affect mental health; and the person with either medication-induced depression (think statins, birth control pills, proton-pump inhibitors like Nexium and Prilosec, and even vaccines). We’re going to be exploring all of these potential triggers in detail in the upcoming chapters.
Although scientists are now trying to identify drivers of different types of depressive syndromes, the medical industry still offers a one-size-fits-all solution (read: one drug, one disorder model). This is akin to studying all the different sources of, say, back pain—from a torn muscle or a herniated disc to cancer or a kidney infection—but using the same treatment protocol on all cases. It doesn’t make sense, and there can be unintended consequences if that singular treatment entails risky drugs or surgery. And when it comes to using antidepressants for all signs of depression, this can be very tricky terrain, as the next chapter shows.
Truth Serum: Coming Clean About the Serotonin Myth
How You’ve Been Misled, Misdiagnosed, and Mistreated
There’s no such thing as an antidepressant.
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The chemical imbalance theory of depression is heavily promoted but remains unfounded.
Do you take antidepressants? Do you know someone who does? Maybe you even have friends and family members who swear they have been lifesaving. Antidepressants might seem like a reasonable option, particularly if things are dire. But do you know the whole story?
At the risk of sounding extreme, let me give you an example from my own case files that sets the tone for this chapter. Kate had never been on an antidepressant and never suffered from depression, but she felt overwhelmed and frazzled after the birth of her first baby. At her six-week postpartum follow-up appointment, her obstetrician prescribed Zoloft. Within one week of starting it, she had written a suicide note and was planning to jump off of her fifteenth-floor Manhattan balcony. She said to me, “It just made sense at the time. And I felt really detached about it, like it was nothing.”
Kate’s experience is not an outlier. She is among millions of women who are reflexively prescribed medication for symptoms of distress. She’s also among those who have serious side effects that may seem like part of the depression—not a result of the drugs. Rather than examining the sources of her postpartum plight, Kate found herself in dangerously unfamiliar territory in the name of treatment. If only she had known the whole story before deciding to fill that prescription.
The ease with which these medications are dispensed is partly why so many take them: 11 percent of all Americans, 25 percent of whom are women in their forties and fifties. The use of antidepressants has increased almost 400 percent from 1998 to 2008, making them the third most commonly prescribed drugs across all ages. The sharp increase does not necessarily signify a depression epidemic. Through the early 2000s pharmaceutical companies aggressively tested antidepressants for a variety of disorders, which led to an explosion of FDA-approved uses, from depression to premature ejaculation.1 Believe it or not, we are spending more on antidepressants than the gross national product of more than half of the world’s countries. Sixty percent of people on antidepressants stay on them for more than two years, and 14 percent do so for more than a decade. By a conservative estimate, 15 percent of pregnant women take psychiatric medication today, a rate that has tripled in just the last couple of years.
The medical industry isn’t selling a cure. They are selling sickness.
SELLING SICKNESS2
Is there a connection between the profligate use of antidepressants and increasing rates of disability? Before antidepressants became so widely used, the National Institute of Mental Health (NIMH) assured people that recovering from a depressive episode was common and that experiencing a second episode was uncommon.3 But then how do we explain soaring rates of disability and escalating prescriptions?
Robert Whitaker, a notable critic of modern psychiatry and author of Anatomy of an Epidemic and Mad in America, has compiled and analyzed data showing that days of work lost are not decreased by medication treatment.4 Much to the contrary, they are increased by drug treatment, and so is long-term disability. He also has reported on studies showing that people treated for the illness are three times more likely than the untreated individuals to suffer a “cessation” of their “principal social role,” meaning that they function less optimally. And they were nearly seven times more likely to become “incapacitated.” Moreover, 85 percent of unmedicated patients recover in a year, with 67 percent doing so by six months.5 From my perspective, that’s an enviable statistic.
What’s going on here? In the past half century, the Diagnostic and Statistical Manual—the DSM, the bible of diagnosable disorders in psychiatry—has lengthened to more than three hundred diagnoses in its fifth edition. In 1952 the DSM was a slim 130 pages and outlined 106 illnesses. Today’s version is a colossal 886 pages and includes 374 diagnoses. It encompasses a general consensus by a committee consisting of practitioners with profound conflicts of interest and pharmaceutical enmeshments.6 As Dr. Allen Frances of Columbia University and author of Saving Normal states: “Wholesale imperial medicalization of normality that will trivialize mental disorder and lead to a deluge of unneeded medication treatment—a bonanza for the pharmaceutical industry but at a huge cost to the new false positive patients caught in the excessively wide DSM-V net.”7 Dr. Frances is the psychiatrist who chaired the task force that produced the fourth edition of the DSM and has been critical of the latest tome. In 2013, Frances rightfully said that “psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests.”8
When you look at the impossibly long list of symptoms and maladies for which antidepressants can be prescribed, it’s practically farcical. These drugs are indicated for classic signs of depression as well as all of the following: premenstrual syndrome, anxiety, obsessive-compulsive disorder (OCD), bipolar disorder, anorexia and binge