Let’s get a few facts straight from the get-go. I’m not a conspiracy theorist. I’m not even that politically minded, but I do like to think for myself. I’m a natural skeptic and pragmatist. These days, there are a couple of issues in my line of work that are making my blood boil, and I’m working to connect the dots between them to help establish a framework for a truth in science “sniff-test.” For one, symptoms of mental illness are not entirely a psychological problem, nor are they purely a neurochemical issue (and, as we’ll see shortly, not a single study has proven that depression is caused by a chemical imbalance in the brain). Depression is merely a symptom, a sign that something is off balance or ill in the body that needs to be remedied.
And two, depression is a grossly misdiagnosed and mistreated condition today, especially among women—one in seven of whom is being medicated. (For reasons we’ll be exploring, women experience more than twice the rate of depression as men, regardless of race or ethnic background. One in four women in their forties and fifties use psychiatric drugs.)2 Although I was trained to think that antidepressants are to the depressed (and to the anxious, panicked, OCD, IBS, PTSD, bulimic, anorexic, and so on) what eyeglasses are to the poor-sighted, I no longer buy into this bill of goods. And after reading this book, you too may think twice about all you thought you understood about the causes of depression.
We owe most of our mental illnesses—including their kissing cousins such as chronic worry, fogginess, and crankiness—to lifestyle factors and undiagnosed physiological conditions that develop in places far from the brain, such as the gut and thyroid. That’s right: you might owe your gloominess and unremitting unease to an imbalance that is only indirectly related to your brain’s internal chemistry. Indeed, what you eat for breakfast (think whole wheat toast, fresh OJ, milk, and multigrain cereal) and how you deal with that high cholesterol and afternoon headache (think Lipitor and Advil) could have everything to do with the causes and symptoms of your depression. And if you think a chemical pill can save, cure, or “correct” you, you’re dead wrong. That is about as misguided as taking aspirin for a nail stuck in your foot.
While it’s well documented that multiple forces—such as a tragic life event or the fallout from hormonal shifts—can trigger symptoms labeled (and treated) as depression, no one has explained the potential for antidepressants to irreversibly disable the body’s natural healing mechanisms. Despite what you’ve been led to believe, antidepressants have repeatedly been shown in long-term scientific studies to worsen the course of mental illness—to say nothing of the risks of liver damage, abnormal bleeding, weight gain, sexual dysfunction, and reduced cognitive function that they entail. The dirtiest little secret of all is the fact that antidepressants are among the most difficult drugs to taper from, more so than alcohol and opiates. While you might call it “going through withdrawal,” we medical professionals have been instructed by Big Pharma to call it “discontinuation syndrome,” which is characterized by fiercely debilitating physical and psychological reactions.
So unlike most psychiatrists, I’m not one to diagnose a “permanent” condition, write a prescription, and send my patient on her merry way—the knee-jerk gold standard in my field today. Nor do I have her sit on a couch and talk about her problems endlessly. Much to the contrary, my first item of business is to discuss her medical and personal history, including questions that give me a sense of her life’s exposures since birth, from noxious chemical encounters to whether or not she was born through the birth canal and breast-fed. I also order lab tests that help me take in the bigger picture of her total biology; these are noninvasive screenings that most psychiatrists and general practitioners don’t even think about doing (and in this book you’ll be learning about these easy-to-obtain tests as tools to help you personalize your path to healing).
While I acknowledge my patient’s past experiences, I also focus on what’s unfolding today from a cellular standpoint and the potential impairment (“dysregulation”) of her immune system. The medical literature has emphasized the role of inflammation in mental illness for more than twenty years. I listen closely and ask her about her current lifestyle, a dismissed and neglected variable in conventional medicine. I reflect on her entirety, considering factors like how much sugar she consumes and other dietary habits, how well her gut and its microbial communities are collaborating, hormone levels such as thyroid and cortisol, genetic variants in her DNA that can put her at a higher risk for symptoms of depression, her beliefs about health, and her intentions for our work together. (And, yes, this takes hours.)
All of my patients share similar goals: they want to feel physically vibrant and emotionally balanced, which I believe is everyone’s birthright—not perpetually drained, unsettled, mentally foggy, and unable to enjoy life. Under my guidance, they achieve these goals through very simple and straightforward strategies: dietary modifications (more healthy fats and less sugar, dairy, and gluten); natural supplements like B vitamins and probiotics that don’t require a prescription and can even be delivered through certain foods; minimizing exposures to biology-disrupting toxicants* like fluoride in tap water and fragrances in cosmetics; harnessing the power of sufficient sleep and physical movement; and practicing behavioral techniques aimed at promoting the relaxation response. These basic lifestyle interventions facilitate the body’s powerful self-healing mechanisms, and there’s plenty of science to support these protocols. This isn’t New Age medicine; I will prove my claims and back my recommendations with current peer-reviewed studies from the world’s most esteemed publications.
I do not deny that I have developed a sometimes belligerent relationship with much of conventional medicine over the past several years. After having witnessed the devastation this paradigm has wrought upon the lives of hundreds of my patients, I’m convinced that the pharmaceutical industry and its bedfellows, concealed behind official titles such as certain medical societies and associations, have created an illusion of science where none exists, in the service of profit over professional responsibility. I will myth bust just about everything you think you know about the role of drugs in the treatment of depression and anxiety. It’s time to turn the lights on in this dark room. Let’s open up this conversation and embrace a perspective on depression that radically challenges mainstream assumptions and theories. If I do my job well, you’ll never look at another ad for an antidepressant again in quite the same way.
Admittedly, I haven’t always been militant about my now unshakable, passionate belief in the effectiveness of holistic, drug-free medicine to heal women’s minds, moods, and memory. I’ve crossed over from the other side in many ways, having once been a dyed-in-the-wool allopathic doctor. I’m from a family that regards conventional medicine as a guiding light. I was always interested in neuroscience and the promise of understanding behavior and pathology, and I pursued psychiatry for that reason. My inner feminist wasn’t totally satisfied, however, until I began to specialize in women’s health. There’s a growing field in psychiatry called perinatal or reproductive psychiatry that focuses on the risk-benefit analysis of treating women during their reproductive years. This is a uniquely vulnerable time period, particularly if a woman is contemplating taking drugs while simultaneously planning a pregnancy or is already pregnant. I soon began to feel constrained by the medication and/or talk therapy model of treating depression, and I delved into how to cultivate better options for not just women in their reproductive years but all women across the entire life cycle.
The further I stepped away from traditional psychiatry, the more I started to ask questions few others in my field were raising, principally “Why?” Why have the body and mind become dysfunctional in so many millions of women? Are we inherently broken? Why have we gotten so much sicker in the past century when our DNA—the same DNA we’ve had for millions of years—hasn’t changed? Or are doctors just getting better at labeling symptoms under the wastebasket diagnosis that is depression?
These are among the many questions addressed in this book; the answers pave the way to a revolutionary—and by that I mean extremely self-empowering!—new approach to well-being.
I’ve seen extraordinary turnarounds in health. Take, for instance, the fifty-six-year-old woman who entered my office complaining of low energy, pervasive pain, dry skin, constipation,