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Depression

When using GABA for anxiety does tolerance increase and which amino acid to use for a low mood?

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gaba and tolerence

Today I’m sharing some great questions I’ve received about GABA and serotonin support for anxiety and low mood, and my feedback to give you some ideas on what to look for as you use the amino acids for your own issues (or with clients/patients if you’re a practitioner).

I cover possible reasons for ongoing low GABA levels, long-term use of the amino acids, low mood associated with menopause, problems with mainly sugar- and gluten-free, the role of the adrenals and thyroid, the amino acids I’d start with for low mood, how lithium orotate may help, how to know if collagen is causing a low mood and making you more anxious, and some resources for you.

GABA tolerance has increased

Gaba has been a lifesaver for my anxiety! I also use taurine sometimes for anxiety too, and that has helped too. Right now, I take 1000 mg [of taurine]. As for GABA (I now take 1000 mg of that also) I have noticed that my tolerance for it has increased.

Here is my feedback: I’m really pleased GABA and taurine are helping ease your anxiety. I have not seen tolerance to be a factor with my clients using GABA and I’m not aware of any research on this topic. I would look into what could be depleting GABA at a faster rate so you seem to need more and more.

This could be caused by:

  • increased stress which lowers zinc and increases cortisol
  • poor gut health and dysbiosis (there is a bacteria in the gut that may consume GABA – it’s called gabavorous)
  • low zinc and low B6 (which are needed to make GABA and other neurotransmitters)
  • toxin exposure (we’re now seeing that GABA has a protective effect – this blog covers have GABA is protective of the thyroid after fluoride exposure)
  • thyroid problems (the amino acids are less effective in this instance)

Keep in mind that long-term use of the amino acids is not the plan. Once the diet is addressed and the other underlying biochemistry, nutrient deficiencies, toxins etc. are addressed they should no longer be needed. At most, an occasional “top-up” may be needed.

Low mood associated with menopause

Which amino acids would you recommend for low mood associated with menopause? No panic attacks but a crashing low mood for 24hrs or more before slight recovery, a few easy days and then the cycle begins again. Diet is mainly sugar- and gluten-free. Any suggestions would be appreciated, thank you

Here is my feedback: When I hear “diet is mainly sugar- and gluten-free” with mood swings I always look into gluten exposure and blood sugar dips. Keeping a food mood log is an easy first step to see if the low mood is tied to what is being eaten and when.

I would recommend the complete removal of gluten and sugar. Gluten can trigger depression, anxiety, OCD and lead to many psychiatric symptoms. Blood sugar swings can cause both depression and anxiety. The amino acids make it easy to quite sugar and gluten – no willpower required and no feelings of deprivation. Do the questionnaire and do a trial of the amino acids that apply. Based on the above symptoms I’d suspect tryptophan and tyrosine may help and are always a good first step while everything else is being figured out.

I would also look at adrenal function as they take up the slack in menopause and rule out Hashimoto’s thyroiditis and Graves (as you can get mood swings with both as the thyroid levels shift).

Low lithium can also cause mood swings too and lithium orotate can help to keep an even mood, allowing the amino acids to be more effective.

Finally, I’d want to know if collagen, gelatin or bone broths have recently been added to your diet and are being consumed in an on-an-off pattern that correlates with the low mood. Certain susceptible individuals find that it lowers serotonin and increases depression and anxiety, and causes insomnia.

Next steps are a full workup looking at sex hormones, low zinc, low B6, low magnesium, the gut, EMFs, sleep and other dietary factors like salicylates, histamine, glutamates etc. We look at all the possible 60+ nutritional and biochemical root causes and address them or rule them out.

It’s also important to have a good support system in place for those very low days – friends and family members, being part of a community and even keeping a mental health support line number close at hand.

And of course, I always say this: get out in nature, get some exercise, hug someone and have a good laugh.

Resources for you

  • My book The Antianxiety Food Solution (my Amazon affiliate link) has an entire chapter on the amino acids GABA, tryptophan, tyrosine, and DPA (and how to use them), a chapter on blood sugar balancing and glutamine and a chapter on gluten issues (and much more). Read it and become a savvy health-advocate for yourself. Become someone who is well-informed about the amino acids, the precautions and nuances, and all the nutritional approaches for anxiety-relief. Share a copy with your doctor and point out the references.
  • If figuring it out alone or reading my book feels overwhelming to you, or you’re afraid to use the amino acids on your own, my home-study Amazing Aminos for Anxiety program walks you through a step-by step approach on how to figure out which symptoms are tied to which neurotransmitter deficiency, and how to trial each respective amino acid. Stay tuned for a special upcoming launch with live Q and A calls so you can get your questions answered. (If you have recently purchased the homestudy ONLY version we will be contacting you to invite you to participate.)
  • Here is a blog to read if you’re new to GABA: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety
  • Here is a blog to read if you’re new to tryptophan: Tryptophan for the worry-in-your-head and ruminating type of anxiety (it’s a blog about low serotonin anxiety but applies to low-serotonin low mood too)
  • Here is a blog to read if you’re new to tyrosine: Tyrosine for focus, motivation, energy, a good mood and possibly even anxiety
  • You can find the amino acids in my supplement store here.

Can you relate to either of these questions? And are you good at playing a detective to figure out why something may not be working as expected?

What has worked for your anxiety and/or low moods?

Feel free to post questions in the comments too.

And let me know if you’re interested in the homestudy program with live Q and A calls. (If you have recently purchased the homestudy ONLY version we will be contacting you to invite you to participate.)

Additional Anxiety Resources
Click on each image to learn more

Delayed IgG food sensitivities: depression and anxiety due to inflammation, leaky gut, leaky blood brain barrier and low serotonin

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It’s really encouraging and exciting to see a major study confirming what we’ve known about IgG food sensitivities or IgG food reactivity for years, and also reporting a link to irritable bowel syndrome (IBS) and depression. The paper, published in May this year, The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls states

There is an increasing amount of evidence which links the pathogenesis of irritable bowel syndrome (IBS) with food IgG hyperreactivity. Some authors have suggested that food IgG hyperreactivity could be also involved in the pathophysiology of major depressive disorder (MDD).

The following diagram and excerpt illustrates the gut-immune-inflammatory-brain model for depression that is associated with food IgG hyperreactivity or sensitivity.

The gut-immune-inflammatory-brain model for Major Depressive Disorder associated with food IgG hyperreactivity. According to the hypothesis proposed in our previous work, we present a possible mechanism underlying the MDD [major depressive disorder] development, suggesting that the interplay between genetic and environmental factors may lead to disruption of tight junctions, the loss of their integrity and both gut and BBB [blood brain barrier] permeability. Undigested food compounds, which would normally break down in the gut, translocate into the blood circulation, and trough epitopes combine with food IgG antibodies to form immune complexes. This, in turn, provokes an abnormal response and triggers immune-inflammatory cascade. Uncontrolled release of the proinflammatory mediators may contribute to low-grade systemic inflammation and low-grade neuroinflammation, which, via pathological processes in CNS [central nervous system], i.e., changes in neurotransmitter metabolism, neurogenesis, glutamate excitotoxicity, may in consequence induce and then maintain and prolong depression.

[diagram and excerpt from The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls]

I wrote my book, The Antianxiety Food Solution, in 2011 and there wasn’t research on the gut-immune-inflammatory-brain model, but I do write extensively about delayed IgG food sensitivities (as well as other types of food issues). If you don’t have my book I’m including some of the highlights related to this (and I encourage you to pick up a copy too!). If you do have my book I hope this next section encourages you to go back and read chapter 4 again (and even check out the other books I mention below).

I write about how with delayed food reactions, it may take a few hours to several days before symptoms appear, which can make it difficult to identify the offending food or foods. In these reactions, the body responds by creating a type of antibody known as IgG (immunoglobulin G).

I also write about how food sensitivities can have effects beyond physiological symptoms, including creating imbalances in key chemicals in the brain, which can cause anxiety, phobias, depression, irritability, and mood swings. When food sensitivities have these effects, they are sometimes termed “brain allergies” or “cerebral allergies.” Dr. Carl Pfeiffer wrote extensively about this and used these terms in his wonderful book, Nutrition and Mental Illness, way back in 1987. (This book is a quick read and is one of my favorite older books on the subject of mental health and biochemical imbalances.)

I also reference the work of my colleague and friend, clinical nutritionist Liz Lipski. In her 2004 book, the 3rd edition of Digestive Wellness she shares that

24 percent of American adults claim they have delayed food and environmental reactions.

She feels that these sensitivities are often the result of leaky gut syndrome, a condition characterized by damage to the microvilli lining the intestinal walls. This allows undigested food particles to travel across the intestinal wall and into the blood, where the immune system responds to them as foreign, harmful substances and creates antibodies to neutralize them.

All this sounds very similar to what the new study is reporting doesn’t it? I’d prefer it not to take so long for the knowledge from as far back as 1987 to get into mainstream journals but it’s the world we live in and we can just appreciate that we are moving forward and in the right direction!

The 2018 paper mentioned above concludes the following:

Our findings suggest more common food-specific serum IgG hyperreactivity among patients with IBS and MDD [major depressive disorder], which may be one of the mechanisms leading to the development of immune activation and low-grade inflammation observed in these disorders.

They do support an elimination diet for IBS but not for depression:

There is no causal relationship which could confirm clinical utility of an elimination diet in patients with depression

I do love research, but this really bothers me as it’s just common-sense and we do have some case studies supporting the use of elimination diets. In this case study the patient’s “treatment-resistant” depression improved considerably with an elimination diet, with similar results in another case study where a gluten-free elimination diet improved both anxiety and depression and everyday functioning.

In the meantime, we’ll continue to rely on the wisdom of practitioners like Dr. Pfeiffer and Liz Lipski, and all the clinical evidence showing how an elimination diet does help with both depression and anxiety. Just read some of the success stories on this blog – Paleo and grain free diets: anxiety and depression success stories.

Other mechanisms: nutrient malabsorption and serotonin production

There are other mechanisms that I also cover in my book – nutrient malabsorption and a more direct impact on serotonin production.

One possible mechanism is indirect effects of gastrointestinal damage due to eating problem foods, resulting in nutrient malabsorption. In a 2009 double blind placebo-controlled study:

65 celiac patients aged 45-64 years on a strict gluten-free diet for several years [and showing signs of low folate, low vitamin B12 and low vitamin B6] were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months

I doubt folic acid or this form of B12 would be used today but even with these forms at these low doses, the study participants showed homocysteine in a good range and reported improvement in general well-being – after just 6 months of supplementation.

Another possible mechanism is the fact that gluten sensitivity and the resulting damage to the gut can limit the availability of tryptophan and therefore lead to decreases in levels of serotonin. Research published in 2005, Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study, reports that:

serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioral disorders among adolescents with untreated coeliac disease

In addition to removing the foods that are causing the sensitivities, you need to heal the gut and boost serotonin levels with a targeted individual amino acid like tryptophan.

Give the link between anxiety and depression, all of the above could apply if you have anxiety too.

Have you had IgG food sensitivity testing and found that an elimination diet helped reduce your depression or anxiety symptoms?

Kate Spade: suicide, hormonal imbalance, antidepressants as a trigger and the stigma of mental health

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Photo by Paul Keleher (originally posted to Flickr as kate spade) [CC BY 2.0], via Wikimedia Commons
Kate Spade, a well-known American fashion icon and handbag designer, died by suicide last week at the age of 55. I’m always torn in situations like this…just share the news story with my sympathies in order to respect the family or use this as an opportunity to learn from and prevent others from suffering the same fate. This time I’m doing the latter – with the risk of appearing insensitive – because there are red flags here and I feel so strongly that we all need to learn from this in order to move mental health forward. I’m hoping her husband and family would approve.

In the announcement about Kate Spade’s suicide in the New York Times, Mr. Spade said:

that though his wife had suffered from anxiety at points during their relationship and marriage, her serious bouts of depression only began about six years ago, at the age of 49.

Kate suffered from depression and anxiety for many years. She was actively seeking help and working closely with her doctors to treat her disease, one that takes far too many lives. We were in touch with her the night before and she sounded happy. There was no indication and no warning that she would do this. It was a complete shock. And it clearly wasn’t her. There were personal demons she was battling.

My heart goes out to Kate Spade’s husband, young daughter and loved ones. Her suicide is just so sad but as I said I have a fair bit to say about this….

 

Hormone imbalance triggering anxiety and depression?

According to the reports, Kate’s “serious bouts of depression only began about six years ago, at the age of 49, but she had suffered “from depression and anxiety for many years”.

Perimenopause and menopause is a classic time for women to experience worsening anxiety and depression and can be driven by fluctuating hormones, especially low estrogen. In this study, Depression and the menopause: why antidepressants are not enough? the authors share that

Postmenopausal depression is more severe, has a more insidious course, is more resistant to conventional antidepressants in comparison with premenopausal women and has better outcomes when antidepressants are combined with HT (hormone therapy).

Addressing hormone imbalance as one possible root cause can eliminate the anxiety and depression. Some of my favorite resources for hormone balance are these books: The Hormone Secret and Cooking for Hormone Balance.

 

Low levels of neurotransmitters like serotonin, catecholamines and GABA?

Directly connected to hormonal imbalance is brain chemistry imbalance. Addressing low levels of neurotransmitters like serotonin, the catecholamines and GABA provide results quickly when they are used in a targeted way based on individual needs:

  • Low serotonin is an issue when estrogen levels are declining and the amino acid tryptophan can have profound benefits if low serotonin is one of the root causes, leading to depression, worry, fear, overwhelm and sleep issues.
  • Low catecholamines can cause the “I just want to say in bed” depression and low motivation, together with fatigue and poor focus. The amino acid tyrosine can help to eliminate some of this and also provides thyroid support.  Poor thyroid health can also be a root cause of depression.
  • We see low GABA levels when progesterone is low and if this is one of the root causes, it can result in increased physical anxiety and insomnia. The amino acid GABA, opened on to the tongue, can provide calming results within minutes.

I can totally relate to the hormonal aspect as I suffered from PMS for years and my anxiety issues and panic attacks started in my late 30s and I had a really low spell as I was going through menopause.  Both GABA and tryptophan turned things around very quickly for me as they do for my clients.

 

The role of diet and nutritional psychiatry?

There is so much new science behind the role of a real foods traditional diet for alleviating both depression and anxiety. The SMILES study, published by Prof Felice Jacka early 2017, was the first randomized controlled diet depression study and ONE THIRD of the dietary intervention group saw improvements in their depression symptoms.  This was just diet alone and switching from processed and junk food to real food with no specific dietary restrictions.

There is also much clinical evidence supporting how diet can have an impact. Holly, suffered from with severe depression and anxiety changed her diet and shared this with me:

Over the course of a year and a half, I was given 10 different psychiatric diagnoses and cycled through 10 different medications. I discovered the healing power of diet completely by accident, and it changed my life. I now live with no diagnoses and no symptoms.

I started with the Whole30 (strict paleo), then went paleo, dabbled with a ketogenic approach, and now I eat a modified paleo diet, with some rice and goat dairy.

This has been termed nutritional psychiatry and you can read more diet-depression and diet-anxiety success stories here.

Keep in mind that your prescribing psychiatrist may not yet be on board with this or up to date on the newest research. Just last week someone told me what happened when they discussed nutritional psychiatry with their doctor and showed them my book The Antianxiety Food Solution (my Amazon link). He said: “Good luck with that!”

 

Could the antidepressant medication have triggered her suicide?

The statement from Kate’s husband says “She was actively seeking help for depression and anxiety over the last 5 years, seeing a doctor on a regular basis and taking medication for both depression and anxiety.”  Could the antidepressant medication have triggered her suicide or played some part?

We will never know with Kate but this is always my first thought when I learn of a suicide and when we hear of homicides in the news. One of my colleagues shared this when her suicide was first announced: “I was wondering if she was under psych care and what role meds might have played in this tragedy.”

This paper is one of many papers reporting similar antidepressant suicide and violence risks, and concludes that:

Antidepressants double the occurrence of events in adult healthy volunteers that can lead to suicide and violence

Kelly Brogan MD – Holistic Psychiatrist​ no longer prescribes psychiatric medications because we don’t know who will experience this side-effect. She writes this about a Swedish study and antidepressants and increased suicides

As antidepressant prescriptions increased 270% over 15 years, suicide rates also increased. Strikingly, more than half of the young women who committed suicide (52%) were prescribed antidepressants within a year of committing suicide. And antidepressants were detected in 41% of the women who committed suicide, showing that they were under the influence of antidepressants at the time of death. 

 

What if you are taking an antidepressant and seeing benefits?

When I posted some of this on Facebook earlier in the week someone who is on an antidepressant and benefiting shared her frustration that we are blaming suicide on medications.

There are many who do benefit but there are two issues I have:

  1. Even if someone is doing well on an antidepressant, benzodiazepine or other psychiatric medication I feel we need informed consent about the side-effects and training for the individual and family on what to look out for as things can change. The can occur when meds are changed, doses are increased or decreased, new meds are added, one or more are stopped abruptly or too quickly (called discontinuation syndrome). Many doctors also need to be educated and to acknowledge that suicide and homicide are very real side-effects of these meds.
  2. We don’t know who will be adversely impacted, which is why consent/knowledge about this is so important.

When we rent ski equipment or go bungee jumping we sign an informed consent form, acknowledging the possible risks of death. Why is this not happening with these medications? I just want individuals to be going into this with eyes wide-open so they don’t say “why didn’t anyone tell us this?”

If someone is currently seeing benefits from antidepressants (or benzodiazepines) I make sure they know ALL the risks and encourage them to continue to look for root the causes and address these (never stopping medications abruptly and never without the prescribing doctor’s permission).

There are many possible biological or biomedical or metabolic causes of depression and anxiety and many of these can play a factor in suicide.  Here is a list of just some of them:

My concern is that none of these – the medications or poor diet and nutritional deficiencies – are ever discussed when someone does commit suicide or goes on a violent or homicidal rampage.

 

The stigma of mental health and the fear of seeking help

There are reports that “Kate Spade felt unable to seek help or discuss her mental health because she feared this might damage the brand she created.”  This is a huge issue and if it was true for her or if anyone with a mental health condition feels like this, this has to change!

As Dr. Mark Hyman MD​ said this when I interviewed him last year before the launch of his Broken Brain docu-series

I began to realize that the body was driving a lot of this brain dysfunction, and that if you fix the body, a lot of the brain disorders would get better, that it wasn’t a primarily a mental problem, but it was a physical problem.

Our interview and full transcript is here and we cover the gamut in 12 minutes: the gut and microbiome, nutritional deficiencies, food sensitivities, heavy metals, other environmental toxins and medications.

We don’t hide the fact that we have a broken leg so why do we have to hide it when we have a broken brain? If we can start to acknowledge that mental health issues so often have this physical aspect (and often it’s 100% physical) then hopefully we can end this crazy stigma.

And even if there is also trauma or lifestyle factors that make someone depressed or anxious – so be it. Stop the stigma and shame. Why do we have to put on a brave face and pretend all is well. It has to stop so people can ask for help.

Last but not least, I feel we need to offer practical nutritional psychiatry resources to the family who have been traumatized by the loss of a loved one to suicide.  We know the amino acids and B vitamins help individuals recover from psychological stress after a natural disaster and these same nutrients can help the family in the midst of their sorrow.

I am aware it’s a very delicate subject and I’m sure this will rub some people the wrong way but I believe we all need to be talking about this and not tip-toeing around it.

I really feel this all needed to be said today. I hope this helps you or a loved one.

Rest in peace Kate Spade.

I wake in the middle of the night with a jolt of fear, feelings of dread or feeling depressed

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Waking in the night feeling anxious and with a jolt of fear, having a panic attack, experiencing feelings of impending doom, with a pounding heart and even feeling depressed is a common issue I see with clients and it’s a common question that I’m often asked on my blog and on Facebook.

Here is a typical question you may relate to:

I usually wake between 5-6 am and have this overwhelming feeling of dread and start thinking of all the things I have to get done. And then I can’t fall back asleep. What is this?

Or this one:

Does anyone have severe depression when waking up in the middle of the night, but never during the day or before falling asleep. It doesn’t go away until after I’m fully awake and upright in the morning.

Low serotonin?

Serotonin is known to dip later in the day and at night and we know low serotonin can cause depression and insomnia/waking in the night, so my first thought would be to assess for low serotonin and address this if it is the case. I use the questionnaire and trial method.

I always start with tryptophan, but may switch to 5-HTP if that’s not working as expected as some people do better on one versus the other. We add melatonin if the tryptophan or 5-HTP isn’t quite enough to help with the waking.

There are many possible causes of low serotonin so over the course of the next few months these will be addressed too, on a case by case basis. Some of the causes in include: a poor diet, low stomach acid, malabsorption, low zinc, low B6, low iron, low magnesium, dysbiosis and/or parasites and/or candida, the birth control pill, MTHFR defects (with this defect expressing) etc.

Low GABA?

Low GABA levels may be a factor too as this can contribute to insomnia and waking, especially when there is physical tension. New research reports GABA’s involvement in unwanted thoughts and it’s a common factor in my community and clients. Again, I use the questionnaire and trial method to find the ideal amount of GABA for each person.

High cortisol?

High cortisol in the night can also be a factor and I suspect this when someone says they wake with a jolt of fear or feels what they describe as an adrenalin rush. Saliva testing can confirm cortisol levels and Seriphos is the best product I’ve found to lower high cortisol. Addressing low blood sugar and finding the root cause of the adrenal issues are also key. General adrenal support with B vitamins and adaptogenic herbs are often needed too.

Hormone imbalances and/or PMS?

Here is another typical question you may relate to:

I’ve had the worst week regards 3am panic attacks, lurid dreams and wake up aching. It always feels like the end of the world and yet I get up and stagger out to do my morning routines and all is right with the world (apart from physical aches and pains). I have often had bouts of this. It’s a week to go until my period.

If the anxiety or panic attacks are cyclical and tied to your menstrual cycle I will still start with a trial of tryptophan which has been shown to help PMS, tension, depression and mood swings. Serotonin support also helps with fibromyalgia-type aches and pains.

A trial of GABA is often needed too and can help with alleviating the panic attacks, waking and some of the aches. Other factors like a gluten sensitivities, adrenal issues and high oxalates may also play a role in physical aches.

Lurid dreams clues me into the possibility of low vitamin B6, which is an important co-factor for making both GABA and serotonin, as well as being important for alleviating PMS symptoms and the social anxiety condition called pyroluria. The pyroluria protocol, with vitamin B6, zinc and evening primrose oil, helps both the social anxiety as well as PMS symptoms and insomnia.

Address the basics

You may be looking for the perfect supplement to help and while the amino acids come pretty close to being that, it goes without saying that you want to always address the basics. This means making sure you are eating a real whole food diet with quality animal protein and getting that animal protein at breakfast in order to balance blood sugar. The following needs to be eliminated too: caffeine, gluten and sugar. Some individuals do even better on a ketogenic diet.

Looking at sleep hygiene factors fall under the basics too: a dark, cool and quiet room, no PC or iPhone late at night, no iPhone or other EMF sources close by, sunlight exposure in the early morning etc.

And we mustn’t forget stress reduction, exercise and nature.

Address other bigger issues

Medication side-effects must always be considered. Here are a few examples:

Hashimoto’s thyroiditis must also always be considered especially when there are fluctuations in mood, anxiety and sleep. These fluctuations in mood and anxiety can happen at any time of the day and not necessarily in the night.

If the insomnia and middle of the night anxiety and depression persists we continue to dig and look at dietary histamine and oxalate issues, SIBO, parasites and other digestive issues.

If we are still not seeing results then a referral for Lyme disease, mold, sleep apnea and heavy metals may be needed.

My checklist

My checklist when I start when working with someone with issues similar to the above. This will be tweaked based on each person’s own biochemistry and where they are in terms of diet, supplements and lifestyle:

  • Low serotonin? Do a tryptophan or 5-HTP trial
  • Low melatonin? If tryptophan or 5-HTP trial isn’t quite enough then add melatonin
  • Low GABA? Do a GABA trial
  • Low blood sugar? Add quality protein at breakfast, plus glutamine
  • High cortisol? Support the adrenals and use Seriphos or something else to lower the high cortisol
  • PMS/sex hormone imbalances or Hashimoto’s? Address with diet, nutrients and hormone support as needed
  • Low magnesium, low zinc, low B6, low iron? Assess for these deficiencies and address them
  • Gut health issues like leaky gut, dysbiosis, candida, parasites, SIBO? Address these issues
  • Histamine, oxalate or other dietary issues? Address these issues
  • Medication side-effects? Figure out which one is an issue and work with the doctor to taper if needed and address why the medication was initially prescribed.
  • If the issue persists – a referral for Lyme disease, mold, sleep apnea and/or heavy metals

As you can see there are many overlaps with some of the 60+ root causes of anxiety.

Here is additional information on tryptophan for low serotonin, GABA for low GABA and glutamine for low blood sugar, plus the list of supplements I use with clients.

As always, if the amino acids are new to you, review the precautions and be smart about using them. My book The Antianxiety Food Solution (Amazon affiliate link) has an entire chapter on the amino acids, plus chapters on diet, gut health, caffeine, blood sugar and more.

We’d love to hear which of the above approaches have helped with your insomnia and waking with a jolt of fear or dread or pounding heart.  

The Broken Brain highlights: Trudy Scott interviews Dr. Mark Hyman

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I’m really excited to share my in-person video interview with Dr. Mark Hyman, MD. It’s an interview I arranged because I’m so excited about his Broken Brain docu-series which will start airing on January 17th. You may have seen it when they recently did a test launch but if you haven’t yet seen the series it is well-worth watching and is highly recommended! (Registration link here)

In this interview with Dr. Hyman we talk about root causes of anxiety, depression, dementia, Alzheimer’s disease and ADHD: medication side-effects, diet, the microbiome, nutritional deficiencies, brain chemical imbalances, heavy metal toxicities and more; he shares his personal mercury toxicity story and the why behind the Broken Brain series; we cover off-label medications, trauma, labels and functional medicine.

I love the term he uses to describe body-mind medicine (which is different from mind-body medicine): somatopsychic = mental symptoms caused by bodily illness i.e. all of the above root causes.

One of the big reasons I’m supporting The Broken Brain docu-sersies is that it offers solutions and plenty of hope!

Here is the interview and transcript.

(there are captions on the video – if you don’t see them be sure to click the CC on the bottom right)

Trudy: – Welcome, it’s Trudy Scott here, food mood expert, certified nutritionist, author of The Antianxiety Food Solution, host of The Anxiety Summit, and today I’ve got the pleasure of interviewing Dr. Mark Hyman, who is the creator and host of the new Broken Brain series, and I’m just really excited to be here. I’ve been such a fan of yours for so many years. I know my community knows who you are, and they’re really excited about the Broken Brain series. I wanted to get together with you, and give some highlights, and talk about firstly why you created the Broken Brain series, and you’ve got a story behind your passion about it.

Dr. Mark Hyman: – I do. I do. Thank you for having me. Yeah, so about 20 years ago, I went from being a very healthy young doctor to having a broken brain, and a broken body, and it turned out it was from mercury poisoning that I got when I was in China, and I just developed severe chronic fatigue, where I couldn’t focus, I couldn’t remember, I couldn’t think, I couldn’t pay attention, I was depressed, I couldn’t sleep, I felt just completely not myself, and through that journey, was able to discover this world of functional medicine, which I thought was fairly developed at the time, but was really just in its infancy, and through discovering functional medicine, I was able to repair my own system, and fix my broken brain. I began to apply this with patients, seeing all kinds of things, without really knowing what I was doing, I was just treating people’s physical systems, fixing their gut, helping their immune system, cleaning up their diet, optimizing their nutritional status, balancing their hormones, and all their mental problems would get better. Their anxiety would get better, their depression would get better, and I wasn’t actually treating the depression or anxiety. Autism, ADD, memory issues, dementia, all these things would start to get better, and I began to realize that the body was driving a lot of this brain dysfunction, and that if you fix the body, a lot of the brain disorders would get better, that it wasn’t a primarily a mental problem, but it was a physical problem. Just as there’s a mind body effect, which is real, there’s also a body mind effect and that hadn’t been really talked about, so I wrote a book called The UltraMind Solution 10 years ago, which outlined this model, and then really this has been an incredible 10 years of brain research that I felt needed updating, and so we created a documentary series online looking at the new research, and how this applies, and the things that I noticed 10, 15, 20 years ago are now becoming more and more accepted and understood as real, and so we’re able to actually work with people in a very specific and direct way to help heal their broken brains, and to help people recover from things that we thought were really irreversible, not just anxiety, depression, but ADD, autism, dementia, Parkinson’s, all sort of issues that affect the brain that have a very different approach that can be used to repair and heal.

Trudy: – That’s so powerful, and I love that you talk about this effect that the body has on the brain, because we know about mind body medicine, you talk about that in the series, about how we can use our mind to affect our health, but you use this term. Tell me what the term is that you use that talks about how physical issues in our body, nutritional deficiencies, imbalances, can actually affect the brain.

Dr. Mark Hyman: – You mean the body mind effect?

Trudy: – Yes.

Dr. Mark Hyman – Yeah.

Trudy: – You’ve give it a term, and it was called?

Dr. Mark Hyman: – Oh, somatopsychic.

Trudy: – Somatopsychic, yes.

Dr. Mark Hyman: – We think of psychosomatic, but there’s also a somatopsychic phenomena. I would say if you have mercury poisoning, or you have a thyroid problem, or you have abnormal gut flora, or you’re vitamin D deficient, or B12 deficient, it’s very hard to have a proper functioning brain. You can’t just say someone’s got depression, that’s what’s causing their hopelessness, and helplessness, and sadness, and maybe many other things, it could be psychological, it could be a trauma, but it also could be so many other factors, and they often are overlooked and ignored, and when I start peeling back the layers of what’s happening with these people, and looking underneath the hood, and looking through the functional medicine lens at the body as a system, and correcting the imbalances, it’s shocking to me what happens. I always remember when I start applying this, I was like, wow, you got better? I can’t believe it. You shouldn’t really get better, according to Western medicine.

Trudy: – Amazing, and you mention trauma. Even if someone has experienced trauma, if their nutritional status is good, they’re able to deal with it better.

Dr. Mark Hyman: – Right.

Trudy: – And maybe have less symptoms of post-traumatic stress.

Dr. Mark Hyman: – That’s right.

Trudy: – If they have a good nutritional status, and there’s a lot of good research supporting that.

Dr. Mark Hyman: – Absolutely.

Trudy: – You talk about that in the series as well.

Dr. Mark Hyman: – Yeah, absolutely. Your brain has the ability to be resilient, but if you’re nutritionally depleted, and if you’re having all sorts of inflammatory problems, if you’re eating foods you’re reacting to, or allergic to, your brain can’t work properly, so your baseline is going be much lower, but if you fix all those things, then your capacity to deal with your psychological issues, it’s not that they don’t exist, it’s that your ability to cope with them, to work through them, to heal and repair the more difficult things, which are early life traumas, or abuse, or addiction, these are much easier to deal with once you fix the basic constitution of the person.

Trudy: – Right. Now one thing that you talk about a lot in the Broken Brain series, which I really appreciate, is the fact that there’s so much over-medication.

Dr. Mark Hyman: – Yeah.

Trudy: – Can you talk a little about it today? And I know with your story, you also had anxiety, depression, and you were prescribed medications as well.

Dr. Mark Hyman: – Yeah.

Trudy: – So this is common.

Dr. Mark Hyman: – Yeah.

Trudy: – You talk about antipsychotics. You shared some pretty scary stats on the increase that we see.

Dr. Mark Hyman: – When you look at it, it kind of goes up and down, but psychiatric medication as a whole, is the number two or three most prescribed category of drugs in America, and increasing across the globe, and it’s being used instead of dealing with the real issues, and they don’t really even work that well. I mean, anxiety medications can work, but antidepressants have been shown really not to work that well for mild to moderate depression. For severe depression, they can be helpful, and they can be life saving for some people, but they’re not a panacea, and when I was a kid, there was that one kid in the class, Patty Ainsworth, who was a troublemaker. Now it’s like 10% of the class is on ADD medication. That’s a problem.

Trudy: – It is.

Dr. Mark Hyman: – And when we see one in four people have depression in their lifetime, and if the knee jerk reaction is medication, it just sort of gives people a sense of numbness, but it doesn’t really deal with the issue. So I think we are way over-medicated, and on top of that, there’s pushing of medications for off-label use, which means that they’re not approved for those indications. So they’re doing this for kids with antipsychotics, and they’re actually been sued. So the pharma companies have been held liable for promoting these drugs for off-label uses, which they’re not allowed to do, for kids. They get fined billions of dollars, but they don’t care because they’ve made umpteen more billions, and they just see it as a marketing expense. So it’s really discouraging to see what happens to the pharmaceutical use in this space, because even for example, ADD is so fixable by dealing with the root causes, and most of us not are not even trained how to think that way.

Trudy: – That’s why I love the Broken Brian series, because it offers a message of hope, offers some practical solutions, and it empowers the person who’s suffering from the brain disorder, whatever it is, anxiety, depression, dementia, you name it, empowers them with solutions, and I think the other thing is it’s going to give curious practitioners who are not on board with this functional medicine approach some insights into what the future may hold, which I think is very promising.

Dr. Mark Hyman: – Yeah. It’s very powerful. I remember this guy who read my book, The UltraMind Solution, which is really what the Broken Brain series is based on, and he was a doctor, and he had a kid with autism, and he said, “We’re so desperate. Our kids was five, he wasn’t talking. We just started with the diet. We just got him off gluten, casein, and a few days later, all of a sudden, he started talking in full sentences,” and this is a skeptical physician who witnessed this, and I see this all the time. Patients, for example, have Alzheimer’s, or dementia, or diagnosed with dementia, and it turns out they have other issues. They have heavy metal poisoning, or they might have Lyme disease in the brain, or they might have severe nutritional deficiencies, or they might be insulin resistant with high levels of sugar in their diet that are affecting their brain, and you can fix those things. There may still be issues left over, but it’s going to be much easier to deal with those after.

Trudy: – Get to the root cause, and address those root causes.

Dr. Mark Hyman: – That’s right. That’s the purpose of functional medicine, which is a medicine of why, not what, and we have all these labels, but you know, if someone comes into my office, and they’re hopeless, and helpless, have no interest in life, can’t focus, can’t sleep, don’t want to have sex, I know what’s wrong with you. Depression, but depression isn’t the cause of those symptoms, it’s the name of the symptoms. It doesn’t tell you what’s really wrong with that person. It’s could be a host of things, from low thyroid, to gluten, to mercury poisoning, to vitamin D deficiency, to B12 deficiency, to insulin resistance. All these factors can lead to depression. Same syndrome, but different causes. So I’m much more interested in addressing the causes, then you don’t have to use the medication.

Trudy: – And some people have an issue with gluten, and have autism symptoms, and someone else can have depression or anxiety or dementia.

Dr. Mark Hyman: – That’s right.

Trudy: – So it can affect different people in a different way.

Dr. Mark Hyman: – That’s a very good point. So in functional medicine, we see that one disease can have many causes, but on the other hand, one causative factor can create many diseases. For example, heavy metals may cause dementia, or autism, or depression, or anxiety, or insomnia, or gut issues can cause all these various things that are not one disease, or for example gluten, like you mentioned, can cause autoimmune disease, can cause cancer, can cause diabetes, can cause osteoporosis, can cause anemia, can cause depression, can cause even dementia. So how do you begin to think about it? Our current naming of diseases doesn’t make any sense. So all the labeling, if you look at the diagnostic criteria, we have something called the DSM-5, which is the diagnostic and statistical manual that categorizes and catalogs all the psychiatric disorders, and they’re all categorized by symptoms. So it’s all descriptive. It’s says if you have these five symptoms, you have this, but it doesn’t tell you why, and it doesn’t really help you, other than giving you a label, which doesn’t mean anything about helping you understand what’s really going on.

Trudy: – And then you’re on a medication that’s going to give you side effects, and not actually get to the root cause of the problem.

Dr. Mark Hyman: – Right.

Trudy: – And yeah, just make some nutritional changes, addressing the thyroid, getting off gluten, addressing the gut – big session in the Broken Brain series.

Dr. Mark Hyman: – Yeah, it’s huge.

Trudy: – The gut brain connection.

Dr. Mark Hyman: – I mean, we’re just learning about this. For example, for years one of the main ways I treated the brain was fixing the gut, and that means optimizing the flora, getting rid of bad bugs, helping heal leaky gut, and we just did it, we didn’t really have a deep understanding other than we knew the microbiome was important, but now we know, for example, that there are more bacterial molecules in your blood than your own molecules, that you have 10 times as many bacterial cells in you as your own cells, 100 times as much bacterial DNA, and that DNA is all producing proteins, and all those proteins, you have 20,000 genes, there’s two million genes of bacteria in you, and they’re all producing molecules that are entering your blood stream, and driving all sorts of biological reactions, that aren’t even human molecules. So we have to begin to sort of how do those affect the brain and what’s going on? And it’s very powerful.

Trudy: – And so much research in this area, it’s just growing and growing.

Dr. Mark Hyman: – Yeah.

Trudy: – So you mentioned earlier that you wanted to do this because of all the new research. There is so much research on the gut brain connection, nutritional psychiatry. Dr. Drew Ramsey talks about this recent study on depression, and just getting people onto a real whole foods diet, and how 30% saw remission of symptoms, just changing their diet.

Dr. Mark Hyman: – Of course.

Trudy: – Not even going gluten free. So it’s powerful. These small changes can have powerful effects.

Dr. Mark Hyman: – Profound, profound effects

Trudy: – Well, thank you so much.

Dr. Mark Hyman – Thank you.

Trudy: – For your wonderful work that you do. And for making time today. I highly recommend the Broken Brain series with Dr. Mark Hyman, all the wonderful experts.

Dr. Mark Hyman: – Oh, so many. We’ve got 57 experts.

Trudy: – Amazing, some of our favorite functional medicine practitioners.

Dr. Mark Hyman: – Yeah.

Trudy: – Thank you.

Dr. Mark Hyman: – Thank you.

(I’m a tad disappointed that there is the background noise of people talking – and apologize – but I am hoping the great content overrides this and it’s not too distracting.)

Save the date for the 8 -part Broken Brain docusersies, hosted by Dr. Mark Hyman – and register here. It airs January 17-25th

Here’s a list of ALL the episodes, to showcase just some of what you will have access to. Each episode will be available for 24 hours, at no-cost!

  1. The Broken Brain Epidemic / My Story (January 17)
  2. Gut Brain Connection: Getting to The Root of a Broken Brain (January 18)
  3. Losing Your Mind (Alzheimer’s, Dementia, MS, and More) (January 19)
  4. ADHD and Autism (January 20)
  5. Depression & Anxiety (January 21)
  6. Traumatic Brain Injury: Accidents, Sports, and More (January 22)
  7. 7 Steps to An UltraMind (Part 1) (January 23)
  8. 7 Steps to An UltraMind (Part 2) (January 24)

I hope you enjoy it and get as much out of it as I did!

I actually flew from Sydney to LA for this opportunity to meet and interview him, and share more about the Broken Brain series, and I’m so glad I did! It was the first time I’d met Dr. Hyman in person and it truly was an honor to be in the company of this great man who is doing so much in the functional medicine world! Again, here is that link to register

Please share if any of this resonates with you – what solutions you have found have helped you and/or what you are working on addressing now?

AN UPDATE: there has been some feedback on the term “broken brain” being too negative and even scary so I gathered some feedback and share it in this blog: Is the term ‘broken brain’ hopeful and real or too negative and scary? I really want to hear your thoughts if you are offended by the term broken brain.  I also want to share Dr. Hyman’s apology.

Midday bright light therapy for bipolar depression

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A recent study from Northwestern University and published in The American Journal of Psychiatry: Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial has found that midday daily exposure to 7,000 lux bright white light for 6 weeks, significantly decreased symptoms of depression and increased functioning in people with bipolar disorder.

The press release issued by Northwestern University reports as follows

Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD.). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects.

Compared to dim placebo light, study participants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light.

Images used with permission from Northwestern University

How the 7,000 lux bright light therapy was used

Here are the details of how the 7,000 lux bright light therapy was used in the study:

The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start.

Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.

Study lead author Dr. Dorothy Sit shares that starting low and slowly increasing the treatment made it more tolerable. None of the study participants experienced side effects, likely because the treatment was customized for each patient:

No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors.

A noticeable mood improvement with bright light therapy was also noticed as quickly as four weeks, which is similar to other light therapy research for non-seasonal depression and depression during pregnancy.

How do you do this in the middle of a work day?

You may have concerns about doing this at midday as this facebook follower voiced:

I guess if your bipolar depression is so debilitating that you cannot hold a job, then this is worth trying.

But 60 minutes!! What working person has 60 minutes in the middle of their workday?

It’s very doable because there are very nice desk versions that could easily be used at work (without anyone knowing – if privacy is a concern) or at a home-office desk for your convenience. I share some examples in this blog – Winter blues or SAD: light therapy.

I have tried lights in the morning but found that it caused agitation

I also received this feedback about increased agitation:

I have tried lights in the morning but found that it caused agitation. Over time my tolerance went down so that I could only use for less than 5 minutes. I haven’t ever tried midday light though. I’m not bipolar but I have depression which is generally worse in the winter. Exercise helps.

It may be worth trying midday light therapy if morning light therapy causes agitation or other adverse effects.

The press release mentions that light therapy is typically used in the morning to help reset circadian rhythms and the authors are unclear why midday light therapy worked for these patients with bipolar disorder. They plan to investigate further. If it is working via the same mechanism i.e. by resetting circadian rhythms, then it may well work at this time for other individuals too.

It may also be that your depression (and/or anxiety) is not caused by low serotonin but by something else instead – such as low catecholamines, poor thyroid health, gluten issues, poor diet and so on.

Using light therapy and tryptophan (or 5-HTP)

I have also found that some people do well on a combination of light therapy and tryptophan (or 5-HTP). One of my clients had many low serotonin symptoms and did better mood-wise and with reduced anxiety, on a small amount of tryptophan but still needed additional serotonin support. Additional tryptophan was too much for him and increased his day-time sleepiness, but using a small amount of tryptophan together with light therapy was the ideal balance for him.

Have you used light therapy with success – for the winter blues or depression or bipolar disorder? Or even for anxiety?

Have you ever used it at midday or at other times?

And have you used light therapy in conjunction with tryptophan or 5-HTP?