depression

Time magazine: ketamine is NOT the solution for treatment resistant depression!

August 11, 2017 By Trudy Scott 25 Comments

Seen at LAX airport en route back to Australia – this cover of Time magazine:

The Anti Antidepressant. Depression affects 16 million Americans. One third don’t respond to treatment. A surprising new drug may change that.

It’s scary to think that ketamine and ketamine-like drugs are being considered the solution to “treatment resistant depression”. I’ve never liked this term and in my opinion, what it really means is that the root cause of the depression has not been found. To me it looks like the mainstream medical mental health community is desperate!

It really is time to get all the well-researched nutritional psychiatry approaches to the forefront! They do work! The timing of this article is even more interesting since I was returning from the first international meeting of the International Society for Nutritional Psychiatry Research in Bethesda, MD.

Lead food mood researcher Professor Felice Jacka presented her SMILES paper where dietary changes from a junk food diet to a real whole foods diet reduced depression in 30% of the participants.

Microbiome researcher Professor John Cryan discussed the gut brain connection. This paper: Recent developments in understanding the role of the gut microbiota in brain health and disease, was published just last week:

recent preclinical and clinical evidence suggest that targeting the microbiota through prebiotic, probiotic, or dietary interventions may be an effective “psychobiotic” strategy for treating symptoms in mood, neurodevelopmental disorders, and neurodegenerative diseases

And research on sulforaphane for psychosis, and depression and anxiety was presented: Sulforaphane produces antidepressant- and anxiolytic-like effects in adult mice

these findings demonstrated that SFN [sulforaphane] has antidepressant- and anxiolytic-like activities in stressed mice model of depression, which likely occurs by inhibiting the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory response to stress. These data support further exploration for developing SFN [sulforaphane] as a novel agent to treat depression and anxiety disorders.

I presented on the benefits of a gluten-free/grain free/Paleo diet for certain individuals for depression and anxiety, and did a poster presentation on GABA for eliminating anxiety.

As you can see from the TIME Magazine article the only approaches that have been considered (and have failed) are medications in various different combinations:

Every week, when Ian Hanley sits down with his therapist, he goes through a list of depression treatments he’s been researching online. The best-known treatments at the top of the list–half a dozen antidepressants and known combinations of those drugs–are all crossed out….

Most diagnoses do not come with 20-plus medicines approved by the Food and Drug Administration to treat it–and yet with depression, more options don’t always mean better outcomes. Ever since the first antidepressants were introduced 60 years ago, doctors have had patients like Hanley–people who don’t seem to get better even after they’ve worked their way through the lengthy list of available drugs. About 30% of all people with depression don’t respond adequately to the available treatments. That’s a dismal failure rate for a class of drugs designed to improve a person’s basic ability to function.

According to this article in Time magazine:

The biggest development has been the rediscovery of a promising, yet fraught, drug called ketamine. It’s best known as a psychedelic club drug that makes people hallucinate, but it may also have the ability to ease depression–and fast. In a race to shape the next generation of antidepressants, Johnson & Johnson and Allergan are fast-tracking new medicines inspired by ketamine.

I encourage you to read the entire article and take note of the following: the side-effects seen with medications over the years and the fact that doctors “don’t know the consequences and potential side effects of taking tiny doses of ketamine over and over again”; “she tried nearly everything” (you’ll read this in all the articles advocating for ketamine but unfortunately they are only referring to medications); the ketamine effects are temporary and cost $15,000 per year (and are not covered by insurance); and ketamine “is thought to stimulate an opioid receptor in the brain” and is already known to be addictive.

When I shared this image and article on my Facebook page I discovered that is a pretty divided topic with a number of people feeling really strongly about the fact that this approach needs to be researched further and considered. I acknowledge their concern for the individuals who have not found a solution for their depression. BUT my question is this: have all the dietary and nutritional approaches been considered and looked into with these people who have not responded to antidepressants?

I strongly believe that ketamine is NOT the solution and that nutritional psychiatry is!

Have you used this ketamine approach personally or with patients?

Would you consider using ketamine personally if the antidepressants didn’t work for you? Or would you be more willing to work with a functional medicine or functional nutrition practitioner to find your true root causes and address them with diet, nutrients and a functional medicine approach?

Trudy’s coconut seed bread recipe (modified from The Real Meal Revolution)

July 21, 2017 By Trudy Scott 27 Comments

My favorite “bread” and the only one that I can actually eat right now is a coconut seed bread that I bake myself. I adapted a recipe from Tim Noake’s wonderful book The Real Meal Revolution, a recipe book from where I grew up – South Africa.

Why I modified the recipe

I opted to leave out the sunflower seeds and almond flour because of the higher levels of oxalates in these seeds and nuts. I have an oxalate issue right now but I’m also concerned with all the nuts that I see in Paleo recipes. Another possible issue for someone with anxiety and low zinc is the high copper levels in nut flours.
I typically don’t add sugar or anything sweet to baked goods so just left out the stevia/xylitol
I love coconut anything so why not try all coconut flour – it worked out great!

The ingredients and recipe for my version

0.5 cup ground flax seeds (freshly ground)
1.5 cups coconut flour
2 tablespoons psyllium husk
250g / 1 cup plain Greek yogurt
6 organic or pastured eggs
10ml /2 teaspoons aluminum-free baking powder
0.5 teaspoon sea salt

Grind the seeds and mix all the dry ingredients in a bowl.
Mix the wet ingredients and combine with the dry ingredients using a wooden spoon.
Pour into a loaf pan that has been greased with butter.

Bake at 350 F/ 175 C for 50 minutes. I check it at 40 minutes and then take it out at 50 minutes once it starts to look brown on top and on the sides (I use a glass/pyrex loaf pan).

How to enjoy it?

It’s lovely eaten right away, warm and with loads of butter. I slice it thinly and keep a few slices in the fridge and freeze the rest in batches to use as needed through the next few weeks. It freezes really well and needs about 30 minutes to thaw at room temperature.

A few days a week I’ll have a slice with butter (I love butter!) and soft-boiled eggs, topped with whatever fermented vegetables we have on hand, and a side of avocado and left over vegetables from dinner the night before.

In case you’re curious, on this particular day, I used Kehoe’s Kitchen Fermented Paleo Mustard Pickles (it has a lot of cauliflower) and Kehoe’s Kitchen Beetroot & Ginger Sauerkraut. Both of these products are firm favorites in this household!

Similar products in the USA are made by The Brinery or FireFly Kitchens (just search online for “organic fermented vegetables”). Or make your own!

Remember if you buy fermented vegetables make sure to get them in the refrigerated section of the store. They need to be RAW in order to get all the benefits of the good bacteria for gut health and balancing your microbiome, and ultimately helping with reducing anxiety and depression.

The original recipe

Here is the original recipe from Tim Noake’s book (I don’t have the recipe book in hand right now as it’s still packed away with our move but I think this is the original)

0.5 cup ground flax seeds (freshly ground)
0.5 cup ground sunflower
1 cup almond flour or coconut flour
2 tablespoons psyllium husk
250g / 1 cup plain Greek yogurt or sour cream
6 organic or pastured eggs
10ml /2 teaspoons aluminum-free baking powder
0.5 teaspoon sea salt
Pinch stevia or teaspoon xylitol

Optional: Cinnamon, caraway seeds, pumpkin seeds, various chopped nuts and/or cranberries/raisins

Tim Noakes and anxiety and depression success stories

Here is some additional information about The Real Meal Revolution. It started out as a Banting recipe book and has grown into a movement in South Africa. Banting is similar to Paleo but does include dairy. My darling sister gave me a copy of this very popular book on one of my trips back to visit family and I really like it! It is fastest selling cook book in South African history with over 200,000 copies sold and is now available internationally in the UK, Australia and New Zealand.

In this blog post about anxiety and depression success stories when eating Paleo and grain-free, Alice shared this about her change to a Banting way of eating:

Three days after I stopped eating grains, my chronic depression lifted and has never returned (it’s three years later now). I had been a vegetarian most of my life, discovered in my early 50s that I was gluten intolerant, went off grains, started banting (Cape Town craze!) and have never felt better. Gut, mood, bones, energy, skin … all better!

Let us know if you try this recipe and enjoy it and do share some of your favorite fermented vegetable companies or recipe books.

And do let us know if you do better on a grain-free diet.

Migraines, anxiety, depression and gluten: on the Chronic Headache & Migraine Summit

June 26, 2017 By Trudy Scott 5 Comments

The goal of a 2015 Russian study titled Gluten Migraine, was to study the prevalence of migraine among patients with celiac disease and to assess the efficacy of a gluten-free diet in its treatment. There were 200 celiac disease (CD) patients and the

CD group had migraine syndrome four times more often than the control group. The attacks were more frequent in CD patients who were older than 50 years old.

The migraines disappeared in 25% of patients with migraines who were on the gluten free diet and the reduction in the intensity and/or frequency of attacks was observed in 38% of patients.

This is the study conclusion:

We revealed the clear association between migraine syndrome and CD and the high efficacy of gluten FREE diet in the treatment of migraine symptoms.”

I would suspect similar results if you have gluten sensitivity. And here is some gluten-migraine feedback from 4 different women in my community:

HUGE decrease in my migraines now that I eat more cleanly. I used to start to get headaches immediately upon eating gluten-y meals
I had them frequently from teenage years right up until my Celiac diagnosis in my thirties. Once gluten was gone so were the migraines
Stopping gluten stopped my migraines
My migraines always came from gluten and dairy

Of course there is also an anxiety-gluten and the depression-gluten connection so getting the gluten out of your diet will help with both anxiety and depression most of the time too.

I talked about all this on The Chronic Headache & Migraine Summit.

The other topic I covered is the autoimmune condition called Antiphospholipid Syndrome (APS) which is one of many possible contributing factors for both migraines and anxiety. Of course, with any autoimmune condition gluten removal is key.

I also cover low serotonin as one possible cause of migraines (and anxiety) and the use of tryptophan (instead of SSRIs). An amino acid like tryptophan or GABA also helps you break the gluten addiction so you don’t have to rely only on willpower!

Have you got questions or comments? Please post in the comment box below.

Prozac Nation Is Now the United States of Xanax in New York Times Magazine: my response

June 23, 2017 By Trudy Scott 11 Comments

This is the title of a new article recently published in the New York Times Magazine: Prozac Nation Is Now the United States of Xanax. In other words, depression has been surpassed by anxiety and the antidepressant Prozac has been replaced by Xanax (and other benzodiazepines /anti-anxiety medications) by the US population!

It’s an excellent read for creating awareness about anxiety and benzodiazepines but also sad because there is so much we can do and no solutions are offered. Here are some startling stats shared in the article:

According to data from the National Institute of Mental Health, some 38 percent of girls ages 13 through 17, and 26 percent of boys, have an anxiety disorder. [Note: this was quoted in the article. I’m trying to track down the source because an article in Time Magazine last year says this: ‘About 30% of girls and 20% of boys–totaling 6.3 million teens–have had an anxiety disorder, according to data from the National Institute of Mental Health’ as of 2015.]
On college campuses, anxiety is running well ahead of depression as the most common mental health concern, according to a 2016 national study of more than 150,000 students by the Center for Collegiate Mental Health at Pennsylvania State University. [Both anxiety and depression have shown slight but persistent increases each year for the past six years]
Meanwhile, the number of web searches involving the term [anxiety] has nearly doubled over the last five years, according to Google Trends. (The trendline for “depression” was relatively flat.)

I’m the optimistic type, I’m proactive and I like to give hope as well as solutions – and I have quite a bit to say about this article so here goes.

#1 Too many people are prescribed benzodiazepines without knowing what they are getting into

The article does not address the issues with benzodiazepines: how too many people are prescribed benzodiazepines without knowing what they are getting into, with many suffering dreadfully and never offered nutritional solutions. When I shared the article on my facebook page, someone in my community shared this (and gave me permission to share it further in the hope someone else will be spared her suffering)

Been totally disabled by benzo for 3.5 years. I have been off meds for 17.5 months and the impact of these meds makes any anxiety I ever felt a cake walk. Please run from the poison. Find healthy foods, nutrition and take the break your body is begging you for. We need to listen to our bodies! If it is screaming with anxiety maybe you need to make some life changes. I wish I did instead of taking a med that has almost destroyed me.

I asked her what symptoms she was experiencing, and as well as suffering from severe motion sickness (so badly she can’t even leave her home) she also shared this:

I have locked shoulder muscles, neck, jaw; I have internal vibrations, I get bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks, my teeth all feel like they will fall out but they are not lose, it feels like adrenaline or cortisol rushes through the body. Sometimes arms go numb. I am pretty tortured every day. These meds are truly causing chemical warfare on some of us.

I believe this will be the next big epidemic and I hope I heal somehow to help others

She had been on a variety of benzodiazepines, SSRIs and other medications for over 17 years and you may think this is an isolated incidence. I assure you it is not – just read the list of the most common psychological and physical symptoms of benzodiazepine withdrawal.

Here is some useful information about the risks and dangers of benzodiazepines:

#2 Let’s help anxious individuals like you find solutions

Scott Stossel, journalist and author of My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind was quoted as saying this in the article:

The silver lining for those with nervous disorders is that we can welcome our previously non-neurotic fellow citizens into the anxious fold.

My first response to the article is this: I say NO to Scott Stossel and instead I say let’s think bigger and instead let’s invite the anxious citizens into the calm and no-more-anxiety fold!

Scott’s book is well-written book, offers an excellent understanding of what it feels like to experience anxiety and panic attacks, and has many compelling stories. But as a number of his Amazon reviewer’s say the big question is this: what is the answer or solution? Unfortunately it’s not provided in his book (or the New York Times Magazine article).

The New York Times Magazine article provides another anxiety resource that has helped “bring anxiety into the open, and allowed its clinical sufferers to band together in a virtual group-therapy setting”: The Sarah Fader on twitter, creator of the hashtag #ThisIsWhatAnxietyFeelsLike and a mental-health advocacy organization called Stigma Fighters.

Again, these are wonderful resources for support, awareness and advocacy but they don’t offer solutions if you suffer from anxiety. With nutritional solutions we can change this to #ThisIsWhatCalmFeelsLike.

#3 Too few people know about nutritional solutions

Too few people know about nutritional solutions and that has to change. Clinically we know it works and there is now SO much research supporting this approach.

Here are a few of many blog posts on my site that share powerful anxiety nutrition solutions:

Here is one of the latest food and mental health studies – A modified Mediterranean dietary intervention for adults with major depression: Dietary protocol and feasibility data from the SMILES trial

This and other dietary and nutritional approaches for both depression and anxiety will be presented at the upcoming International Society of Nutritional Psychiatry Research conference in Bethesda, MD next month)

Here are two book resources too: my book The Antianxiety Food Solution and integrative psychiatrist Kelly Brogan’s book A Mind of Your Own.

I’d love your feedback

Which nutritional solutions topics do you have questions about and in what areas do you still need help?
What ideas do you have for getting this nutritional solution message out in a bigger way?
What do you wish you’d known when you were first diagnosed with anxiety and prescribed medication (such as a benzodiazepine or SSRI)?
How do we convince the naysayers that this does work and is worth implementing?
How do we get the mainstream mental health community on board?
What anxiety resources do you have to share

Depression as a black dog that comes in and lays down beside you at night

May 26, 2017 By Trudy Scott 18 Comments

Trevor King’s interview about his journey with depression – on That Vitamin Summit – is not to be missed if you are depressed, have ever suffered with depression or if you have a loved one or friend with depression. He shares how he feels a sense of complete hopelessness at times:

It descends like a black cloud that makes me almost sort of retreat into myself. And my eyes will know and I don’t want to take the world in. I don’t want to get out of bed at times. Actually, that’s one of the things that … one of the only things that actually helps me, is going to bed and lying down.

Winston Churchill famously described it as this black dog who’d come in and lay beside him at night.

“From the moment my eyes opened in the morning, I am engaged in a battle. I must protect myself with armor against ongoing, negative, intrusive thoughts that flood into my brain, while sending my prefrontal cortex, which is the home of logical thought, the green light to make decisions and take charge of my brain’s limbic system. That is, before the fear center completely spazzes out. I spend more time and energy chasing and maintaining good health than I do in any other aspect of my life. My marriage, family or work. Because I know that everything meaningful and good around me depends on a stable base. And I hope and pray that one day, I don’t have to fight so hard for my sanity.”

He talks about how he is affected by sugar and low blood sugar, and how he’s found some benefits with niacin, chromium, magnesium and tryptophan (when he’s consistent with taking them!).

Trevor actually talks about the GABA interview I did with him a few days earlier and how he’s very interested in what he learned. He is planning to do a trial of GABA to see if it can help him further.

Here is a snippet from my interview on GABA (so do tune in to this interview if you’re new to my work and the targeted amino acids):

GABA is really quite profound. When I had my anxiety, GABA was my lifesaver. It completely turned my life around. Within three days of using GABA, the panic attacks stopped and the anxiety started to go down, and then I had to look for all the other root causes. It worked immediately so I’m a complete believer, just because I’ve experienced it myself. You’ll hear a lot of people say GABA won’t work. It doesn’t cross the blood/brain barrier so it’s not going to have an impact.

We’ve now got research showing that there may be ways that it crosses the blood/brain barrier. We’ve also got research showing that we have GABA receptors in various parts of our body. We’ve got a lot in our muscles, and with low GABA symptoms you’ll have physical tension.

The beautiful thing is it works. It works quickly, and if you have these low GABA symptoms, which is the physical anxiety, which could be panic attacks. It could be stress eating, it could be drinking to calm down. If you are the kind of person who needs wine to wind down at the end of the day, that’s a big sign that you may need GABA. You take the GABA and you just feel this physical tension release from you, you know you’re onto something good.

I just wish I’d known about his struggles with depression at the time of our interview – I would have talked more about tyrosine for dopamine support (for curl up in bed depression) and DPA for endorphin boosting (for low endorphins weepy depression).

I did discuss gluten and would consider this especially since his daughter has issues with it. I talked about low serotonin and mentioned Lidtke tryptophan. If someone doesn’t do well on another brand I’d have them trial the Lidtke brand. I’d also look into SIBO – I have SIBO and rice and grains make me feel flat and low and I see this often with clients. Finally I’d look into lithium orotate for keeping an even mood.

Trevor shares these wise words at the end of his interview:

You do find that when you actually bite the bullet and share it with people,

people are very, very understanding. And actually, you’re amazed that many people have been there themselves.

I could not agree more which is why I’ve always shared my journey with anxiety. I appreciate him for being willing to share his story with depression!

If you’re not already registered here is the registration link for That Vitamin Summit

Feel free to post questions or feedback below – and share your story with anxiety or depression if you feel drawn to do so

Anxiety, depression, GABA and cortisol: effects of Lactobacillus ingestion

April 14, 2017 By Trudy Scott 23 Comments

We now know that good bacteria or probiotics have the potential to alter brain chemistry and have an impact on anxiety and depression. You may recall my interview with Professor Ted Dinan on a prior Anxiety Summit – Microbes in the gut and psychobiotics as a potential treatment for anxiety and depression. He shared his paper and this definition of Psychobiotics: a novel class of psychotropic.

…we define a psychobiotic as a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness. As a class of probiotic, these bacteria are capable of producing and delivering neuroactive substances such as gamma-aminobutyric acid and serotonin, which act on the brain-gut axis.

Research published by Dinan, Cryan and their teams also found benefits of Lactobacillus rhamnosus on stress, anxiety and depression type behaviors in mice. This is older research (published in 2011) but it’s the first time I’ve shared it on the blog. I talk about this paper in the upcoming Microbiome Medicine 2 Summit so I like to share study excerpts and links to the study.

The write up in Science Daily is a good one – Mind-Altering Microbes: Probiotic Bacteria May Lessen Anxiety and Depression

…mice fed with Lactobacillus rhamnosus JB-1 showed significantly fewer stress, anxiety and depression-related behaviours than those fed with just broth. Moreover, ingestion of the bacteria resulted in significantly lower levels of the stress-induced hormone, corticosterone.

The part that I find fascinating is the effects of Lactobacillus on GABA receptors in the brain (GABA is your main calming neurotransmitter):

The researchers also showed that regular feeding with the Lactobacillus strain caused changes in the expression of receptors for the neurotransmitter GABA in the mouse brain, which is the first time that it has been demonstrated that potential probiotics have a direct effect on brain chemistry in normal situations.

In this paper the authors discuss the vagus nerve and the three-way communication:

…the vagus nerve is the main relay between the microbiome (bacteria in the gut) and the brain. This three way communication system is known as the microbiome-gut-brain axis and these findings highlight the important role of bacteria in the communication between the gut and the brain, and suggest that certain probiotic organisms may prove to be useful adjunct therapies in stress-related psychiatric disorders.

What is even more fascinating is this:

the neurochemical and behavioral effects were not found in vagotomized mice

What does this mean? When the researchers severed the vagus nerve in the test mice – removing the communication between the gut and the brain – they found that the behaviors and stress hormone levels reverted back to the way they had been i.e. the vagotomized mice were more anxious, more stressed, more depressed and had higher corticosterone levels.

You can find the abstract of the paper here: Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve.

What does this mean for you? It means that good bacteria in your diet could well improve your anxiety and depression symptoms and even have an impact on your adrenals and cortisol levels. This could be in the form of a good probiotic and should always include fermented foods like sauerkraut, kimchi, kombucha, yogurt and kefir (if dairy is tolerated), water kefir (if dairy is not tolerated).

Have you observed an improvement in your anxiety and stress levels since adding a probiotic or fermented foods into your diet?