![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by dapper on November 5, 2009, at 23:59:36
Hey everybody, been quite some time since I have posted here. Long story short, I have spent years battling symptoms of depression, and have tried more meds than I can remember. I stopped taking any AD about 4 months ago, but I can't deny the struggle is still there. Severe lack of motivation, withdrawal, flatness, and constant thoughts of death still invade my mind far more than is normal. Never been a known precipitating factor, my life and surroundings have always been fairly good. I should be content, and enjoying my life and youth. I refuse to get back on to a medication dependence. My new method is to see if there is a root cause rather than continue to mask the symptoms. Now that I hold a job that gives me insurance, I am going to see an internist to discuss what I can look for to see if there is a root to my feelings of depression. Anybody had any luck in finding the root to their symptoms, or care to offer suggestions of what to bring up to the doc to look for? As with my past posts, all feedback and comments are appreciated!
Posted by emmanuel98 on November 6, 2009, at 0:09:28
In reply to Underlying cause, posted by dapper on November 5, 2009, at 23:59:36
If you're looking for a root cause, I would see a therapist rather than an internist. CBT/DBT therapists are particularly good at helping you identify thought processes that contribute to feelings of dysphoria. For sure, you should rule out hypothyroid and such, but CBT has a great track record in "curing" depression.
Posted by seldomseen on November 6, 2009, at 4:10:50
In reply to Underlying cause, posted by dapper on November 5, 2009, at 23:59:36
IMO there is no one underlying cause of depression. I think it is a multifactorial condition with mutiple etiologies. In fact, it reminds me a lot of cancer.
I think an internist is a great place to start, as they (hopefully) may rule out any problems with your heart, thyroid, anemia, dental problems etc...
Is there a history of depression in your family?
I've lived with depression my whole life and managed it actively for the past 10 years now, to some measure of success.
I went into treatment and therapy thinking (well, hoping actually) that I would have one of those infamous aha! moments like people do in movies. I would hug my psychiatrist, and after that all would be well.
It didn't happen. I had some aha! moments that connected my past to the way I was thinking today, but they just lead to more work on my part to try and correct my own behaviour.
I'm not saying this will happen to you, but for me it was sad to realize that this was the hand I was dealt, but I have no other choice but to play it.
Also, in my opinion, there is no magic pill that will take away all symptoms. I certainly have to do most of the work myself - directly challenging negative thinking, literally forcing myself to do *something*, and taking risks to make my life better.
I've even been known to ask myself "If I felt better, what would I do" and then I would drag myself out and do it. Sometimes I enjoyed it, sometimes I didn't. Oh well, not every day is the state fair you know?
That's not to say that I don't think meds have a place management of this illness, I certainly think they can help. Then again, I responded to the SSRIs and in that aspect, I was very very lucky indeed.
Now, I'm not saying that people can just think or behave themselves out of depression. Good lord knows I've heard enough "Hey! Cheer Up" in my life to make me scream. But, IMO, we do have some measure of choice that is independent of meds, or how we feel.
It's a condition I have to fight every day of my life. Sometimes I win, sometimes I don't.
Seldom.
Posted by Phillipa on November 6, 2009, at 10:25:50
In reply to Re: Underlying cause » dapper, posted by seldomseen on November 6, 2009, at 4:10:50
Excellent post seldom. Phillipa
Posted by bleauberry on November 6, 2009, at 18:27:02
In reply to Underlying cause, posted by dapper on November 5, 2009, at 23:59:36
Yes, I have had luck in identifying the root cause(s)...usually several intermingled together...one causes another causes another, and depression is just one of them mixed in it all.
I doubt an MD who takes insurance is going to be helpful however. It will really take an Integrative MD...some take insurance and many don't. They are full fledged MDs, also trained in naturopathy and all kinds of different tests that mainstreet MDs are not trained to do. To save money, you could go to an Integrative MD for just one visit to specifically request the test kits you want to take.
The best a mainstreet internest might do is a complete thyroid panel...freeT3, T4, TSH, and if you're luck, thyroid antibodies. You want it all. That is a good start. Very doubtful they will find anything in their routine tests or even special tests.
I can direct you to some of the most common things to focus your detective work on. The positive side is that you will not need much money, and you will not need a doctor, to test for these things.
Candida or yeast/fungi. Long story. Highly underdiagnosed, often not even viewed as a legitimate thing. Difficult to test for...the best lab test is a urine test that shows the telltale unique chemicals excreted by yeast hiding within you somewhere. A mainstreet doctor won't know anything about it, an Integrative MD will. An easier test is to try a couple antiyeast herbs and see what happens. Caprylic Acid, Oil of Oregano, very high dose garlic (has to be the smelly kind, the odorless has weak anti-infection action), Grapefruit Seed Extract, Pau D'Arco. A common diagnosis goes like this...feel better than you've felt in a long time for a couple days (the organisms have been paralyzed and suppressed but are not yet dead). Then you become worse than you were at the beginning. This is the die-off effect called the Herxheimer reaction...massive toxins from the dying and dead, can't flush out that much fast enough, so you become toxic until the pathogen load is lowered. At this point, you just made a diagnosis. Cost, maybe $12 per herb. And, you also already found the correct agent the organism, whatever it is, is susceptible to. No guessing.
A Herx reaction can be quite severe. It can land you in bed with what feels like the flu or worse. The degree of the Herx is a fairly good yardstick of the degree of infection. Keep in mind, the herbs mentioned are foods that healthy people eat or drink because they like the taste or the health benefits...no side effects. If you get real nasty side effects, you know for sure something is up. You the detective just found a criminal in hiding.
Lyme disease or similar. Highly under-recognized, highly underdiagnosed, high rate of false lab tests. There are a handful of organisms that co-infect with the Lyme bacteria, and equally as bad, or sometimes infections with those without Lyme. Either way, psychiatrict symptoms resistant to treatment are a hallmark clue, and almost universally common with almost everyone in the infected group. Antibiotics to try would be Doxycyline, Amoxycycline, Clindamycin. Again, the same scenario as the yeast thing...feel better almost right away, then a lot worse. Diagnosis made.
Herbs for the bacterial infection challenge tests would include Olive Leaf Extract and the same herbs mentioned above for yeast. They are all broadly antifungal, antibacterial, and antiviral. Herbs specific for Lyme include Andrographis, Coptis, Teasel Root, Cat's Claw, Japanese Knotwood. They are also broadly antimicrobial and pro-immune and anti-inflammatory.
Worms, Babesia, protozoa. Usually co-infections with something else. The herb Artemisia wipes them out in short order, more powerful than meds. Safe, nontoxic herb.
Toxic burden. Most likely would be lead or mercury. Especially if you have or ever had silver fillings in your teeth. But also plastics, pesticides, herbicides, petroleum byproducts. The chelation drug DMSA is prescription, but also available at online cheap as a food supplement. You would need an Integrative MD for this because they have access to the labs. You would take low doses of DMSA every 4 hours for several days (25mg per dose), then a whopping 1200mg as a single dose...collect urine prior to that dose and then collect urine the 6 hours after that dose. The lab compares the two. The warmup days were to loosen stored metals, the big dose was to gather all that loosened stuff up at once. Even without the lab test, if you felt really good for a few days, or really bad for a few days, either way, you would automatically know that something is up. Because DMSA at those low doses has no side effects. You can also do the single large dose with no warmup doses. A longer term chelation can be done with an algae called Chlorella, as it picks up all kinds of toxins, whereas DMSA is most specific for just lead and mercury.
Cortisol. A huge player as a symphony conductor of neurotransmitters and receptor sensitivity. You would need a saliva cortisol sample taken 4 times throughout a 24 hour period. Again, an Integrative MD has access to the test kits for this. I am convinced almost everyone with longstanding psychiatrict problems has severely disturbed cortisol patterns...either a direct cause of the depression or a result of it...either way it will require fixing. That involves trials of Siberian Ginseng, Rhodiola Rosea, Licorice Root, Adrenal Cortex extracts, Tyrosine, and in some cases (like me) ultra low doses of physiological replacement hydrocortisone (2.5mg-20mg, far lower than problematic doses used for inflammation).
Food sensitivities. Gluten and dairy are the primary ones. Both are easy to test by eliminating them from your diet for 2 weeks. It's a rough two weeks without the foods you are accustomed to, but worth it for the test. Rule it in, rule it out, at least you'll know in two weeks without a doubt. If you feel a lot better at the end of those two weeks, and then reintroduce gluten or dairy (one at a time) and begin to feel worse, bingo, you just made a diagnosis.
In any and all of these situations, it is no wonder psych meds were a deadend road. They did absolutely nothing to manipulate the chemistry involved in the mood disorder, and in fact made it worse often times.
A complicating factor is that it is usually not one thing or another, but probably a cluster of things. For example with me, silver fillings put enough toxins in me to weaken an otherwise strong body so that I was now a fertile opportunistic home for infectious agents. People can have Lyme disease and yet no symptoms. It is the weakened bodies that show the symptoms. Whether metals, yeast, bacteria, whatever...the thing that almost always takes a beating is the adrenal glands, and thus very dysfunctional cortisol, and therefore very dysfunctional neurotransmitters and receptors.
For anyone with longstanding psych symptoms, I feel these things should be a part of their daily routine:
Olive Leaf and/or Oil of Oregano, to lower pathogen load in the body.
Chlorella, to lower toxin load in the body.
A modest daily multivitamin/mineral, preferably a food-based one rather than chemical one.
Anything that can strengthen the body's ability to fight back is good.
A filter on the kitchen sink faucet (Aquasana) to remove all debris, chlorine, metals, chemicals, fluoride, bacteria, everything). Pure water, and lots of it.
If inflammation is suspected (definite if any of the above challenge tests prove positive), then an anti-inflammatory diet is heavy on veggies, fruits, and grains, with only 20% proteins. Limit sugars and caffeine. This is just the opposite of what many dieters suggest...which is a high protein low carb diet, which worsens inflammation issues.
Healing is longterm...months to a couple years. The rewards however can be quite dramatic and last the rest of your life. That is the difference between this type of healing and meds. True healing restores and endures. People who have truly been bedridden and waiting for death have been born again feeling 20 years younger and gone back to work and school with minimal symptoms, sometimes none. (permanent organic damage may have occured sometimes)
Yeast, bacteria, toxins, adrenals, foods...these are the primary areas for you to become an expert detective, because these are the areas where most people like you and me find they have severe hidden problems all along and never knew it. That's why the psych meds didn't work well. You can test all of these yourself with very little money, and in doing so will learn more about yourself than 50 years of internests will be able to tell you.
There are other causes of depression, but the ones I mentioned I am fairly confident cover about 90% of the spectrum.
In your trials, it would not hurt to go back to basics and try things like low dose tyrosine and/or low dose 5htp. I'm talking 1/10th the doses on the bottle, taken for at least a month, and increasing if no effect or hint of good effect, abandoning if bad effect. The primary cause of failure with these neurotransmitter makers is too much too fast.
So, of everything I have said in this post, how do we know these things are actually related to depression? We know this because there are literally thousands of personal accounts on the web from real people like you and me, with heartfelt stories that would make you cry. And because a small minority of doctors who specialize in this stuff have patients travel hundreds or thousands of miles to see them when word of mouth spreads that they are actually healing people back to life from hopeless situations. In all of these cases, it is one of the above issues that was at play. I am just one of tens of thousands.
Without much explanation or science, toxins clog receptors, destroy receptors, create enzyme roadblocks in manufacturing or neurotransmitters, disrupt hormones, disrupt immune system. No wonder then, the depression that results. No wonder a reuptake inhibitor was impotent.
Microbials secrete very powerful chemicals in their waste. These chemicals have a high affinity for our brain receptors, as well as corrupting our own serotonin and dopamine. No wonder the meds didn't work...we were increasing amounts of polluted neurotransmitters. The microbes are also devastating on the immune system and many biochemical functions. Depression is almost unavoidable with all this hidden unsuspected assault going on.
When a psychiatric med history is long, tortured, and unfruitful, that itself is a very powerful clue not to be ignored. It should not be viewed as a mystery or a disappointment. It is telling us something powerful and very loudly so...one of the above things I mentioned.
Posted by dapper on November 6, 2009, at 19:43:42
In reply to Re: Underlying cause, posted by bleauberry on November 6, 2009, at 18:27:02
Thanks Bleua, very informative response. The idea of the integrative MD is something I am looking for, and will probably pursue. Money, unfortunately, is a hurdle for me at this time. I would imagine running the tests, prescriptions and visits to this special MD could run over 1K? Might be worth it. Better to explore these possibilities than to leave them unknown. When you got to the root of your symptoms, did it change your life and make you realize you were definitely not feeling 'normal'? I mean, was the difference in outlook and mindset incredibly relieving? For all I know, how I feel is normal. But very hard to believe it's normal to feel the way I do daily. We all have a built in instinct saying 'something just ain't right'...
Posted by bleauberry on November 6, 2009, at 19:53:30
In reply to Underlying cause, posted by dapper on November 5, 2009, at 23:59:36
I want to now offer some ideas to help your mood. While detective work lies in your path, you need something right here right now without delay, to help you feel better and get on with your life.
In my last post I tried to save you years and years of wasted time, thousands of dollars looking in the wrong places, coming up empty handed, doctor shopping with no results. That is the typical scenario. I don't want to see that happen with you. Stay focused on the things that really truly cause serious depression that doesn't respond well to psych meds, and that is easily testable and treatable with nontoxic inexpensive substances.
Though it can look daunting when you are first exposed to it all, it really is pretty simple. It is not rocket science. Everything I talked about is simple, reliable, cheap, and for the most part self-directed. A doctor can help you along the way, but honestly, many of the most striking success stories belong to patients who took responsibility for their own health and treatment. As is seen all the time on the TV show Medical Mysteries. It is almost always the patient that discoveries the mystery, not the doctor. The doctor can then, however, help treat the discovered condition.
Comments on some substances that might help right away:
St Johns Wort. I doubt this one will help. But it could. There are a few stories at sjwinfo.org of people who have been on many ADs who found SJW to be fantastic. It happens. It is also a powerful antimicrobial, which could make you feel worse via the Herx reaction. Or if the whole increase-the-neurotransmitter thing made you feel worse, it might not be a good choice. Hard to tell. In any case, it is generally slow acting, not usually a quick cure.
Rhodiola Rosea. This one can work fast, 10 days or less. Many people including psychiatrists and wives of psychiatrists have been stunned by the effectiveness of this herb. It needs to be Siberian Rhodiola (not Russian or Chinese or any other) and standardized.
Siberian Ginseng (Eleuthero). This can be a very good antidepressant through a multitude of mechanisms, none of which are reuptake inhibition, but it takes time. With capsules it can take up to 6 months to get full benefit (2 caps 3 times per day). More than anything, it is a whole-body tonic that rebalances hormones, immmune system, and nervous system over time. It has mild MAOI action. It is not usually thought of as an antidepressant, but can be an excellent one. For faster more potent action, the liquid tincture made by HerPharm is on par with the good stuff used in Russian studies.
Olive Leaf Extract. What? Kidding? Seriously. This is never thought of as an antidepressant. Do a goodle search on Olive Leaf and depression and you might find a few tidbits here and there, but not much. But what happens very frequently is that patients are finding it very beneficial in things like Lyme, Chronic Fatigue Syndrome, and Fibromyalgia...with some of the noted benefits being more energy, less brain fog, and good mood. I can attest from my own trials of this herb, improvement of mood can be noted within a couple days. It needs to be a standardized capsule extract 500mg taken 3 times a day 20 minutes before meals. It can be increased as high as 3 caps 3 times per day, sometimes even higher. The very first thing you should notice is increased energy and wellbeing, probably by day 2 or 3. It is not a stimulant or an upper, but somehow has the effect of picking you up physically and emotionally. It is a Biblical herb, delivered to Noah as a sign the Great Flood was ended. I've been taking this herb myself for 2 weeks now and I am liking the benefits. Strong at first, more subtle now (some Herxing going on) but a definite keeper no matter what else I take or try. It is in the mix permanently.
Licorice Root extract. If you have low adrenal function, this will help. It also has mild MAOI activity. It slows down the enzymes that destroy your cortisol as well. And many other benefits on digestive system and immune system. This herb is a very common ingredient in most Chinese medicines because of its wide range of benefits on the body and mind.
I could get into some other things for you, but the above should keep you occupied for the near future. In order of preference, I would suggest:
Start Olive Leaf Extract at one 500mg standardized capsule 3 times per day.
After a week, add Siberian Ginseng at a low dose (1 to 3 caps per day) and plan on keeping it for at least 6 months. Don't count on it doing anything right now, just take it like a vitamin.
You are now on a real good whole-body whole-mind tonic booster fortifier, and you are already probably feeling a lot better.
Start Rhodiola Rosea as a bonafide antidepressant trial. This would be the big guns with antidepressant as the goal, if you feel you need it. You might not. I found enough benefit in other herbs to wait on Rhodiola. When I did try it, it made me feel worse...but not to scare you, this is very rare...I only found one other person who had that experience. Almost all others are very positive. Energy will be a side benefit. If jittery, the dose is too high.
At any time you can experiment with Licorice root. Just be stabilized on whatever else you are taking so that you can judge what Licorice feels like.
If sleep or nervousness are ever issues, good choices are Passionflower, Skullcap, Valerian, Herbsom.
Keep in mind, these are not nuclear bomb single function substances like the psych meds were. These are very wide spectrum multifaceted substances that offer a concert of benefits throughout the body and mind and in harmony with the body. They are medicinal foods. Without even knowing what the cause of your depression is, these plants suppress a wide spectrum of them and strengthen your body to naturally overcome them.
In my wildest dreams I never would have expected that someday I might be suggesting Olive Leaf Extract to someone for mood problems. It really is a keeper. The success stories with it are quite fascinating. Better mood is just a side effect. A nice one.
Posted by softheprairie on November 8, 2009, at 5:54:21
In reply to Underlying cause, posted by dapper on November 5, 2009, at 23:59:36
This will probably only be a partial answer, but you might inquire about getting a lab reading of your vitamin D-25 Hydroxy and then possibly having an idea of how far you are from optimal (even many readings that say they are normal are suboptimal).
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.