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Guts and Brains and Hormones, Oh My!

Published on November 4, 2013

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When a woman experiences fatigue, brain clouding, flat mood, PMS, and constipation, we call it anxiety or stress and we stick her on an antidepressant that she will likely take for the rest of her life. Where in this protocol have we investigated why she is feeling that way? How have we personalized the treatment to her unique biochemistry? What is the plan for side effects including new and different psychiatric symptoms resulting from this prescription? We haven’t. We’ve applied a one-size-fits all treatment to mask symptoms without consideration for the cause.

The Immune System and Depression

Psychiatry has known about the role of the immune system in certain presentations of depression for the better part of the last century, and more recently, pioneering thinkers like Maes, Raison, and Miller have written about the role of altered immune set points and inflammation in models of depression. Our immune systems are largely housed in the gut and the interplay between the gut and the brain is a complex and profoundly important relationship to appreciate.

We all recognize that anxiety or nervousness can impact our guts – most of us have had butterflies before a date or even diarrhea with extreme performance anxiety? We are just learning that this relationship is bidirectional; however, and that the gut can also communicate its state of calm or alarm to the nervous system. We think that the vagus nerve is a primary conduit of information and that inflammatory markers are the vehicles traveling this highway. Scientists have studied the “protective effects” of severing this nerve when animals are exposed to gut-related toxins that normally cause depressive symptoms. We are getting ahead of ourselves; however, because we need to better elucidate why inflammation matters, where it comes from, and why it is the universal driver of chronic illness.

How Does Inflammation Start?

When a woman feels foggy, run-down, easily overwhelmed, and flat, we know that her hormones as messengers between her gut and brain are out of balance. From my perspective; however, hormone derailment is a downstream effect of cellular dysfunction from oxidative stress and inflammation. Inflammation stems from many sources, including, hallmarks of the modern American lifestyle:

Sugar. Sugar, particularly in the form of fructose and sucrose, spikes insulin and triggers release of inflammatory cytokines. It forms advanced glycation endproducts when it binds to proteins, and oxidizes lipids which form cell and mitochondrial membranes.
Chemicals. Pesticides, environmental pollution from industrial waste, hormonally-modulating plastics, fire retardants, and cosmetic additives all stimulate our immune systems to varying extents and disrupt optimal production of energy on a cellular level, particularly in vulnerable tissues like the thyroid.
Pathogens. The aforementioned culprits, and notably herbicides, gluten grains, and genetically modified foods, promote intestinal permeability, changes in our intestinal flora that facilitate growth of pathogenic bacteria, yeast, and fungus which keep our immune systems in a state of alarm,
Stress. This catch-all term, broadly defined, represents the ultimate link between hormones and inflammation, because stress, whether it’s psychological or physiologic, triggers the release of cortisol. Cortisol helps to mobilize blood sugar so that you can run effectively and efficiently from that tiger chasing you. It also acts as a systemic immune suppressant, lowering levels of secretory IgA, an important body guard of the gut mucosa.

Cortisol and insulin are like stress-response sisters, and high cortisol states will also contribute to insulin resistance, or high insulin and high sugar while the cells, themselves, are starving. Insulin protects fat storage (inhibits lypolisis), and fat cells secrete their own inflammatory signals in addition to aromatizing testosterone to estradiol contributing to states of estrogen dominance, while also increasing DHEA and androgens to fuel that process (as well as acne, hair growth, and agitation).

Cortisol also inhibits the conversion of storage thyroid hormone to active hormone leading to states of hypothyroidism even with normal-looking labs.

What Does Inflammation Do?

Once inflammation is active, it is highly self-perpetuating. These inflammatory cytokines travel throughout the body causing oxidating stress to the fragile machinery of the tissues and mitochondria, specifically. In the brain, inflammation serves to shunt the use of tryptophan toward production of anxiety-provoking chemicals like quinolinate, instead of toward serotonin and melatonin. They produce a replicable collection of symptoms called “sickness syndrome”, noted for it’s overlap with “depressive” symptoms: lethargy, sleep disturbance, decreased social activity, mobility, libido, learning, anorexia, and andhedonia. Psychiatric researchers have observed that patients with higher levels of inflammatory markers (like CRP) are less likely to respond to antidepressants, and more likely to respond to anti-inflammatories.

Where Do We Begin to Heal?

How is any of this good news? This approach to chronic illnesses like depression views it as a complex, non-specific symptom reflecting a state of bodily disharmony. It isn’t that you were born with bad genes or low serotonin. It is far more likely that you are experiencing an unhealthy inflammatory balance, driven by cortisol dysfunction, and stemming from a sick gut. We can come at modifying your system from many angles, but here is a basic starter kit:

Exercise – Burst exercise is my primary recommendation. It is the most bang for your buck in terms of cardiovascular benefit and specifically enhancing mitochondrial health because it puts a special kind of stress on the body when you move to your max for 30 seconds that then recover for 90. I recommend 8 intervals 1-3x/week.
Meditation – The effects of stimulating the relaxation nervous system, even through listening to a 20 minute guided meditation, can be far-reaching. Enhanced genomic expression of anti-inflammatory genes and suppression of inflammatory ones was demonstrated in this study.
Diet – I recommend a diet that controls for glycemic fluctuations through elimination of refines carbs and grains, and through high levels of natural fats to push the body to relearn how to use fats for fuel. This is the brain’s preferred source. I discuss some therapeutic foods here.
Strategic supplementation – Natural anti-inflammatories like polyunsaturated fats (evening primrose oil and fish oil), curcumin (the active component of turmeric), and probiotics to name a few, can help promote a synergy of beneficial effects from the above interventions.

In my practice, despite some suggestion that antidepressants may actually be having their effect through an anti-inflammatory mechanism, these medications have become obsolete. An appreciation of the role of inflammation and immunity in driving hormonal imbalance which directly impacts mood, energy, and wellness, is at the core of personalizing the definition of “depression”. Don’t be lured into the simplicity of a one disease-one drug model. There’s no room for you in that equation.

About the author. Dr. Brogan is an M.I.T/Cornell/Bellevue-trained psychiatrist specialized in holistic women’s health. She is a mother of two and has a busy practice in Manhattan. A passion for understanding the intersection between health, nutrition, and the environment are the bedrock of her wellness approach with patients and at home. Visit her site at: Kelly Brogan, MD, Holistic Women’s Health Psychiatry.

References

Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Miller et al Biol Psychiatry. 2009 May 1; 65(9): 732–741.

Cytokines and cognition – The case for a head to toe inflammatory paradigm. Wilson et al. JAGS 50:2041–2056, 2002.

A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression: the role of baseline inflammatory biomarkers. JAMA Psychiatry 70:31–41.

Not Endometriosis. Now What?

by R S

Published on June 25, 2013

23643 views

I was functioning under the assumption that I had endometriosis. It seemed the most likely disease based in the information given me by my doctors. I underwent a diagnostic laparoscopy and waited for my surgeon to follow up with me.

It’s Not Endometriosis

As it turns out, I don’t have endometriosis and my internal structures appear normal. I’ve been referred to a pain management specialist. It has been suggested that I might see a neurologist as well. “If we can’t find the cause, we can at least treat the symptoms. You may have a rare form of cystitis, or you may not. Please try to focus on the good news: you don’t have cysts or tumors or scar tissue,” said my surgeon. I admit I was very disappointed in a strange way. It’s the very human need for an explanation. Without a known cause, how can we stop this from returning again?

Four days after surgery, I got food poisoning. I recovered after five days.

However, now I am terribly dizzy and have severe fatigue. Is it related to the endometriosis-like abdominal pain or something else? I can barely stay awake. In fact, I sleep most of the day and night. It’s not sleepiness. I simply cannot stay conscious. I’m always hungry and eating, but I’m losing weight slowly. There is ringing in my ears on and off. I find myself confused by simple tasks. I tried to fry an egg on a good day and found I couldn’t lift the pan. I’ve fainted twice last week: once after a blood draw, and once just in my home after a stressful conversation.

My general practitioner has run blood tests for anemia, vitamin deficiency, diabetes, and thyroid disorders, as well as a comprehensive blood count. He also told me that most of the time, when trying to diagnose fatigue and dizziness, these blood tests come back normal. I should be prepared to search for other answers. Diabetes and thyroid disorders run in my family, and I’m really hoping it’s easily found out so I can find treatment soon. My ears were checked for infection, and they appear fine. He also suggested that it could be severe depression, but I’m not so sure. I’ve had depressive episodes before, and while I was sluggish and slow to make decisions, I wasn’t this dizzy or weak.

Symptoms that Led Us to Suspect Endometriosis

As for the pelvic pain, it started in late November, very sharp and stabbing on the right-hand side over my ovary over the course of two days, growing rapidly more painful. The ER docs said it was a ruptured ovarian cyst, and noted that when pressed, my left ovary was very tender and painful as well.

That pain was supposed to heal in three to five days and just didn’t, growing less stabbing. It was a constant ache, day and night, for four months over my right lower quadrant with intermittent sharp cramping. When pressed, my left lower quadrant was just as painful, but didn’t throb or cramp on its own.

A course of progesterone halved the pain. Birth control dampened it a bit more. Hot baths and heating pads also helped somewhat. Exercise made it much worse, as did standing and walking for even short periods or leaning over. Pelvic exams and ultrasounds also hurt very much. Going to the restroom hurt terribly.

What really helped was removing the benign tumor in my colon. Some of the pain had been very bad intestinal cramping throughout my abdomen. I have most of my mobility back now. Occasionally, it will feel like there are hot, throbbing points in my pelvis for about three to six hours at a time, usually on the right side. Advil, a heating pad or ice pack, and lying very, very still help.

Also, since November, my periods have been dreadful. Terrible cramps like I’ve never had, and the week before and after my period, I’m very tender throughout my pelvis and it feels like I’ve thrown my lower back out. They never used to be this way.

After the laparoscopy, where everything was found normal, I had sharp, hot throbbing for several days over my right ovary again. The surgeon said she has no explanation except for perhaps a very uncommon form of interstitial cystitis, but I don’t have half of those symptoms. Sitting in a moving car and long walks cause a sharp ache on the right side of my pelvis, but it isn’t constant like it was for three months beforehand. The pelvic pain comes and goes, and it’s about one-third of its former intensity. I don’t know what would cause it to come back full force and constantly, but I hope it never does.

After seven months of poor health, I’m baffled by all my tests returning normal. If it’s not endometriosis, then what is it? If these tests come back normal, I’m not sure what other steps to take.

Physical Pain and Depression

by R S

Published on June 21, 2013

3457 views

Physical pain and depression go hand in hand. I’m not looking at any studies when I write this; I’m speaking from experience.

I spent three months between 4 and 9 on the pain scale. When palpated or touched anywhere below my ribs, I would involuntarily shriek and tear up. In pictures taken during that time, my skin was greyish and covered in a sheen of sweat. I was losing ten pounds a month. Specialists and primary care doctors would frequently say, “You shouldn’t be in this much pain. Your pain level is rather high,” and I would have no explanation for them. “I am in this much pain. I don’t know why. Let’s find out together.”

One explanation offered from my first gyno was that because I am severely allergic to all effective painkillers, meaning opiates and opioids, that the experience of moderate daily pain was causing sensitization. Because there was no relief, even temporarily, from pain, my body was becoming more sensitive each week, driving my pain up the scale. It’s a positive feedback cycle. Daily moderate pain started to feel like daily severe pain simply because there was no break from it. I developed an ulcer from the stress of the pain, which means I couldn’t take NSAIDS due to stomach bleeding, but they wouldn’t have done much anyway.

The gastroenterologist said that stress was making my pain worse. If constant pain makes you stressed and the pain gets worse, your stress increases too. He encouraged me to try meditation and breathing exercises, and they do help somewhat.

Pain touches the body and mind in an obviously negative way, but the worst part was depression. There was a definite pattern to the decline in my emotional health, and it had to do with hope of a solution and a return to normal life. The longer I waited for a diagnosis, the more depressed I became. The more research I did, I realized that I may spend my life in chronic pain, spending a lot of money on medical bills, with little hope of relief until menopause. No one could help with the pain, it seemed, because I couldn’t take anything for it. My mood worsened.

One month after starting the birth control, I told my gyno that I thought the pill was making me depressed. I’d been having uncontrollable and unexpected crying jags for seemingly no reason, and I’d read that depression was a possible side effect of some brands of birth control. He gently told me that this class of birth control doesn’t have depression as a possible side effect; others do, but not this one. He asked if I had a history of mental illness, and I said yes, but I’d been stable for four years. He said that I was under a lot of stress and undergoing quite a lot of pain. It would be unusual not to be depressed, and also that four years of stability is about the average, and I was due for a relapse and a medication adjustment. My partner reminded me that I’d been bedridden in the same room for months, experienced intense daily pain, had taken a very long leave from my fulfilling job, and wasn’t able to walk or exercise. Anyone would fall into a depression in my shoes.

I moved in with relatives so that my partner could focus on work. It’s very draining emotionally to take care of someone who is bedridden and in a lot of pain, not to mention lapsing into depression. I thought it would be easier for both of us.

I focused on all the things I could do when I could walk again, like go back to work, go walking in the park, go to karaoke with my friends, go out to dinner with my partner, and go to galleries and plays. I would watch foreign movies on Netflix and fantasize about eating regularly again: pastry, Thai food, German food, sushi … and later dream about food that wasn’t broth, gelatin and Metamucil.

The week of my colonoscopy, I experienced a huge emotional blow due to problems within my relationship, and my depression worsened. I stopped sleeping through the night and spent about two days in a series of panic attacks. I saw my doctor and he adjusted my medication, but I’m still trying to cope with this stress. Prolonged illness was bad enough, but I had hope that when the treatments were over, I could return to my happy home and life as usual. It’s not as easy as that now.

I spent a few weeks crying in supermarkets and drug stores, crying when I would hear familiar songs, staying up for all but one or two hours a night struggling with panic attacks, trying desperately to fake normal emotional levels and not being able to do so. I even cried onto a phlebotomist who wouldn’t stop asking personal questions (She was prying and pretty much asked for tears on her jacket). Isolation drove me to reach out on social media. I admitted that I wasn’t doing so well and needed help. As hard as that was to admit, many people came forward to offer support. A few messaged me every night, all night if the need was there, and I am eternally grateful for them. If you can manage the vulnerability of admitting you need help, you will find it.

Questions about the future regarding livelihood, health, and romance don’t lead down cheerful trains of thought. I dearly hope I don’t lose my job, or a long series of jobs, due to this disease. How does anyone reasonably manage a romantic relationship with this particular type of chronic pain? Do we demand that our partners be celibate when we are, no matter the duration? Do we acknowledge that our needs and wants are different when one person is frequently ill, and they are allowed outside sexual encounters? Or do we simply say that we’re better off living independently, even if we may struggle emotionally and financially due to this illness? I’m not actually looking for answers to these questions. Instead, I’m considering adopting a shelter dog.

Daily pain changed my personality, and I can recognize that. I wasn’t exactly chipper to begin with (I’ve been compared to Daria and Aubrey Plaza), and now I’m frequently withdrawn when the pain hits. Honestly, I’m not as much fun as I was before. Intense daily pain for months on end made me nearly suicidal, and while that’s a common reaction, it’s not easy to live with. It may be unreasonable to ask anyone to live with me at all.

Depression sticks around despite changes to medication and a strong commitment to getting better physically and emotionally. Every morning I wake up and plan activities that my normal self would enjoy. I look in the mirror and practice smiling. This is what a genuine smile looks like, do that when you see people. I plan social engagements, then wonder later if I smiled or laughed enough to convey that I’m having fun. Doing anything other than reading is exhausting. Spending time around people is exhausting. Answering any questions about my health or relationship is exhausting. Pain is exhausting. I am frequently in pain; I am exhausted. My therapist has asked me to seek out small gratitudes and moments of joy in each day, to actually practice being content. Through the mental static of anhedonia, I recognize that happiness is a choice, and a valid one.

It’s difficult to meditate on happiness when I am in so much physical pain. No one I’ve talked to or read about has said, “Why yes, my pain is greatly reduced and my life is nearly normal. I can manage my symptoms, and my treatments are affordable. My doctors take my pain seriously and find solutions in a timely manner. I can work long hours, exercise vigorously, and have great sex. The future looks good, even with this disease. There’s hope in there somewhere.”

What I seem to be looking at is decades of chronic pain, surgeries that may or may not help and will drive me deeper in debt, medication that is risky and also may not help, little or no sex life, and bowel disease that may worsen drastically as I age due to co-morbidity. Clinical depression is understandable considering the experiences of the last six months. Suicide really does look like an option some days. I know I can’t be the only one to think so.

Every person I know who struggles with severe chronic pain, no matter the underlying illness, has admitted to considering suicide. It’s not that life isn’t worth living any more or loved ones don’t matter, it’s that life has become a seemingly endless tunnel of pain. One more hour seems like too much, much less one more year or decade. Let it be known that suicide is not a sound idea and causes more suffering than it ends. If you are planning suicide, please call a hotline or arrange a ride to the nearest ER. However, it’s understandable, even normal, to think about suicide when living with painful, prolonged illness.

I realize that I won’t feel this way forever as long as I engage in healthy and productive activities and go on living life. I keep my appointments, take medication, exercise as much as I can and engage in social activities. Mostly, I act as if life is going to get better, even though my mind doesn’t seem to agree with me right now. I’m hoping that sharing this less-than-sunny account will help other people who live with pain and depression feel less alone.

Adventures in Prescription Medications – Woman to Woman

by Lana Hanson

Published on May 25, 2013

2174 views

How’d you like to bypass years of countless doctor visits, cornucopias of medications with names beginning with every letter from the alphabet, take-one-a-days, with- meals, mixtures, combinations, co-pays, micrograms and tears?

The answer might be simpler than you think:

Just eliminate one or two real assholes from your life!

And the only known side effect you’ll “suffer”: New found, authentic happiness – organically produced by your formerly abused spirit… the one that always seemed ready and willing to absorb total blame and negativity for what was wrong in your life!

Woman, this is a deep, dark secret the big pharmaceutical companies DON’T want you to know: that all too often, the truth about your misery and “depression” can’t be found at the bottom of a pill bottle, but lies on the other side of your bed. The root of your problem? The jerk lying with his manipulative little head on the opposite pillow, snoring like a revved up chainsaw, not some “chemical imbalance” roiling in your brain. And woman, just boot him out of your bed, and you’ll step into your fresh, drug-free future!

Can it really be that easy? Well, yes and no.

Remember how Alice in Lewis Carroll’s classic Alice’s Adventures in Wonderland only had to choose which side of the mushroom to bite to “right size” her enlightenment? We real-world women let ourselves endure strenuous drug trials and errors much more dangerous than Alice’s mushroom. Why? Because in typical womanly fashion, we’re so prone to look in the mirror and accuse the face we see there, rather than look outward and objectively scrutinize the fingerprints of asshole’s thumbs we’re stuck under.

Sister, if I had a dollar for every woman I’ve heard say, “I quit antidepressants cold turkey because I realized they did absolutely nothing for me,” I could buy as many shoes as Imelda Marcos. And needless to say, you’d never see me twice in the same pair of stilettos.

Women, we can only find our salvation by making serious changes in ourselves and our surroundings – starting with understanding how and why we think, feel and react to negative and self-lacerating “triggers,” and then learning to dance with these shadows rather than fear them. We can find true healing in all sorts of crazy ways: places, faiths, interests and communities too large and lively to fit into any capsule. Sometimes even complete solitude can be our alternative to prescriptions.

While suffering my own deepest depression about five years ago, I remember feeling envious of people who claimed antidepressants at least made them feel like zombies. The pills never got me near feeling no pain, and the grass certainly did seem greener on the other side, ‘cause my side of life seemed to be a daily skate on thin ice. At any moment, I dreaded a crack might start in the ice, through which everything in my world would slip, never to be seen again.

But then I took the “great risk”: I removed the asshole from my world. I didn’t go crazy off the pills, I not only regained my sanity and my life, I realized how terribly sad that pill-driven desire was – to feel nothing, to want my days to roll over like fog mist. Now I know every day is too precious, too fragile…too full to waste. Me, I was truly better off letting those medications slip down the trash bag rather than into my blood stream. My life’s still filled with challenges. I still cry. I still worry. But I’m no longer afraid of the “edges” of experience. They’re there, and I’m here. I accept the love and support of people who honestly love, benefit and respect me. Anyone else, I show the door.

I know that for many women the issue of whether or not to take antidepressants is no question at all; it’s necessary to avoid the insistent beckoning call of the edge. Taking a pill never makes you inferior, and you shouldn’t feel ashamed to take one if you have a true, measurable chemical imbalance. But never forget: You’re not the pill; you’re a woman, aware and alive enough to value and cherish the air in your lungs. And that pill might be keeping you from being that inspiration to others you could be.

Many of us stand in the space between poor, suffering lab rats and the Big Pharma company fat cats. We struggle to decipher what extra help we might need to lead vital and healthy lives and whether to cut out the magic bullets that weren’t magical after all. Here is where we indeed have something in common with Alice: Even she had to deal with a conniving Cheshire Cat. Are we willing to consider that some manipulative “cat” has driven us to Dr. Feelgood and the pill bottle?

The old “Serenity Prayer” still applies when it comes to deciding which pills to swallow and which ones to ditch. God grant me the serenity to know when I’m able to remove myself from trying chemical paths to health, even the courage to disregard a doctor’s orders when my gut instinct says, “Hell no!” to still another prescription. And the wisdom to know the vast differences between these very grey areas. Amen.

Oh, and P.S.: God grant me the gumption to toss out every asshole in my life once and for all, even if I don’t toss all the pills out with them, too!

Personal Perspective – Hormones, Mood and Endometriosis

by Angela Wice

Published on November 29, 2012

2010 views

When I think back to when I was 10, that is when I started to get chronic headaches. This must be when my hormones started to kick in. I got my period at 13 and from then on things for me have never really been the same.

Hormones, Menstruation and Mood: Was there a Connection?

I had emotional outbursts as a teenager but I couldn’t connect them to my periods at the time because my periods were all over the place. My period could come every 15 days or 45 days. I never knew when it would come. There was no consistency and I was never one to check it off on a calendar, or worry about it.

I remember my teenage years as being dark and depressing. I couldn’t seem to get out of a funk. It only got worse after I graduated from high school. To me that was the beginning of the end, with excruciating abdominal pain, migraines and mood swings. In the 10 years since leaving school, I was diagnosed with multiple co-morbid diseases such as Fibromyalgia, Chronic Fatigue Syndrome, Thoracic Outlet Syndrome, Restless Leg Syndrome, Depression, complicated migraines and finally endometriosis when I turned 27.

Doctors made me feel so crazy in my head and were quick to tell me I was depressed. I was once told by a doctor that he couldn’t see me anymore because I cried too much. After seeing at least 40 doctors, I was starting to really breakdown mentally. Why was everyone ignoring what I was saying? No one seemed to listen. They just pricked me with needles and said I was fine. I knew I wasn’t fine.

Pregnancy and Postpartum Hormones

I had my daughter when I was 25 and from that point on, the hormones went through the roof. I thought I was losing my bloody mind. I started to get more and more migraines to the point I had no choice but to go to the hospital to get medicated. Nothing seemed to work because of how sudden they would come on. I didn’t know at the time that my hormones were so out of whack. All I knew was that my mental state started to deteriorate and I no longer felt safe in my own apartment. I was seeing demons in my room. I was freaking out on my daughter. She was only two years old at the time. I knew I was suffering from depression now, but this was too long after postpartum wasn’t it?

Could it be Postpartum Depression?

I was watching TV one day and saw a show about postpartum depression. I decided then and there that I was going to bring myself to the hospital and just pray they wouldn’t take my kid away from me. I ended up talking to some man that didn’t even get what I was saying. He just threw me some sleeping pills and told me I was just tired.

Hormones, Mood and Endometriosis: Maybe There was a Connection

Soon after being sent home with sleeping pills, for what was likely postpartum depression, I received the results from a recent ultrasound. The 10cm cyst that would eventually lead to my diagnosis with endometriosis, was found. I was put on Marvelon21, a form of hormonal birth control. From the first week, I swear on my life, I felt like my world was full of rainbows and butterflies. I didn’t have the depression or the horrible thoughts. I started to really calm down. To this day, it is rare for me to get really angry and yell. I really think my hormones had me trapped for far too long. It is probably the main reason why I don’t ever feel that I could stop taking Marvelon ever. It saved my life. One little white pill, a very low dose birth control pill worked for me. Although, I know it doesn’t work for everyone.

I definitely feel that there are more than just hormones that affected my state of mind. I don’t feel that my body has ever been normal. I was an object of wonder when it came to doctors and their students. I was treated like a piece of dirt by every doctor. Most acted like I was making this all up. The few that were actually nice, didn’t really tell me to do anything further with treatments. They just told me what diseases I had and sent me home. No follow-ups just more confusion.

I try not to focus on the co-morbid diseases like I once did. I take one problem at a time. I refuse to believe that I actually have some of these diseases. Either way, I am not going to let my ill-health steal my life or my mind another day.

Blind Faith, No Longer Blinded: Tales of Thyroid Illness

by Michelle T. Bickford

Published on July 22, 2012

2825 views

At 11-years-old, you hardly understand the complexities of life and the implication of any diagnosis. My doctor told me I had Hashimoto’s Thyroiditis, and that it was insignificant… a pill, every day, and blood tests, every 6 months. Simple. My mother, a pediatric nurse, brought me to the best pediatric endocrinologist in the NYC area. With blind faith, I went about life veiled by ignorance about thyroid disease.

I professed my Hashimoto’s at every medical visit. Yet, it was never considered in any treatments. I was told I was depressed and prescribed anti-depressants. I had irregular periods and was prescribed birth control pills. I had dry hair and told it was from processing and products. My skin was like that of a crocodile. Must be genetics, as I shared so many similar behavioral, mood and medical similarities to my father. I accepted my genetic fate, but never once made the connection to our shared diagnosis of Hashimoto’s. That is, until the Hashimoto’s emerged and demanded recognition.

My doctors called it postpartum depression. I could not seem to manage my moods and anxiety, but I was not depressed. This was my third child and the baby weight was not coming off. Something was wrong, I could feel it in my soul. I was driven to research my disease. Soon, I realized all of my idiosyncrasies were symptoms of my “insignificant” disease and my hormone imbalance was distorting my reality.

In the 24 years since my diagnosis, the field of Endocrinology has improved the treatments of Hashimoto’s and other thyroid conditions, yet my treatment remained the same. I encountered countless others who also had their lives forever shifted due to these “insignificant” disorders, but I also discovered treatment options that alleviated those symptoms. My blind faith that my physician knew best dissolved. My doctor transformed into a human with flawed knowledge of a rapidly changing field, and from the once naive patient emerged a woman who refused to accept this was acceptable.

This shared experience with innumerable thyroid dysfunction patients also suffering from symptoms of a disease, yet labeled with minimizing terms such as depressed, mentally unstable and hypochondriacs. This motivated me to action. If we demonstrate and express our experience, if we grab the ear of our physicians who dedicate their lives to healing us – then I have faith we can change our future and heal the next generation. This new found faith inspired me to write, “Endocrinologists: Patients with Thyroid Dysfunction Demand Better Treatment.”

This international petition amassed over 3600 signatures from over 65 countries. It inspired, Denise Rodriguez, an amazing woman with a different, yet similar, thyroid journey, to shape and mold my raw petition into the amazing movement it is today (a little less than 3 months later). We just launched ThyroidChange™, a web-based initiative, to unite the voice of thyroid patients worldwide.

Hormones matter! I have faith that our voices, when strengthened with worldwide support, can change the future of thyroid care. Please join us on our journey.

Hormones and Mood

by Chandler Marrs, PhD

Published on November 28, 2011

6593 views

Hormones and Mood: Most Women Experience the Mood Changes

Mood swings and depression can occur anytime in woman’s life. But women seem to be more vulnerable to mood changes during the time of hormonal fluctuations – peri-menopause, pregnancy, or their periods. Eighty percent of women acknowledge some increased emotional sensitivity before their period starts, 8-10% have severe ‘hell-on-earth’ mood changes the 2 weeks before their period. For some women hormonal flux can trigger mild to severe mood disorders including depression and bipolar disease. Postpartum depression can affect 10 to 15% of women and can last up to a year after the child is born.

Hormones and Mood: Premenstrual

Research suggests 8-10% of women experience PMDD (Premenstrual Dysphoric Disorder) which is characterized by severe moods swings, depressed mood, irritability, anxiety and physical symptoms (occurring exclusively during the luteal phase (weeks 3-4) and remitting within 3 days of the onset of menses.

Hormones and Mood: Brain Chemistry

Hormonal problems are believed to be linked to the imbalance in neurotransmitters that are directly responsible for mood state, particularly serotonin, norepinephrine, dopamine, GABA, and acetylcholine. Estradiol is a hormone known to affect mood. It increases serotonin and beta-endorphins that are associated with the positive mood state. Estradiol acts to increase neuronal excitability thus producing a brain stimulant-like effect.

Decreased level of estradiol was shown to be linked to panic attacks. Additionally low estradiol can cause headaches, foggy mind, memory lapses, and sleep problems.

The progesterone metabolite, allopregnanolone (ALLO), produces a sedating/calming Valium-like effect. ALLO works on GABA receptors in the brain and is a powerful anxiolytic, anticonvulsant, and anesthetic agent which decreases anxiety and depression.

Hormones Matter

Where health, hormones, and a whole bunch of other stuff, make sense.

depression - Page 3

Guts and Brains and Hormones, Oh My!

The Immune System and Depression

How Does Inflammation Start?

What Does Inflammation Do?