Hormone Imbalances, Mental Health, and Depression by Gregory Lawton

ABSTRACT

The primary focus of this presentation is the investigation of somatic hormonal imbalances as they are related to mental wellbeing and depression. Depression may be caused by genetic, nutritional, hormonal, physical, psychological, and environmental factors. Recognized symptoms include feelings of sadness, grief, poor self-esteem, hopelessness, anxiety, and fear as well as symptoms of fatigue, chronic illness or infection, body wasting and atrophy, and a general loss or interest in or withdrawal from life and interpersonal relationships. Thoughts of selfharm or suicidal thoughts or actions may make depressive disorders a life-threatening condition.

CLINICAL REVIEW SERIES Hormone Imbalances, Mental Health, and Depression

Dr. Greg Lawton

The Blue Heron Academy of Healing Arts and Sciences

All rights reserved. No part of this program or its content shall be reproduced, stored in a retrieval system, or transmitted by any means - electronic, mechanical, photocopying, recording, or otherwise - without written permission from Dr. Gregory T. Lawton, the National Association of Therapeutic Exercise, and American Health Source, Incorporated. Gregory T. Lawton, D.N., D.C., D.Ac. The Blue Heron Academy of Healing Arts and Sciences 2040 Raybrook Street, SE, Suite 104 Grand Rapids, Michigan 49546 888-285-9989 Toll Free 616-285-9999 616-956-7777 www.blueheronacademy.com info@blueheronacademy.com Every effort has been made to ensure that permission has been obtained for use of text references herein. If any required acknowledgement has been omitted or any rights overlooked, please notify the publishers; omissions will be rectified in future editions.

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CLINICAL REVIEW SERIES – Hormone Imbalances, Mental Health, and Depression Introduction Depression is a common condition, and in the United States during the year 2020, an estimated 15 million U.S. adults (aged 18 or older) had at least one major depressive episode. This number only reflects those adults that reported or sought treatment for a depressive episode. This statistic is up by 2 million adults from 2019 and represents 6% of all American adults. Based upon information and belief, I estimate that in the classes that I teach, up to one-quarter of my students are taking one or more anti-depressant medications, along with a hypnotic or sedative for a sleep disorder. In addition, many of the patients and patient conditions that we treat in our clinic - from chronic pain to auto-immune disorders - will have depression or major depression as an associated symptom. The primary focus of this presentation is the investigation of somatic hormonal imbalances as they are related to mental wellbeing and depression. Depression may be caused by genetic, nutritional, hormonal, physical, psychological, and environmental factors. Recognized symptoms include feelings of sadness, grief, poor self-esteem, hopelessness, anxiety, and fear, as well as fatigue, chronic illness or infection, body wasting and atrophy, and a general loss of interest in (or withdrawal from) life and interpersonal relationships. Thoughts of self-harm or suicidal thoughts or actions may make depressive disorders a life-threatening condition. In my clinical practice, I have recognized the relationship between mental wellbeing and physical health and wellness. It is difficult, perhaps impossible, to maintain a normal, wellbalanced mental state while suffering from poor health or disease. It is also difficult, and once again probably impossible, to adjust the essential hormonal equilibrium of the neurotransmitters and hormonal regulators of the eleven human body systems when one or more systems and/or its organs or glands are malfunctioning. Often when researchers, physicians, psychiatrists, psychologists, therapists, and counselors discuss depression, they do so from a perspective of an imbalance of a single neurotransmitter, and of increasing or decreasing that neurotransmitter through a synthetic, petroleum-based drug. Often the hormones these doctors are attempting to regulate are dopamine or serotonin. While these neurotransmitters are important, they are simply two hormonal chemicals in a “sea” of constantly changing chemicals flowing through our blood stream and interacting with nerve synapses, cells, tissues, and organs. Attempting to manipulate one or two of these hormones as if they are functioning in isolation from the rest of the body is clinically ineffective. Neurotransmitters function on emotional, mental, and physical levels that determine our sense of self, wellbeing, and mood. Within our emotional environment, they affect states of happiness and joy, or sadness, anger, and fear. On the mental side of this equation, they affect concentration, learning, cognitive processing and decision-making, or confusion and memory

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loss. On the physical level, they affect sleep, hunger, eating, libido, digestion, and the perception of pain. In terms of effective clinical treatment, what is needed is a holistic approach that identifies disordered somatic function at the cellular level and in body organs and systems. Such a holistic approach is both specific and global at the same time. A holistic approach recognizes the “ideal body” as an organism in a balanced relationship between mind, body, and spirit. This balanced state is called homeostasis. Imbalances in the levels of certain neurotransmitters are not the only causes of depression; dysfunction of the endocrine glands, body organs, nerves, synapses, and the brain are as well. This includes imbalances in the pituitary, pineal, and thyroid glands, as well as our reproductive organs and the hormones they produce. With so many potential degrees of somatic dysregulation, is it possible to effectively treat mental health and depressive conditions with SSRIs, TCAs, SNRIs, NDRIs, and/or MAOIs? What does a holistic, mind, body, and spirit treatment program that addresses hormonal imbalances, mental health, and depression look like? Further on in this presentation, I will outline for you the basic components of an individualized holistic and naturopathic approach for the treatment of these conditions. First, however, let’s investigate how our current patterns of behavior, perception, and thinking affect our emotions and mood. The Role of Behavior, Perception, and Mood on Mental State, Wellbeing, and Depression It is too easy to say that my doctor told me that my depression is caused by a hormonal imbalance in my brain. Rather, we want to ask, “Is the condition only in the brain?” and even further, “What is the cause of that?” Generally, the recognized causes of hormonal imbalances include: • • • • • • • • • • •

Trauma and post-traumatic stress disorder (especially early childhood trauma) Too much stress in general Addiction Medications and drugs Poor nutrition and nutritional deficiency Insomnia Seasonal affective disorder (SAD) Surgery (hysterectomy) Diseases of the central nervous system (multiple sclerosis and related disorders) Diseases of the endocrine system Diseases within any of the eleven human body systems that damage the endocrine functions of an organ or gland.

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These are a few of the main causes, but as was cited above, there are many diverse causes that include diseases and disorders of the nervous system, digestive tract, reproductive system, and any of the glands and organs of the endocrine system. In the list of common causes of hormonal imbalances above (which is far from a complete list of potential causes of hormonal or glandular dysfunction), we see that some causes are related to personal behavior or habits and are therefore within our control. Other causes are outside of our immediate control, such as early childhood trauma and resulting PTSD, the level of stress in our lives (from war, disease, accidents, surgery, or major setbacks in life), or loss of a loved one due to death. Regardless of whether a causation of hormonal imbalance (an imbalance that may potentially result in depression) is within our control or not, how we respond and adapt to the factors that cause imbalances may be within our ability to identify and regulate - through how we choose to perceive the causes and respond to them. Depression is not a condition or state that begins with an isolated depressive episode, although the initiation of an episode of depression may be the exact moment that an emotionally depressed person first relates to the condition of “being depressed”. Depressive states, like any disorder, are multifactorial and complex processes that begin with subclinical signs before the appearance of symptoms. Some of these subclinical signs of depression can be identified from personal family history, individual medical history, the life history of the individual, and certain personality traits (both inherited and acquired). During my 50 years of clinical practice, I have had the privilege of meeting and treating immigrants and refugees who have fled areas of conflict and war where they have suffered extreme trauma and privation. Many have lost parents, grandparents, children, and other family members due to murder and genocide. Many have witnessed the violent murder of loved ones from execution, being burned alive, or other horrific and terrorizing means. What I have not witnessed in these individuals are major depressive episodes or the need for pharmacological medication for the treatment of depression. What I have learned from these individuals is that while experiences of depression and grief are normal emotional states that everyone experiences in life, there is not necessarily a direct causal relationship between traumatic life experiences and chronic major depression. How we react to life trauma is highly individualized. Our personal perception of life, life’s tests, difficulties, and traumas are a key factor in whether stress and/or post-traumatic stress syndrome becomes a debilitating or life-threatening mental health condition. This is where our early childhood development and our young adult experiences intersect. When this intersection results in a continual and recurrent perception of certain life events as “negative” in nature, these perceptions accumulate within us as “bad stressors”. Bad stressors (as opposed to “good stressors”) are the negative perceptions we develop and our resulting emotions that constantly pull and tear away at the fabric of our emotional state, 4|P a ge

resulting in somatic imbalances and dysregulation in our essential organ systems, organs, and glands. Negative emotional states like depression do not just happen; they are the result of personality traits and habits. These patterns of behavior can be altered, but not by medication – they are altered by changes in lifestyle, diet, exercise, mental health therapy, a resetting of the somatic system, and herbal medicine appropriately directed at the organs or glands contributing to somatic dysfunction. Neurons, Synapses, and Neurotransmitters Let me ask you a question: “What is your normal response to anxiety, fear, or anger?” What I am alluding to is how you perceive threats to yourself and how you respond to stress. Most people have heard of the fight or flight response, but few understand its harmful effects on the body and the brain or recognize when they (or outside factors) are provoking or magnifying it. Every time we are subjected to tests, difficulties, and challenges, we have an opportunity to see these “stressors” as either positive, negative, or somewhere in between. When we perceive a challenge as positive, meet the challenge head on, solve the problem, and move on, the energy needed to address the challenge is usually minimal, and our body quickly resets to a balanced state. This is called homeostasis; it is the body’s response to changes in its internal and external environment, and an efficient return to a normal state on the physical and emotional level. When we perceive a stressor as a threat and therefore negative, we are increasing the energy demands of our cells, organs, and glands, and we are releasing stress hormones like adrenalin and cortisol into our blood stream. When we perceive a stressor as a threat, we are exciting the areas of our brain and brain stem that deal with life and death circumstances. An argument with a spouse or an employer should not provoke this level of response. When we frequently or continually dwell on such events or occurrences, we are placing ourselves and our bodies in a constant state of threat arousal and fight or flight. Addictions occur when we habituate certain behaviors and increasingly imprint greater numbers of neurons around a specific habit. This process of recruiting and imprinting behaviors and memory upon neurons is very similar to what happens to a neuron in depression. The more often we are depressed, and the deeper and more progressive our depressive states become, the more likely we are to suffer from major depressive episodes. These depressive states become a habitual cycle of depression. Gradually, over time, the depressive states become more frequent, and more severe. What then is the way out of a habitual depressive state? This is a question that will be addressed in the section of this presentation that pertains to treatment strategies.

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The Clinical Review Series as it Relates to Primary Organ Systems, Organs, and Glands In 2003, I published a series of booklets entitled the “Clinical Review Series”. This series of booklets served as a lecture outline and student notes for classes on the following six topics: 1. 2. 3. 4. 5. 6.

INSULIN RESISTANCE OBESITY DIABETES THYROID DYSFUNCTION ADRENAL DYSFUNCTION MENOPAUSE/DYSMENORRHEA/PMD

I associated these six conditions as the cause of all non-trauma related degenerative diseases of the human body. For example: •

•

Insulin resistance, obesity, and dysglycemia leads to, and causes, diabetes. The metabolic disruptions that occur in the diabetic state also cause soft tissue inflammation and joint degeneration. Thyroid imbalances, such as hypothyroidism and adrenal exhaustion, further contribute to abnormal muscle and joint conditions, and present with numerous musculoskeletal symptoms. Perimenopause, menopause, and postmenopause stages in women cause and contribute to inflammatory states, musculoskeletal disorders, metabolic disruption, and the inability to heal and recover from the combined effects of injury, tissue trauma, and the general effects of aging.

In this presentation, I am revisiting the devastation wreaked upon the body by insulin resistance, obesity, diabetes, nerve damage (such as neuropathy and central nervous system lesions), endocrine system disorders (such as thyroid and adrenal dysfunction), and dysmenorrhea, PMD, and tumors of the uterus and ovaries. I am associating and relating several of these conditions with dysregulation of the body’s primary neurotransmitters: dopamine, serotonin, Gamma Aminobutyric Acid (GABA), endorphin, norepinephrine, glutamine, and others. Neurotransmitters are chemicals that are produced in the body that allow peripheral nerves to carry sensory and motor information throughout the body and the central nervous system (comprised of the spinal cord and brain) to coordinate neurological functions. Neurotransmitters enable the brain to carry out a variety of vital functions through the process of chemical synaptic and neural transmission. These neurological chemicals are integral in shaping and balancing our everyday life and body functions. Depression has long been linked to functional imbalances of the neurotransmitter’s serotonin, norepinephrine, and dopamine. Serotonin and dopamine imbalances will be the primary focus of our discussion regarding hormone imbalances and mental health. Although I am focusing on 6|P a ge

these two primary hormones, they do not work in isolation from the body’s other important hormones, such as hormones of the thyroid gland, hormones of the reproductive organs, hormones of the adrenal glands, as well as hormones of the pituitary gland (like cortisol and endorphins). Imbalances in the levels of specific neurotransmitters and hormones have been observed in various neurological disorders, including Parkinson’s disease, schizophrenia, depression, and Alzheimer’s disease. For the purposes of this presentation, I will break the neurotransmitters - specifically regarding their effects on mood state, feelings, and emotions - into categories such as inhibitory, excitatory, and modulators (although several individual neurotransmitters have more than one function or effect on the nervous system). The following list contains the names of several of the neurotransmitters, but it does not include all of them: • • • • • • • •

Glutamate Acetylcholine Norepinephrine Epinephrine Dopamine GABA (Gamma-Aminobutyric Acid) Serotonin Endorphins

I will use the terms “neurotransmitter” and “mood modifier” interchangeability. (The term “neurotransmitter” can be confusing when attempting to describe the effect of hormones on mental health and mood states.) As we begin this discussion, let’s revisit the primary causes of somatic dysfunction in the human body. Dysglycemia, Hyperglycemia, Hypoglycemia, Pre-Diabetes, Diabetes Type 2, Insulin Resistance, Obesity, Thyroid and Menopausal Conditions Hypoglycemia is recognized as a condition that affects a significant number of Americans in varying degrees, with about 4% of the population being diagnosed with this clinical disorder. Insulin resistance is a condition that involves increased levels of insulin but impaired cellular responses to insulin’s actions. This condition results in increased insulin, increased stress on the beta cells of the pancreas, and blood sugar dysregulation known as dysglycemia. Insulin is an anabolic hormone that plays a role in sugar, fat, and protein metabolism. Insulin is involved in cellular utilization of blood glucose by the cells of the body. It is released by the pancreas in response to increased blood glucose levels. Insulin facilitates the entry of glucose into the muscle and fat cells to form glycogen, fatty acids to form triglycerides, and amino acids to form proteins. Insulin also has catabolic activity and inhibits gluconeogenesis, which is the production of glucose from lactate and amino acids. Insulin is involved in the breakdown of 7|P a ge

glycogen and fat. Basically, insulin communicates to the cell that glucose is available for cellular metabolism. Insulin resistance results when there is an interference with the ability of insulin to facilitate the entry of glucose into the cell. When insulin utilization is impaired, the cells have less glucose available as fuel. This results in higher levels of glucose in the blood, which the pancreas detects as requiring more insulin, and which it produces and releases into the blood stream. This results in hyperinsulinemia. Insulin resistance has been calculated to affect over 25% of the nondiabetic adult population of the U.S. Poor insulin utilization and elevated blood glucose levels are causation factors in the following diseases: • • • • • •

Hypertension Obesity Ischemic Heart Disease Dyslipidemia (raised triglycerides, reduced HDL, high cholesterol, high LDL) Type 2 Diabetes Neuropathy and neurological lesions

Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to health because it's an important source of energy for the body’s cells, tissues, and organs. It is the brain's main source of energy. For the purposes of this presentation, when we refer to diabetes, we are referring to Type 2 Diabetes. Obesity is a disease. It is increasing at alarming rates in the U.S. Obesity is the most common pathological disease in modern Western society. Over 50% of the U.S. population is overweight or clinically or morbidly obese. Obesity is a recognized risk factor in diabetes, heart disease, neurological disorders, and several cancers, including reproductive and breast cancer. Thyroid Menopausal Conditions Statistically, women have an overall higher incidence of hypothyroid and hyperthyroid conditions than men do. Estimates of incidents of hypothyroidism run from fifteen to forty percent of the female population of the U.S., with 40% of the population considered to have suboptimal thyroid function. This translates into 80 million Americans who could be benefited by thyroid education and care. Over 50% of the U.S. population is clinically obese, with an 85% increase in obesity occurring over the last few years. By the end of 2022, 50 million women will have reached menopause, and they will account for nearly 20% of the total U.S. population. Many of the signs and symptoms of menopause and thyroid disease are identical. It is therefore possible that a patient may be suffering from either of these disorders individually, or both at the same time. If proper analysis and evaluation is not performed, the assumption may be made (in a case where the woman is of menopausal age) 8|P a ge

that the woman is experiencing the natural progression from perimenopause to menopause, and thyroid disease may be medically overlooked. Additionally, the symptoms of thyroid disease tend to worsen during the onset of menopause, due to changes in hormonal levels and hormonal biological cycles. Surveys have shown that one-third of women over the age of 40 have not discussed menopause with their physician, and that physicians only screen 1 in 4 women for thyroid conditions - even when these women have clear indicators for thyroid disease. Currently, more than 13 million Americans have an active thyroid problem. Undiagnosed thyroid conditions cause a significant increase in obesity, diabetes, heart disease, neurological disorders, depression, autoimmune disease, musculoskeletal pain and dysfunction, and other hormonal disorders. Undiagnosed or subclinical hypothyroid disease can also be a cause of hypertension in perimenopausal, menopausal, and postmenopausal women. Adrenal Exhaustion or Insufficiency The most significant factor in the progressive development of chronic adrenal problems is stress. Stress is biologically defined as cellular aging. Some of the causes of clinically significant stress are intangibles like anger and anxiety, and others are caused by physical forces or biochemical factors. The early seminal research into the field of stress was performed by Dr. Hans Selye, and in 1956 he described the three phases of stress including: 1. Alarm (fight or flight response) 2. Resistance (adaptation to stress) 3. Exhaustion (decreased resistance and adaptation, failure state) In the alarm phase of stress, both cortisol and DHEA increase. This phase is usually asymptomatic. In the early stages of physiological failure, cortisol increases but DHEA decreases, and the symptoms and signs of stress begin to appear. In the later stages of physiological failure, both cortisol and DHEA are low, and many of the signs and symptoms of adrenal insufficiency and exhaustion are apparent. Interwoven within the major causes of stress, chronic adrenal dysfunction, and the aging process are these nine factors: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Impaired cellular energy biochemistry (impaired mitochondrial function) Blood glucose imbalances (dysglycemia) Chronic inflammatory conditions (EMFA) Cardiovascular risk factors (imbalanced methylation reactions) Neurological disorders and diseases Impaired detoxification (autointoxication) Allergen/antibody reactions (poor immune function) Adrenal cortex stress responses (chronic stress responses) Endocrine imbalances (thyroid/adrenal/testes/ovary) 9|P a ge

Dysmenorrhea, PMD, Perimenopause, Menopause, and Postmenopause I recently completed a series of several talks on women’s health issues that included dysmenorrhea, PMD, perimenopause, menopause, postmenopause, fibrocystic breast disorder, and a few other conditions related to disorders and diseases of the female reproductive system. These talks included a discussion regarding prevention, causes, and treatment of these conditions, disorders, and diseases. One of the outstanding points raised during these talks is the harm that is being caused to women, pregnant women, infants, and children from environmental pollutants (and specifically xenoestrogenic chemicals) in our food, water, and air. The harm caused by these ubiquitous chemicals is horrifying. Many times, the cause of PMD, dysmenorrhea, and benign or malignant tumor growth is exposure to, and ingestion of, these xenoestrogens. A woman who suffers hormone and reproductive dysfunction, disorders, and diseases often finds effective medical treatment is elusive. This all too frequently results in surgery to remove the female reproductive organs and results in immediate surgical menopause. In the dark ages of medical history, outspoken women were deemed to be “hysterical”, and the remedy was removal of the “offending” organs in a procedure called a “hysterectomy”. A woman’s estrogen levels begin to decline during her third decade of life and continue to decline into postmenopause. Most of the symptoms of menopause don’t begin to appear until a woman is in her mid- to late- 40s, and during the perimenopausal phase. The average time for the onset of perimenopause is usually considered to be around 45 years old. The most common signs and symptoms of menopause include: 1. Hot flashes – This is the most common symptom of menopause. 2. Night sweats – These are hot flashes with profuse sweating. 3. Sleep disturbances – This symptom may be related to hot flashes, night sweats, heart palpitations, and a disruption of the normal sleep cycles by fluctuations in hormone cycles. 4. Menstrual irregularities – Usually occur during the perimenopausal phase. The menstrual cycle becomes shorter, longer, irregular, disrupted, heavier or lighter. As menopause progresses, the period cycle becomes farther and farther apart, until it ceases altogether. 5. Vaginal changes – This includes bleeding, dryness, and atrophy. Symptoms may also include itching, burning, soreness, and recurrent inflammation or infection. 6. Libido changes – The negative symptoms related to vaginal changes may decrease the desire for sex, or the freedom associated with nonfertility may increase the desire for sex. 7. Urinary changes – This may include urinary incontinence or the inability to control urination. Small amounts of urine may leak out during physical activity, laughing, coughing, sneezing, or sex. A burning sensation or pain may accompany these symptoms, especially if an infection is present. 10 | P a g e

8. Skin changes – This is related to the loss of the growth factor of estrogen (due to declining estrogen levels). The skin becomes dryer, thinner, and less elastic. 9. Palpitations – The woman may experience rapid, irregular, and pounding heart beats. This is sometimes associated with a hot flash. 10. Mood changes – Changes in mood states frequently occur with perimenopause. These symptoms include irritability, depression, and anxiety. Mental confusion and disorientation can also accompany perimenopause and menopause. 11. Headaches – This is a common symptom of menopause. The headaches may be severe and be classified as “migraines.” Resetting Your Somatic Systems Thus far in this conversation, we have established an argument in support of the concept that conditions, diseases, and disorders in the body (somatic dysfunction in organ systems, organs, and glands due to various central causes and stressors, along with certain personality and behavior traits and habits) result in chronic depression. Now we want to turn our attention to the methods by which we can return these systems, organs, and glands to normal function - in effect, to reset, rebalance, and restore homeostasis. In suggesting how this might be accomplished, I will organize possible therapeutic approaches into two categories: somatic reset, and therapeutic modalities. Somatic Reset I want to discuss four approaches that can lead to a total reset of the somatic system. These four approaches include: 1. 2. 3. 4.

Fasting Cold therapy Extreme physical activity Solitude

These approaches have been used by various indigenous peoples and ethnic groups over centuries as a means of restoring our most vital functions and homeostasis. These four methods can be used solely or in combination with each other. Let’s investigate the definition and description of each one. Fasting The following statements are taken from my booklet, “The Healing Path, Part Two”, and specifically from the booklet on fasting. “Often when we think of beginning treatment programs for our health issues, our first thoughts center around what we should eat, what supplements we should take, or what herbs we should use. We are thinking about what we can do, or what we can add, to our diet or nutritional regime. Many times, what we should be thinking about is what can we omit or subtract from our diet and lifestyle, and this brings us to the important subject of fasting.” 11 | P a g e

Fasting has long been used in the treatment of physical, mental/emotional, and spiritual illnesses. In some mental health facilities, primarily outside of the United States, fasting is used as a first step in treating mental health disorders. There are many approaches to fasting and several different kinds of fasts - from daily or weekly intermittent fasts, mono food fasts, juice fasts, to water fasts. Which kind of fasting program is best for you depends upon your underlying health issues, physical condition, psychological readiness, and stamina, as well as your purpose for fasting. Cold therapy Exposure to cold air temperatures or cold water as a form of hydrotherapy is another age-old method of resetting body systems and restoring homeostasis. This form of therapy is not for everyone; some people may not be healthy enough to tolerate cold, or they may be elderly and fragile and cold may be very uncomfortable for them. Cold therapy would be contraindicated with allergies to cold or with certain cardiovascular conditions and diseases. But for a younger, healthy person, cold can be a therapeutic modality that is perfectly suited to reset somatic functions. It has been thought that cold hydrotherapy may work by altering physiology and brainwaves like electric shock therapy. Electric shock therapy has long been used to treat drug-resistant forms of depression. Physical activity and extreme physical activity Physical exercise at any level of intensity is a well-established preventative practice and treatment for depression. Physical exercise promotes the release of all the major hormone regulators of the human body including the supreme mood elevators - the endorphins - which are the body’s natural opioid chemicals. When a person engages in higher levels of exercise or endurance activities, they are releasing higher levels of neurotransmitters and endorphins, and they may achieve altered mental or euphoric states. Solitude Solitude is defined as a state or quality of being alone, perhaps in an isolated place. Traditionally, many indigenous peoples, spiritually minded individuals, persons searching for meaning, writers, poets, and thinkers, have sought out long period of solitude. Solitude is often combined with fasting, extreme environments of heat or cold, and/or physical challenges. Therapeutic Modalities There is no one approach to the nutritional or herbal treatment of depressive disorders. As has already been stated, there are multiple causes for depression, and depression is associated with 12 | P a g e

conditions as diverse as menopause, thyroid disease, reproductive disorders chronic fatigue, fibromyalgia, adrenal disorders, and so on and so on. Because there is no one cause, but rather multiple factors implicated in mental health and depressive disorders, treatments are diverse and multifactorial. When a treatment plan is developed for individuals presenting with multiple disorders and depression, the underlying causes must be treated along with the depressive disorder. For example, in the case of a young female patient presenting with reproductive symptoms, dysmenorrhea, PMD, and/or a history of post-partum depression along with chronic depression, the reproductive symptoms must be treated first. As a further example, the main course of treatment in such as case would be dietary and would contain a major reproductive herbal formula or combination that is based upon the signs and symptoms of the case. After the primary organ system, organ, or glandular imbalance or disorder has been addressed, an appropriate single herb for the treatment of depression can be recommended. This single example is true for patients with obesity and insulin resistance, patients with dysglycemia, hypoglycemia, diabetes, thyroid dysfunction adrenal disorders, reproductive conditions, dysmenorrhea, PMD, and menopause. In each of these disorders, the primary somatic dysfunction (the cause of homeosomatic disruption) must be addressed before, in conjunction with, or after the primary disorder is treated. Specific approaches to treatment of somatic dysfunction are well outlined in the clinical booklet series previously referred to. As was previously stated, there is no one approach to treatment of complex disorders involving the endocrine and nervous system. However, the following will serve as an example. Diet and supplementation When we are addressing nutrition needs, please keep in mind that each of the eleven human body systems and the organs and glands all have different nutritional requirements for function and production of metabolic products and hormones. I am normally discussing meeting all our nutritional needs through diet, but there may be times when supplements like D3, K2, zinc, and B vitamins must be supplemented for brief periods of time. Basic nutritional needs for human beings should be met by a plant-based diet. Individuals who are older, ill, or suffering from various diseases may need to consume animal products, but the appropriate diet for most people is vegetarian. Such a diet should consist of complex carbohydrates, legumes, fruits and vegetables, seeds, and nuts. I have two favorite general dietary (lifestyle) programs that I recommend: the Pritikin program and the Ornish program. I recommend these two programs because they are highly researched, evidence-based, have been used for a long period of time, have proven results, have videos, books, cookbooks, recipes, menus and food products, and are approved and covered by numerous medical and health insurance programs (including Medicaid and Medicare). When I am consulting with a patient, I will add specific dietary and nutrient recommendations along with suggested supplements. 13 | P a g e

The Pritikin Program According to the Pritikin website, “There is nothing extreme about the Pritikin Diet except that it is extremely healthy. In more than 100 studies published in peer-reviewed medical journals, the Pritikin Program of Diet and Exercise has been found to not only promote weight loss but also prevent and control many of the world's leading killers, including diabetes, hypertension, and heart disease.” I recommend the Pritikin program for my patients under the age of 50 whose primary condition is not heart and artery disease. I specifically recommend the Pritikin diet and lifestyle for women with multiple comorbidities, especially related to obesity, blood sugar disorders, reproductive disorders and diseases, and depressive disorders. The Ornish Program According to the Ornish website, “Part of the value of science is to raise our awareness by helping us to understand the powerful effects of the diet and lifestyle choices we make each day—and how changing these may significantly, sometimes dramatically, improve our health and wellbeing. In many cases, these improvements may occur much more quickly than people had once believed possible.” I recommend the Ornish program for my patients - for both men and women over the age of 50 with heart and artery disease as a primary concern and other comorbid secondary conditions, disorders, and diseases. Dietary Supplemental Considerations The use of vitamin, mineral, amino acid, or various co-enzyme supplements is referred to as nutraceutical therapy. I am not a big proponent of this approach, but rather prefer treatment via diet, herbal medicine, and lifestyle. I previously suggested that when preventing or treating conditions, disorders, and diseases related to hormone imbalances, mental health issues, and depression, that there are certain nutrients that need to be present in the diet and/or supplemented for brief periods of time. These nutrients include the following: (Daily doses given) •

Vitamin D3 at 2000 IU’s or higher Vitamin D has been reported in the scientific and health media as an important factor that may have significant health benefits in the prevention and treatment of many chronic illnesses, including depression.

•

Vitamin K2 at 90 to 100 mg

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Research has shown that vitamin K2 can normalize blood glucose and reduce anxiety and depression. It works closely with D3 in the body and improves the effectiveness of vitamin D3. •

Vitamin B1, Vitamin B6, and B12 as a B-Complex (Brand - Pure Encapsulations) Vitamin B1, vitamin B6, B12 and B-complex vitamins are important for the normal functioning of the nervous system.

•

Zinc at 15 mg Zinc is an essential element for proper balance of blood sugar levels, normal immune system function, and tissue and wound healing.

•

Alpha Lipoic Acid at 600 mg Studies have found that alpha-lipoic acid supplements can help with neuropathy, nerve damage and nerve (neuron) tissue repair. Neurons are the cells and structures of the brain, spinal cord, and peripheral nerves.

General Herbal Recommendations •

Turmeric at 1500 mg Turmeric is recommended for any health condition that involves inflammation. It is recognized as safe and effective. Turmeric will act as a potent anti-inflammatory supplement that is effective in the treatment of generalized inflammation, soreness, and pain such as those symptoms found in fibromyalgia, neuritis, neuropathy, arthritis, and joint inflammation. Turmeric can also balance and lower blood sugar levels.

Adaptogenic Herbs One of the two primary categories of herbs used to treat hormone imbalances, mental health disorders, and depression, are adaptogenic herbs. I have written a brief booklet on this topic entitled, “Notes on Using Adaptogenic Herbs”, and so I refer the reader of this booklet to that source of information on the use of adaptogenic herbs. There are many herbs that can be used in this category, but they must be selected based on the age, sex, physical condition, symptoms, risk factors, contraindications, and diseases and disorders presented by a patient. Recommendations for adaptogenic herbs, whether as a single herb or a formula or combination, are made on a case-by-case basis. Major adaptogenic herbs include: 15 | P a g e

• • • •

Ashwagandha Ginseng Rehmannia Schizandra

Hormone Regulators The second category of herbs that may be used for the treatment of hormone imbalances, mental health disorders, and depression, are the hormone regulators. These are often herbs that have effects on the female or male reproductive system. Hormone regulating herbs may include: • • • • • •

Chasteberry (Vitex) Damiana Maca Motherwort Saw Palmetto Tang Kuei

Conclusion of Presentation The primary focus of this presentation has been the investigation of somatic hormonal imbalances as they are related to mental wellbeing and depression. Depression, as has been covered in this booklet, may be caused by genetic, nutritional, hormonal, physical, psychological, and environmental factors. Most of the recommendations made in this presentation are general, and your holistic or naturopathic practitioner will make recommendations specific to your personal needs. There is no single pill that can effectively address the multifactorial conditions, disorders, and diseases covered in this booklet. The clinical success rate of allopathic drugs, the SSRIs, TCAs, SNRIs, NDRIs, and/or MAOIs, is reported as an “optimistic” 60% of all patients. That is a 40% failure rate. In addition, what this number does not take into consideration is the long and often dangerous list of side effects, including degenerative damage to vital organs like the liver and kidneys. In this booklet, I have cited and recommended some of my other publications, including: the Clinical Review Series 1, 2, 3, and 4; Women’s Health Issues Seminar Workbook; Notes on Using Adaptogenic Herbs; and The Healing Path, Parts One and Two. It is my hope that the information provided in this booklet will be the beginning of your journey to health and wellbeing.

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