OT Depression

[bigpow5]

Many people have been completely freed from depression by studying these teachings : http://www.bruno-groening.org

Keep an open mind. I wish you all the best.

[Jerry Freeman]

This showed up in my email today in a listing of MedLine articles on adverse effects of Aspartame:

Biol Psychiatry. 1993 Jul 1-15;34(1-2):13-7.

Adverse reactions to aspartame: double-blind challenge in patients from a vulnerable population.

Walton RG, Hudak R, Green-Waite RJ.

Department of Psychiatry, Northeastern Ohio Universities College of Medicine, Youngstown.

This study was designed to ascertain whether individuals with mood disorders are particularly vulnerable to adverse effects of aspartame. Although the protocol required the recruitment of 40 patients with unipolar depression and a similar number of individuals without a psychiatric history, the project was halted by the Institutional Review Board after a total of 13 individuals had completed the study because of the severity of reactions within the group of patients with a history of depression. In a crossover design, subjects received aspartame 30 mg/kg/day or placebo for 7 days. Despite the small n, there was a significant difference between aspartame and placebo in number and severity of symptoms for patients with a history of depression, whereas for individuals without such a history there was not. We conclude that individuals with mood disorders are particularly sensitive to this artificial sweetener and its use in this population should be discouraged.

Publication Types:
Clinical Trial
Controlled Clinical Trial

PMID: 8373935 [PubMed - indexed for MEDLINE]

~~~~~~~~~~~~~~~~~~~~~

I would like to emphasize something I wrote earlier in this thread:

Depression has causes, many of which are invisible to most practitioners because they involve things so common in our diet or environment that they never get considered as a potential source of trouble or, in the case of hormonal or other "borderline" physiological imbalances, are considered "within normal limits" according to what most doctors have been taught.

By all means, pursue the standard mainstream sources of treatment. These have been miraculous for many, allowing them to be reborn into life. However, I would suggest not stopping at what mainstream medical practice has to offer, but try to find out as much as possible about what factors play into your particular depression. Even if the depression itself is mitigated by medication, if there is something that was sending your brain chemistry into a depressive state, figuring out what it is and addressing it will have many other benefits as well, in addition to improving your mood and possibly reducing the need for anti-depressant drugs. (But definitely pursue the mainstream options, and don't delay! As I said, this is in addition to, not instead of.)

Best wishes,
Jerry

[Jerry Freeman]

Here are some specifics on the thyroid/depression connection. Again, this is only one more of a fairly long list of things that might be involved in any one patient's depression.

From Living Well with Hypothyroidism by Mary Shomon:

It's clear that many doctors just don't think of hypothyroidism when faced with a patient complaining of depression, even when other hypothyroidism symptoms are present. So there's a definite risk of misdiagnosis.

Studies have even shown that, among patients hospitalized for clinical depression, 15 percent of them have previously undiagnosed subclinical hypothyrioidism.

Kate Lemmerman, M.D. shared this overview of medical school education on hypothyroidism:

"When I was in medical school we covered the pathology of hypothyroidism very well. But we often failed to consider the human impact of the disease and how best to deal with that. Therefore, if someone's TSH [thyroid stimulating hormone, the most common lab test for thyroid function] normalized then our treatment was successful. If they still felt fatigued, then perhaps it was depression or something 'they would just have to learn to live with.' And if someone's TSH was 'within normal limits' but they had complaints that seemed like hypothyroidism, we were not taught to think that perhaps the range of 'normal limits' may not be the ideal levels for proper functioning in that person."

The idea that 'normal is normal is normal' and that as long as you fall somewhere in the normal range you are properly diagnosed and/or adequately treated is slowly falling by the wayside.

Anecdotal evidence exists that 'normal' for most people without thyroid disease may, in fact be under a TSH of 2 [the typical 'normal' reference range given by most labs is .5 to 5.5].

My [the author's] endocrinologist and some others, for example, firmly believe that most women thyroid patients feel best in the 1 to 2 TSH range, and that above that level, there's greater difficulty in getting pregnant, avoiding miscarriage, losing weight, and getting rid of other symptoms.

I've also heard from various medical professionals, including lab techincians who have indicated that anecdotally, they find that the average TSH for people who are not suffering from thyroid diseasse was around 1. It was not a wide distribution from .5 to 5, but instead concentrated more tightly around a TSH of 1.

More than just anecdotal evidence also exists showing that 'normal' may actually be in the lower end of the range. According to A. P. Weetman, a professor of medicine at the University of Sheffield, writing in the respected British Medical Journal:

"...thyroid stimulating hormone (TSH) concentrations above 2mU/l reflect a disturbance of the thyroid-pituitary axis, values above the upper level of the typical reference range (4.5 mU/l) are highly significant departures from normal rather than one tail of the normal distribution."

[end of excerpt from Living Well with Hypothyroidism]

[cowtime]

I" read this thread with great intrest, coming from a l-o-n-g line of bi-polar folks. (incidentally, I'm sure I have it, just not to the degree that it causes great problems, like my Dad, who was brilliant but had swings of great degree -would work for a week at a time to fix a piece of mining machinery that was down, until he was diagnosed and medicated late in his life, or his mom, who suffered through the "shock treatments of the late 40's early 50's until she took arsenic rather than take another treatment, to her father, who had a reputation for "weirdness and a violent temper"). Also, my I'm sure the father of my first grandaughter(see avatar) is bi-polar,I'm urging him to therapy now, so who knows about her......... Plus, I'm now going to have to look up my lab results from my thyroid tests back in Nov when I discoverd a thyroid nodule. I was told my levels were normal, but have always felt uneasy about that........Anyway , I hope anyone who does not feel "right" will be strong enough to seek help, I know what a difference it made for Dad to do that.

[Jerry Freeman]

Hi, Cowtime.

My mother struggled with bipolar disorder for many years. She was diagnosed as hypothyroid as a teenager, but at various times in her life, one doctor or another would tell her, "you don't need this thyroid medicine," and take her off it. I believe her worst nightmare years were those when she wasn't properly treated for the hypothyroidism. She's 84 now and doing great, with a doctor who's kept a careful eye on her thyroid treatment. There's not a hint of bipolar disorder now, nor has there been for several years. That doesn't mean everyone with bipolar disorder or depression is hypothyroid, but it's very important to take a close look at whether there might be a connection.

Best wishes,
Jerry

P.S. I'll keep a lookout for packages from Virginia addressed to the elves.

[jim stone]

I get the feeling that several different maladies
are being called 'bi-polar' as well as the other
categories of mental illness.
Also I suspect that psychological
and somatic problems are being lumped
together. I've known people diagnosed
as bi-polar, and who certainly fit the
description, who were cured entirely by
psychotherapy.

Also I was never entirely persuaded that the
studies I've read that allege to show that
bi-polarism is somatic weren't tracking
something else. That bi-polarism runs
in your family suggests that it's 'learned'
as much as that it's inherited. That
child abuse runs in families doesn't
show that it's an inherited tendency.
(Nor does speaking English, for that matter.)

I've read studies that showed that
identical twins adopted at birth
tend to have similar rates of bi-polar
disorder. The trouble there is that
if bi-polarism is a psychological disorder,
it may well be tied to culture.

For instance, in some cultures children often get
the message 'Be better than everybody else
at everything you do always, or we won't
love you.' Of course parents who give this
to their children are likely following it themselves,
which means they are competing with their
children. So the children are getting a
second message: 'Fail.'

Bi- polar behaviour, excited grandiosity,
followed by despair and a sense of worthlessness,
is a way of satisfying these demands.

Well, children given for adoption are
often given with the condition that they
remain within the culture (or religious group).
So identical twins
separated at birth are more likely to
both be bi-polar if one of them is, but
this doesn't necessarily mean the condition
is genetic or somatic.

Similarly the rates of bi-polarism in
fraternal twins separated at birth are
somewhat lower than for identical twins.
But a common genetic constitution is likely
to involve more mundane character traits,
and these may explain why the genetic
twins go crazy together, e.g. feisty girls
in a culture that can't stand feisty girls
are more likely to be driven nuts.
Or suppose the crazy conflicting
demands are more likely to be made,
or to be made with greater intensity,
on energetic and highly intelligent
children.

It seemed as though the people doing
the research never considered that
the results supported alternative
hypotheses--you would get them anyway
if the disorder is culturally learned
and if individuals with a certain personality
type (which isn't itself bi-polar) are
especially vulnerable in that culture.

Very confusing! Best

[Jerry Freeman]

As usual, I'm going to say,

"Stop! You're both right!"

I've observed in my own life, and in the lives of patients I've worked with in clinical practice and in informal consulting, that whatever is available at a given point in that person's situation that might provide benefit tends to build on whatever other beneficial influences have already been brought to bear, and create a stepping stone for the next ones. These include all manner of pharmacological, social, psychological, nutritional, etc. modalities.

You mentioned exercise. Consider that exercise is primarily a physical input, but the effect it has on mood can be very powerful. Exercise raises the metabolism, helps burn off toxins, creates endorphins, and influences body and brain chemistry in many ways.

In Sanskrit, there's the saying that "Manas is Prana and Prana is Manas," which is often interpreted to mean that the breath or life force of the body is the same thing as thought and mind, only conceptualized from the objective side rather than from the subjective side.

Best wishes,
Jerry

[cowtime]

[quote="jim stone"]I get the feeling that several different maladies
are being called 'bi-polar' as well as the other
categories of mental illness.
Also I suspect that psychological
and somatic problems are being lumped
together. I've known people diagnosed
as bi-polar, and who certainly fit the
description, who were cured entirely by
psychotherapy.

Also I was never entirely persuaded that the
studies I've read that allege to show that
bi-polarism is somatic weren't tracking
something else. That bi-polarism runs
in your family suggests that it's 'learned'
as much as that it's inherited. That
child abuse runs in families doesn't
show that it's an inherited tendency.
(Nor does speaking English, for that matter.)

I've read studies that showed that
identical twins adopted at birth
tend to have similar rates of bi-polar
disorder. The trouble there is that
if bi-polarism is a psychological disorder,
it may well be tied to culture.

For instance, in some cultures children often get
the message 'Be better than everybody else
at everything you do always, or we won't
love you.' Of course parents who give this
to their children are likely following it themselves,
which means they are competing with their
children. So the children are getting a
second message: 'Fail.'

Bi- polar behaviour, excited grandiosity,
followed by despair and a sense of worthlessness,
is a way of satisfying these demands.

[quote]

Very intresting comments here, much to think about.

I must say though, that I am talking about many generations of my family that I know have all had this problem. I'm talking about my Dad's grandfather, his brothers and sisters, their children, etc. Many many people. Most of Dad's cousins in this line are on some form of chemical to treat this. One of his sister's is. Many have been instutionalized, one uncle for his whole adult life, and of course my grandmother, who did not survive. In my own generation I do not know of any who have had to have medical treatment, but I do know of children of my cousins who have been diagnosed with this.

It just seems odd that all of the above(within modern times) have been diagnosed as bi-polar. The backgrounds are all quiet different, economically and socially.

Personally, when I think of it, both my parents were very supportive of me growing up, but I also did know that I was expected to do well in my endevors. Mom had high standards, but I particularly wanted to please Dad, since I knew excellence would please him. " I always felt he was my greatest champion in whatever I did. Both my brother and I have done a lot with art and music, but in no way did I ever feel in competition with my parents. Now by monetary standards I might not be considered a raving success, BUT, I have always tended to do the extrordinary, and do well(just never anything that brought in money), and in my youth, be a bit of a rebel, especially for my rural area. Perhaps this need to "be different" is tied to this- as I said, very interesting. But, I always knew that I had my parents love, no matter what- in fact I had what would be considered an idealic childhood. I do like to do my best at whatever I do, and am rarely satisfied with my efforts. I can immerse (obsessive)myself for years in whatever intrests I have. But, the difference(I think) is that I realize what I am doing and have control over my actions.

I really can't see though how -
spending money like it grows on trees, staying up night and day to get a menial job done to perfection, spending 6 hours measuring a graveyard to within 1/16" and still considering it not good enough, inventing all kinds of things, spending 2 hours tying a piece of furniture into a vehicle OR sitting and reading for weeks on end, never leaving the chair except for necessities is a "learned" behavior. Particualrly since Dad never got this bad until he was well into his 60's.

Having sifted through this info, I can see that perhaps some things are "learned", however, I do know that when Dad finally got professional help, and they found the right medicine, he was still Dad, but , thankfully , without the mood swings that made life pretty intolerable for not only him, but everyone if it was the "high".

I did hear on the radio the other day that a gene had been isolated that they believed to be linked to this disorder. Whether that's right or not, who knows?

I do agree that an awful lot of folks seem to be told they have this problem now. Is it the disease fad of the moment? I don't know.
I do know that for whatever reason, this is something that has plagued my folks for generations.

[jim stone]

When I say it's 'learned,' well that's not
quite what I mean. Rather it's a response
to psychological factors and a strategy to live up
to impossible and conflicting demands.

For instance, if you have to succeed in extraordinary
terms to satisfy one demand, and fail in order to
satisfy another, one way is to nearly
succeed big and then, at the last moment,
arrange to fail spectacularly and plummet
into despair.

Another is to define success as failure,
as the bi-polar child who says he's flunking.
You say, 'But you're getting all A's'
And he says: 'They're flunking As!'

Or the (suspiciously bi polar) folksinger who says: 'there's no
success like failure, and failure's no success
at all.'

Another piece of the psychology is that mundane, ordinary
experience isn't worth having. Boring. Only
intense and dramatic experience is worth
the trouble. Also the mundane is dangerous,
actually. You can cope with emergency,
not the mundane, so it's crucial to
live with intensity and drama. Cycles
of elation and despair beat the bland.
And they're addictive.

Well, I really don't know what's going on,
here as I admitted above. There may be
several different etiologies of the same
syptoms, several 'diseases' lumped
together, etc. Some psychologically
based, some somatic.
Perhaps you can see how the
psychological explanatiion might
explain quite a few, but maybe
not all, cases typed this way.

By the way, C. S. Lewis argues that Jesus
was either God incarnate or a
lunatic. But he wasn't a lunatic,
so probably he was God.

But if there is a dichotomy here (a big 'if,' mind you),
it's that Jesus was God incarnate or he
was bi polar, one of the chief ways
that Jews have problems if they do.
As we know bi polar people can be brilliant,
creative, and charismatic, though there
is a tendency to come to a tragic and early end.
If Jesus had psychological problems
(IF he did) I wager he was bi polar. Best

[Jerry Freeman]

Hi, Jim.

This is profound stuff that you're saying.

The psychological patterns you've described ring true to me. I think you may be onto something.

However, I still want to emphasize that, in my opinion, it isn't either/or. It's both/and (at least when the psychological stuff you've described actually is part of the syndrome).

Even though it may be possible in some cases to find a "purely psychological" basis for a behavior pattern, there's still going to be an underlying brain chemistry involved.

What I've seen is that whenever there are "issues" that a person needs to deal with, they often remain unaddressed until something changes their body/brain chemistry and allows them a little more clarity or energy, or whathaveyou that gives them the internal resources to start dealing with their stuff.

For example, it's not uncommon, in my experience, to see someone start working through some long-standing psychological territory that had been neglected, only after something nutritional, like treating a zinc deficiency, or immunological, like drying up their moldy basement, or endocrinological, like treating a thyroid condition, had helped clear their head and settle their emotions enough to let them get to work on the "stuff."

Even just incorporating a practice of regular walking, which can have profound physical effects, can bring enough of a shift in body/brain chemistry to provide added clarity and energy and help a person do the psychological work.

Again, as I said, "prana and manas are the same thing," and you can work from both sides, the objective (prana/body) and the subjective (manas/mind) when addressing such matters. In my opinion, the most effective approach is to work on both.

Best wishes,
Jerry

[Lorenzo]

The personal stories on this thread have been inspiring, and to see the support and care that each has shared. That kind of encouragement is so valuable to people with mood disorders who are sometimes afraid to be in public for fear of being misunderstood.

I played in an a couple of Irish music bands for years which sometimes included a combination of a Psychiatrist, and either one or two of his patients.

I had some lesson to learn. To get along with all, I had to be very careful because there is a great deal of sensitivity if someone is not feeling just right.

So I was quiet and kind of went with the flow of other peoples needs, and the doctor would never mix professional concerns with his music hobby, and Wisely so.

In private, he was reluctant to even talk, but did give me some thoughts, knowing my involment in Public Health and a long time interest in body/mind relations.

He said that several of his friends had come to him for help, and other than general encouragement and support, like I find among friends sharing here, he would never speculate or dabble in diagnosis or treatment and therapy in those casual converstions.

The reason why was because of the complexities in the understanding each individual disorder. As an MD, he was taught some generalities about the subject, but getting his advanced training in psychiatry helped him understand how little he knew and how vastly different each case can be.

Anyone really aquainted with the subject knows the dangers of talking too early without professional analysis. The subject can quickly bring out people with "experience" who have all the answers, yet no way of knowing how to seperate the spectrum of possibilities. And this would not be particularly helpful.

The material available (articles and books) is vast, and scanning across the titles of some of the best work reaveals just how complex these issues are.

Take a look at a small fraction of titles from the list:

The association of Borderline Personality Disorder with Bipolar Disorder.

The connection between Bipolar Disorder and substance abuse.

What is the difference between Bipolar-I and Bipolar-II?

Sleep deprivation as a treatment for Bipolar depression.

Bipolar Disorder and the frontal lobes.

Bipolar Spectrum Disorder.

Adjunctive psychotherapy for people with Bipolar Disorder

Seasonal influences in Bipolar Disorder.

Subsyndromal bipolar disorders.

Psychotherapeutic treatment for people with Bipolar Disorder.

Head injury as a cause of Bipolar Disorder.

Vagus nerve stimulation as a treatment for Bipolar Depression.

Keppra for people with hard-to-treat Bipolar Disorder.

Thyroid function and speed of recovery from Bipolar Disorder.

Brain chemistry and Bipolar Disorder.

Rapid-cycling and Bipolarity.

Omega-3 fatty acids as a treatment for Bipolar Disorder.
.
Temperamant in Bipolar mixed states.

Kindling and Bipolar Disorder

The relationship between the Bipolar Spectrum and atypical depression.

Side-effects of medications used to treat people with Bipolar Disorder.

Psychosocial Treatments in Bipolar Disorder.

The genetics of Bipolar Disorder in large families.

Mexiletine in treatment-resistant Bipolar Disorder.

About secondary mania (mania NOT as the result of Bipolar Disorder).

Bipolar Disorder and neurobehavioral dysfunction.

Brain lesions and recovery from Bipiolar Disorder.

The Bipolar Child: The Definitive and Reassuring Guide to Childhood's
Most Misunderstood Disorder. (An important book)

The neuropsychology of Bipolar Disorder.

Lamotrigine as a treatment for people with Bipolar depresion.

The link between serotonin transporter gene and Bipolar Disorder.

Touched With Fire : Manic Depressive Illness and the Artistic Temperament. (An important book)

Olanzapine (Zyprexa) as a treatment for acute mania.

The molecular genetics of Bipolar Disorder.

Interpersonal and social rhythm therapy for people with Bipolar Disorder.

Choosing to have manic-depressive illness.

Prepubertal Bipolar Disorder.

Soft Bipolar Disorders including hyperthymia.

Bipolar II and III: The interface of temperament and soft bipolarity.

Rapid cycling and circadian rhythms.

The relationship between Bipolar Disorder and ADD.

Family history indicators of undiagnosed Bipolar Disorder.

Gabapentin (Neurontin) for people with treatment-resistant Bipolar Disorders.

Lamotrigine (Lamictal) for people with treatment-resistant Bipolar Disorders.

Topiramate (Topamax) for people with treatment-resistant Bipolar Disorders.

Diabetes in patients hospitalized for Bipolar Disorder.

Bipolar Disorder + Anxiety Disorders.

Bipolar Disorder and brain asymmetry.

Complex combination therapy for refractory Bipolar patients.

Treatment of people with refractory and rapidly-cycling Bipolar Disorder.

Child and dolescent Bipolar Disorder.

Circadian rhythms and rapidly cycling Bipolar Disorder.

How lithium controls both depression and mania.

A Brilliant Madness: Living with Manic-Depressive Illness. (An important book)

Psychopharmacologic treatment of impulsive aggression.

___________________________________________________________________

And that's just on the bipolar section. General depression extends much further into Atypical Depression, Borderline Personality Disorders, Borna virus, Cyclothymia, Special Populations, Dysthymia, Eating Disorders and Depression, Genetics, Grief and bereavement, etc.

There are several online group support web sites with people sharing their individual experinces. One site is just for "humor" to cheer each other up. The best thing about a subject like this on C&F is the heartfelt concern and support, and the sharing. I think it's incredible. I really appreciate the personal touches too and would like to thank Jim (and others) for his sharing and contributions. That's good stuff!

BTW Jim, re Jesus and God being bipolar: http://www.theonion.com/onion3716/god_d ... polar.html

[jim stone]

Concerning some of the implications of Lorenzo's post:

I wrote earlier to Audrey, who described the financial difficulties
she's had finding treatment for undisclosed emotional
problems from which her daughter suffers, that I wondered
if Dale might have some helpful advice.
The advice I had in mind was about where
one might look for affordable mental health
services for children.

This message was dumb (it flowed
partly from being sick and exhausted due
to my Beastly Cold).

First, there is no way any professional psychotherapist
can get into giving advice even of this
limited sort over the internet
or in response to e mail from folks on this message board.
Big legal consequences.

Second, my message may be read as a suggestion that
Dale be asked to give psychotherapeutic counseling
over the internet (or in response to e mail)
to Audrey about her daughter's
problems, to Blackbeer, to heaven knows who else!
I trust that the impossibility of his doing so, and the
stupidity of our asking him to, is obvious to all.

Dale is off limits--that's Undisputed.

Also while this thread has been
positive, helpful, and fortunate in its
timing, I do think there may
be potential difficulties about threads
about 'My Struggles With Schizophrenia,'
etc. read by all sorts of people who may
have all sorts of problems which may
consequently surface here where we
are ill-positioned to deal with them
(Blackbeer arguably being the exception that proves
the rule). I don't think that we necessarily
shouldn't have such threads, but there
is a public health dimension that it may be
worth keeping in mind.

Apologies to all. Best, Jim

[Roger O'Keeffe]

Wise words, Jim.

Tom, I've sent you a PM that might be of some very modest assistance.

Stay in touch now, or we'll all get scared!