A Mind of Your Own

#booknotes #health #wellness #spirituality



A Mind of Your Own(2016) is a pretty comprehensive book that dismantles and analyzes depression and offers women various healing modalities so that they can heal their body and reclaim their lives. This book teaches that you can reclaim your health, especially your mental health. Your mental health is not entirely out of your control and you don't have to surrender to taking medication for the rest of your life. The way our healthcare and pharmaceutical industries are set up, you're quick to be prescribed a pill and let's face it... there is literally a pill for everything. The reason that our mental health seems like its out of our control is that it can be difficult to understand what the heck is actually happening inside our body. Also, the steps we need to take to fix our health is so outside of our awareness that we just don't even know how or where to start...or if it would even be worth the effort. This book discusses why mental health issues are so pervasive in our society, specifically in women. It explains the processes in our body that lead to depressive symptoms and also gives really solid advice on how you can start healing yourself without a lifetime of medication. This book was definitely addressing women but there is certainly valuable take always for men too.


These were my bookmarks as I was reading along, combined with my own thoughts, stories and connections to other books I've read.

Depression is Not Caused by an Imbalance in the Brain

More than just a prescription

Biggest myth about depression

Depression is an Inflammatory Disorder

Depression is not genetic, it's epigenetic.

Depression is not all about the brain

Serotonin Myth

Depression: The gut and the brain

Leaky Guts and Inflammation

LPS

We are a Metaorganism

How is the brain and gut linked?!

Diet and Risk for Depression

Thyroid

Insulin

Major Violators

Food is Information

Meditation, Sleep and Exercise

Testing and Supplementing

Tapering from SSRI

Depression is Not Caused by an Imbalance in the Brain:

One of the most profound concepts of this book is that depression is not caused by an imbalance in the brain. Symptoms of mental illness are not entirely a phycological problem and they are not entirely a neurochemical issue. There isn't a single study that has proven that depression is cause by a chemical imbalance in the brain. Depression is a sign that something is off balance in the body.


Most mental illness is caused by lifestyle factors and undiagnosed physiological conditions that develop in places far from the brain, like the gut and the thyroid. Sometimes your gloominess is only indirectly related to your brains internal chemistry. What you eat for breakfast and how you deal with your headaches could have everything to do with your symptoms of depression.


No one explains the potential for antidepressants to irreversibly disable the body's natural healing mechanisms. There are been many long term studies that have shown that antidepressants have been known to worsen the course of mental illness. These medications are known to cause liver damage, weight gain, sexual disfunction and they are difficult to taper from. Coming off of these medications lead to debilitating physical and phycological reactions.



More than just a prescription

Throwing a prescription at someone struggling with mental health issues really doesn't solve anything. Believe it or not, medical and personal history from the time of your birth have an effect on your current mental health. How you were born, whether you were breast fed and the chemical exposures throughout your life must all be considered. There are also many lab tests that should be done. This point here if you're walking into a doctors office and walking out with a prescription for an antidepressant then you haven't received the best care available to you. It is important to look at things on a cellular level, specifically in regards to the impairment of the immune system. The link between inflammation and mental illness has been well documented in medical literature. Lifestyle is something that needs to be strongly considered when addressing mental health but most of the time it's not even a part of the conversation. Factors that you might not even consider like your sugar consumption and other dietary habits, how well your gut and microbial communities are collaborating and your hormone levels: thyroid and cortisol, all impact your mental health. Sometimes there are genetic variants in DNA that put you at a higher risk for symptoms of depression. Even your beliefs and intentions for your health and healing must be considered.


When you really look at how many different factors contribute to your mental health you begin to see how ridiculous it is to be prescribed an antidepressant after a short conversation with a doctor.


Everyone's goal is to be physically vibrant and emotionally balanced. Why be perpetually drained, mentally unsettled and foggy and unable to enjoy life? You can start promoting self healing by:

  • Dietary modifications: More healthy fats and less sugar, dairy and gluten

  • Natural supplements: B Vitamins and probiotics

  • Minimizing exposures to biology disrupting toxicants: fluorides and fragrances.

  • Realizing the power of sufficient sleep and sufficient movement.

  • Behavioral techniques that solicit a relaxation response.

These lifestyle intervention start promoting the body's self healing mechanisms.


Everything you ever wanted is on the other side of fear

Biggest myth about depression: Depression is not a disease. Diagnosis of depression is highly subjective. The doctor labels you based on the symptoms you describe. There is no blood or urine test for this. Psychiatry got it wrong many times in the past, 1949 Nobel Prize winner António Egas Moniz basically disconnected the prefrontal region of the brain. It had severe consequences for the patient. In the 1970s, experiments demonstrated how difficult it is for a doctor to distinguish between an insane patient and a patient that was acting insane. Todays prescription protocol is just as absurd disconnecting parts of the brain, or labeling someone psychiatric when they are not.


The author consulted on a case with a woman who was suffering from sensations of facial burning. Traditional medication didn't cure her. At the heart of her distress was an immune and inflammatory process that could not be fixed by antidepressants and antianxiety drugs.


Depression and all of its relatives are manifestations of glitches in the immune system and inflammatory pathways...not a neuro chemical deficiency disorder. Your doctor isn't going to go over this with you...they will whip out a prescription pad and send you on your way. It has been known for a long time that there is a strong link between toxic conditions in the gut and mood/brain function. Modern medicine drifted away from this truth. This old wisdom needs to resurface now, more than ever.


"All disease begins in the gut" - Hippocrates

Depression is an Inflammatory Disorder


The more inflammatory markers in the blood the higher the risk for depression. Depression is an inflammatory disorder and is not primarily rooted in the brain. You ever wonder why there are so many people suffering with depression despite so many people being on antidepressants?! It's not about brain chemistry. It's about sedentary lifestyles, processed food diets and unrelenting stress. Our diets, high in refined carbohydrates, unnatural fats and foods that create chaos for our blood sugar balance contribute to higher levels of inflammation. The most influential risk factor for depression is high blood sugar. Diabetes, obesity and depression are very closely linked.


For more than 99 percent of human existence our diets did not contain foods that were inflammatory / screwed with our insulin (Sugar, grains, dairy). Our body's microbial ecology is the real victim of the introduction of these foods. 90 percent of our cells are non human in nature and they impact the expression of our genes. Bacteria is fundamental to life and mental health. 100 trillion microbes are colonized in your gut and they out number our cells. Our microbes contain genes of their own which means that 99 percent of the genetic material in your body is not your own...it belongs the microbes. Over time, microbial DNA has become part of our own DNA. Many microbes live in our digestive tract; fungi, parasite, viruses, bacteria etc. We cannot live without our microbiome. We live in symbiosis with it.


The microbiome helps you:

  • Digest food and absorb nutrients

  • Supports immune system and detoxication pathways

  • Produces and releases enzymes and substances that collaborate with your biology

  • Produces chemicals for the brain- vitamins and neurotransmitters

  • Helps you handle stress due to its effects on your endocrine(hormonal) system

  • Ensures you get a good night sleep.

How you feel emotionally, physically and mentally are all influenced by your microbiome.



Epigenetic Depression is not genetic, it's epigenetic. A simple deficiency can be at the root of psychiatric manifestations. We are not at the mercy of our DNA. We are the product of the complex interactions between our genes and our environment. Our health is more impacted by our environment than our inheritance. Genes encoded by DNA are more or less static. The expression of those genes are highly dynamic in response to environmental influences. Epigenetics is the study of sections of your DNA(Marks/markers). They tell your genes how strongly to express themselves. These epigenetic marks affect your health and longevity and also how you pass your genes on to other generations. Your environment can have a generational health impact. It's also important to note that your epigenetic marks can be change to read differently.


Depression is not all about the brain

Depression is not all about the brain. No research has ever shown that a particular brain state causes, or even correlates with depression. Many physical conditions create psychiatric symptoms but are not themselves psychiatric. You don't necessarily have to heal the brain...you have to look at the whole body ecosystem; intestinal health, hormonal interactions, immune system, auto immune disorders, blood sugar, toxicant exposure. We need natural alternatives to psychiatric medications that actually target what's actually messed up in your body. We need a food protocol, exercise, sleep, a detoxed environment, meditation and relaxation. You heal your mind by healing your body.


Main triggers of depression fall into 3 types of patients:

  1. Women with blood sugar and nutritional deficiencies (high sugar/low healthy fats)

  2. Wonky thyroid which effects hormones which ultimately effects mental health.

  3. Medication induced depression (statins, birth control pills proton pump inhibitors and even vaccines).


Serotonin Myth

There has never been a human study that successfully links low serotonin levels and depression. Imaging, blood and urine, post mortem suicide assessments and animal research have never validated the link between neurotransmitters and depression. High serotonin levels have actually been linked to schizophrenia and autism. Paul Andrews is an associate professor of evolutionary psychology in the Department of Psychology, Neuroscience & Behaviour at McMaster University and his research suggests that serotonin is a first responder to stress. When our body is under stress, serotonin helps to reallocate resources at a cellular level. Serotonin can't be measured in a living brain yet, so we don't know how the brain is releasing and using serotonin. Instead, we need to look at evidence about the levels of serotonin that the brain has already metabolized. More serotonin, not less, is released and used during depressive episodes. The increase in serotonin helps the body adapt to depression...it makes the body to devote more energy to conscious thought than other biological functions. Most forms of depression are a normal adaptation to stress. The drugs that are given to treat depressive symptoms interfere with the brains own mechanisms for recovery.

Depression: The gut and the brain

Inflammatory model of depression: The immune system is essential to your health and wellbeing. Basically, it creates distinction between what is self and what is other. There are appropriate forms of inflammation, like when you get a cut or bruised. You can feel and sometimes see these inflammations. The pain, redness and swelling is part of a normal biological response of the body trying to defend itself of something it believes to be harmful. When inflammation is chronic then its effects can be toxic to your cells. Silent internal inflammation has a connection to your mental health. The brain lacks pain receptors so you won't feel inflammation in the brain. There is a lot of scientific research has demonstrated that inflammation underlies the development of depression. There are many messengers that relay information about inflammation between the brain and the body. There are a variety of inflammatory markers (chemicals messengers called cytokines) that tell us that inflammation is occurring and are elevated with in people with depression. A few examples of these markers are C-reactive protein (CRP) and cytokines (Interleukins 1(IL-1) and 6(IL-6)) and tumor necrosis factor alpha (TNF-α). Elevated cytokines in the blood relate to the diagnosis of depression and they are predictive of depression. Inflammation may be the trigger of, rather than the response to depression.


Psychosocial stress can cause inflammation by mobilizing immature immune calls called macrophages from your bone marrow to start the inflammatory process. Inflammation can trigger depression and it can also aggravate depression. It's a vicious cycle.


In certain types of depression, white blood cells called monocytes turn on proinflammatory genes that lead to release of cytokines while leading to decreased cortisol sensitivity. Cortisol is a buffer against inflammation. When your cells lose their sensitivity to cortisol they become resistant to cortisol message and the result is prolonged inflammatory states. The stress response can turn on the inflammatory response. Once triggered, the inflammatory agents communicate with the central nervous system through the stimulation of major nerves(vagus). In the brain, specialized cells called microglia represent the brains immune hubs and are activated in inflammatory states. In activated microglia an enzyme called IDO (Indoleamine 2,3-dioxygenase) stimulates the production of molecules that result in symptoms of anxiety and agitation. These are some of the changes that may occur to let signal to your brain what your body already knows to be wrong. People with high levels of these inflammatory markers are more likely to respond to anti-inflammatories than antidepressants. This is why curcumin is so effective.


Leaky Gut and Inflammation


Low grade inflammation and the stress signals associated with it is often times generated from the gut.

Your gastrointestinal tract is lined with a single layer of epithelial cells. It has 3 main purposes:

  1. Obtaining nutrients from the foods we eat

  2. Prevents harmful things from entering your blood

  3. Home to specialized cells that patrol and alert your immune systems to invaders

Immune system provides immunoglobulins that bind to foreign proteins to protect the body from them. The body uses two pathways to absorb nutrients from the gut:


  1. Move trough the epithelial cells (transcellular)

  2. Moves between the epithelial cells (paracellular)


The connections between these cells(tight junctions) is VERY small and they are regulated. When they become compromised and too permeable then you get leaky gut. These connections are gatekeepers, they keep potential threats that provoke the immune system out. These tight junctions greatly influence the levels of inflammation and ultimately depression.


When the junctions are compromised, cell debris, undigested food particles and bacterial components can sneak by and cause trouble in the bloodstream. Once in the bloodstream it can wreak havoc and ultimately cause depression.


LPS

Researchers say that there is evidence that major depression is accompanied by an activation of the inflammatory response system and that proinflammatory cytokines and lipopolysaccharides(lps) may induce depressive symptoms.


LPS flips on inflammatory pathways. It is found on the outer membrane of certain bacteria that are normally found in the gut. The purpose of the LPS is to protect the bacteria from being digested by the bile salts from the gallbladder. LPS is not supposed to travel beyond the lining of the gut. It is very toxic when it does. When your gut lining is compromised then it does get into the bloodstream. It induces a violent inflammatory response. Research is confirming that inflammatory markers correlate with depression and LPS increases the production of these inflammatory chemicals. LPS makes the gut more permeable AND it can pass the blood-brain barrier which can bring the inflammatory message there too. Research has shown that people with major depression have higher levels of antibodies against LPS. Major depression is also associated with gastrointestinal problems.


We are a Metaorganism

In our body there is an average of 100 mitochondria per cell(except for red blood cells). They generate chemical energy in the form of ATP. They have their own DNA and it is believed that they originated from ancient proteobacteria. They were once their own organisms that found a permanent home within our cells. This is a good illustration that we are a living collection of microbes... a metaorganism! Our intestinal microbes:

  • Synthesize nutrients and vitamins

  • Help digest our food

  • Prevent us from becoming obese

  • The good bacteria can keep things in harmony by regulating cortisol and adrenaline(stress).


Gut-associated lymphatic tissue (GALT)

Our immune system is largely in our gut, in the gut-associated lymphatic tissue (GALT). Since the intestinal wall is the boarder with the outside world, it makes sense for most of our immune system to be located there. Once something is triggered in the gut, it alerts the entire immune systems. This is why what you eat is so important. Intestinal flora:

  • Physical barrier for harmful invaders such as harmful bacteria, pathogens, viruses, parasites

  • Help with digestion and absorption of nutrients

  • Act as a detoxication machine...takes some load off of liver

  • Produce enzymes and substances (vitamins and neurotransmitters, fatty acids and amino acids)

  • Help handle stress via its effects on hormonal and endocrine systems

  • Dictate immune system activity and response

  • Create antibiotic substances

  • Helps regulate inflammatory pathways.


Two important things in understanding what's going on between your gut and your brain:

  • Understand the gut in relation to your immune system

  • Understand how the gut works in relation to your hormones(specifically cortisol)

When either two of these things are not running smoothly, mood and memory suffer to the point where you are labeled as depressed.

How is the brain and gut linked?!


The vagus nerve is the longest cranial nerve and it connects the enteric nervous system to the central nervous system. It forms part of the autonomic nervous system. Microbes in the gut play a crucial roll in our health and behavior. There is a two way communication between the brain and gut bacteria. Experiments have found that germ free mice react wildly to stress(brain chemistry and stress hormones). When given a strain of bacteria called bifidobacterium infantis their behavior and stress response improved. Bifidobacterium longum could be given to treat anxiety like behavior. Fecal transplants can be used to repopulate microbiomes and thus change behaviors of the host. Dr. David Perlmutter has really strong examples of this in humans in his books Grain Brain and Brain Maker.


The microbiome is critically important during certain stages. It begins in utero, inoculation occurs during birth and then further develops during breast feeding. Children born via C-section miss out on this...they receive antibiotics during the birthing process and they are populated with the skin flora of other adults end up living with likelihood of allergies, eczema and some forms of cancer. Even a regular birth in a hospital result in allergies due to colonization of hospital flora.

There isn't one single universal microbiome that is "healthy". At this point we don't know what is optimal. Diets dictate microbiomes. It's more about diversity and the ratios relative to one another. Even good bacteria in the wrong quantities can be problematic.

We are not plants that can be sustained with artificial lights, recirculated air and fertilizer. Our vitality is tied to our greater ecosystem. This ecosystem includes our food and its eco systems, our movement in green space, early daytime exposure to light, contact with the earth and communities. We suffer from modern disconnects from ancestral influences.

Diet and Risk for Depression

Diet is one of the most important factors that determine which microbes are active in our guts. Our diet may be largely responsible for increase gut permeability and loss of bacterial diversity which increases risk for depression. People with an eating protocol that is rich in anti-inflammatory fats and protein enjoy lower rates of depression. Contrarily, a diet high in carbohydrates and sugar is fanning the flames of inflammation. Furthermore, ingredients like gluten and fructose greatly increase inflammation. Fructose increases lipopolysaccharides(lps) by up to 40 percent. The good news is that you can start fixing your microbiome within 72 hours of simple changes.


Top things that are bad for your gut:

  1. Gluten Gluten is protein found in wheat. You can find gluten-like proteins called prolamins in many other foods. These are highly inflammatory. There are different levels of sensitivity to these inflammatory proteins. Celiac disease is when you are highly sensitive however, a lot of people have negative undetected reaction. There are two main groups of proteins in wheat; glutenin and gliadin. You can be allergic to either of these (or any of the sub groups that make up gliadin). Gluten messes with people because it increases intestinal permeability by upregulating a compound called zonulin. Gluten is sticky and it interferes with the breakdown and absorption of nutrients. It triggers an immune response. You might not even feel it. The alarming thing is that it could be a completely neurological disease. Though you might test negative for celiac disease it is important to note that a celiac panel only tests for a small number of potential immune responses. Gluten is capable of producing 23000 proteins. Testing is too limited.

  2. Diary She recommends quitting dairy for 30 days and see how to respond to it when you reintroduce.

  3. GMO Foods: Our foods contain a chemical call Round Up. This topic is extensively covered in the Plant Paradox by Dr. Gundry.

  4. Artificial Sugars: They might be low calories but they affect healthy gut bacteria.

  5. Antibiotics Antibiotics kill beneficial and regulatory bacteria and eating a little yogurt wont fix it. It could take months to repair. The Plant Paradox by Steven R. Gundry uses a good example of a forest. When there is a forest fire, you can't expect the forest to grow back in a few weeks. And then if you start another fire in a few months(antibiotics) you will never let that forest grow. Antibiotics were invented before we had an understanding of the microbiome. Neurological and psychiatry conditions can arise following antibiotics. Antibiotics, like vaccines are like drinking poison to kill the enemy.

  6. Nonsteroidal anti-inflammatory drugs (NSAIDs) and proton-pump inhibitors (PPIs) These things are everywhere and some people use them daily because they've been given a false sense of safety. They are actually quite dangerous and are terrible for your gut and microbes. Quick summary of their negative effects:

  • promote bleeding

  • deplete nutrients

  • increase gut permeability

  • aggravate the immune system

  • trigger autoimmune and inflammatory processes

  • sustain dysbiosis in microbiome.


Thyroid


Ordinary conditions that go undiagnosed can seem like psychiatric disorders. A dysfunctional thyroid, not a dysfunctional brain is the most common conditions that affect many women and remains largely underdiagnosed.


Dr. Brogan talks about one of her 31 year old patients who had symptoms of agitation, racing heart, insomnia and anxiety. She was prescribed Aadvin and Zoloft. I specifically bookmarked this because these symptoms are so common and a lot of people are on these medications. She says that testing is required to pin point abnormalities in physiology. According to routine tests most doctors order, the patients thyroid stimulating hormone TSH were normal. Dr. Brogan discovered that the patients thyroid auto antibodies were highly elevated based on tests doctors don't order. He body's immune system was attacking its own thyroid tissue. This point here is that even though your tests come back normal...you need to be ordering the right tests! (there's a list of suggested tests further down)

Thyroid plays a roll in regulating metabolism, including the creation of new mitochondria, controlling proteins synthesis, adjusting sensitivity to other hormones, and is also involved in detoxification, immunity, and cognition. Thyroid creates T0, T1, T2, T3, T4.

T0, T1, T2, are hormone precursors and byproducts of making thyroid hormone. Their roles not full understood yet. T4(storage form of the thyroid hormone) is converted to its active form T3 in tissues around the body...including the brain. This process is dependent on specialized enzymes, optimal cortisol, iron, iodine, zinc, magnesium, selenium, b vitamins, vitamin c and vitamin d. Why does this even matter? The thyroid hormones are the metabolic lifeline for every cell in the body-- you need to take care of your thyroid. When not functioning properly, you can get many depressive symptoms but so many other health problems.


Thyroid function is at the mercy of cortisol which is produced by the adrenals and signaled by your brain. The real question is...why is adrenal output abnormal and why is the brain shutting down cortisol secretion. Testing cortisol through the day is necessary for seeing the bigger picture of thyroid function.


These things effect your adrenal glands:

  • Birth control pills - lower available thyroid hormone, promote inflammation, deplete antioxidants.

  • Gluten - the thyroid contains amino acid sequences that resemble those found in gluten. Your immune system gets confused and your thyroid gets attacked.

  • Fluoride - interferes with thyroid tissues. Displaces iodine and depletes selenium(required for thyroid function).

  • Endocrine disruptors - derail hormonal balance, promote inflammation and negatively stimulate immune system.


Top toxic things to eliminate:

  • Gluten containing proteins

  • Most forms of sugar- refined sugar, high fructose corn syrup, artificial sugars

  • Non organic and GM foods - corn soy and canola oil

  • Unhealthy fats- processed vegetable oils, casein.

The most effective way to heal an immune system and thyroid gland is to eliminate sugar so that you can control your blood sugar highs and lows. Insulin resistance often manifests as psychiatric symptoms. Most people have a diet in high refined carbohydrates and low in healthy fats and then they get prescribed antidepressants but that doesn't solve the underlying problem. Then imagine a further immune response on top of that due to a gluten response...that would really throw you off.

Insulin


Insulin is one of body's most important hormones. It shuttles carbohydrate based energy(glucose) from food, into cells so that they can be used. Cell doesn't just pick up glucose from the bloodstream on its own. Insulin transports the glucose to the cell. Insulin is produced by the pancreas. Insulin moves the glucose to muscles, liver and fat cells where it is either used as fuel or stored as fat. Normally cells respond to insulin. Insulin is floating by with the key to the cell. The door to the cell opens and the glucose is accepted. This a metaphorical door btw. lol. However, when there is too much insulin knocking on the door all the time, which is caused by prolonged spikes of glucose then the cells don't open the door when insulin shows up. The pancreas pumps out even more insulin. These higher insulin levels cause blood sugar to plummet. This crash causes brain based panic and bodily discomfort...these symptoms are synonymous with depression. This can lead to Type 2 diabetes. This increases your risk for heart disease and depression.


Inflammation measured by high c-reactive protein, and metabolic disorders like high fasting blood sugar and glycated hemoglobin which are extremely predictive of depression in women. Simply, we are not designed to eat the amounts and types of sugar available to us.


Dr. Brogan also discusses a condition called Reactive Hypoglycemia.

When you eat sugar....your blood sugar spikes and then a compensatory spike in insulin. The insulin will plummet your blood sugar and cause a compensatory spike in cortisol which generates a craving for carbs and sugars. Your brain relies on a steady source of fuel. If it is used to running on sugar(rather than fat) then it is at the mercy of theses spikes and crashes. When you're constantly in this hormonal roller coaster you will inevitably feel uneasy. If it continues for long enough you might end up in front of a doctor that's going to give you an antidepressant.




Major Violators

Dr. Brogan lists off many common items that women come in contact with on a regular basis which have a serious impact on your well being. First off, she notes that body lotions, tap water and over the counter pain relievers need warning labels. Tap water?! Holy moly.


She drills down on a some major violators:


Birth control Dr. Brogan emphasizes how detrimental birth control pills are to a woman's health throughout this book. Aside from them lower available thyroid hormone, promoting inflammation, depleting antioxidants, she says that it places all the burden on the women. She also states that birth control ultimately causes mood disturbances.



Statins

Statins are cholesterol lowering drugs. Their benefits are exaggerated with statistical deceptiveness about effectiveness and side effects. Statins are now being said to reduce inflammation. It's important to remember that the body and the brain need cholesterol to thrive. Cholesterol is vital for brain health. Cholesterol is essential for cell membrane structure and support hormone synthesis and vitamin d production. It is an essential fuel for neurons. The brain is the most cholesterol rich organ in the body. Also, cholesterol in the skin, when exposed to UV rays from the sun gets used in the synthesis of vitamin d. Statins can cause decrease cognitive function, depression, muscle pain and diabetes.


Acid reflux medication (PPI):

If you have to take a pill to deal with acid reflux symptoms then you need to consider if a change in your diet would make those symptoms go away. When you're having acid reflux symptoms...ask yourself why you're having this reaction. Stomach acid is critical for your biology. Acid reflux medication can render you deficient in vitamin b12 and put you on a path to depression. B12 supports myelin, the sheath around nerve fibers that allow the nerve impulses to conduct. B12 deficiency drives symptoms such as impaired gait, loss of sensation, dementia and multiple sclerosis.


B12 is best known for its role in red blood cell production.

B12s role in neuro-psychiatric is best explained by two biological mechanisms(methylation and homocysteine recycling).

Methylation: This is the process of taking a single carbon and 3 hydrogens(methyl group) and applying it to countless critical functions in your body such as; thinking, repairing DNA, turning on and off genes, building and metabolizing neuro transmitters, producing energy and cell membranes, and getting rid of environmental toxins. DNA methylation is about marking DNA for expression rather than silencing them. Methylation defects, which can be brought on when certain B vitamins are low can bring on a wide array of conditions...one of which is depression.


Homocysteine recycling

Vitamin B12 is important in the recycling of a potentially toxic compound, homocysteine. Vitamin B12 keeps homocysteine in check.. High Homocysteine are typically found in people with depression.


Essentially, the main takeaway is that proton pump inhibitors trigger vitamin b12 deficiency. They also destroy your gut flora. Tylenol

Don't just take a Tylenol. Tylenol blunts your emotions. It works not only works with physical pain but also with phycological pain. It interferes your your emotions and your processing of information. It depletes the body's most vital antioxidant, glutathione. Glutathione, helps to control oxidative damage and inflammation in the body and the brain. This is a note to self but N-acetyl cysteine enhances glutathione production.



Advil, Motrin, Aleve (NSAIDs) Because these NSAIDs are available over the counter most people think that they are harmless. These are mean to treat inflammation and fever. They work by reducing

the amount of prostaglandins in the body. Prostaglandins promote inflammation that is necessary for healing, blood clotting functionality and protect the stomach from the damaging effects of acid. NSAID mess with both upper and lower intestines. It has been demonstrated that it erodes your lower intestines. Remember that the gut lining is that important barrier between "you" and the outside world. When it is compromised...it triggers an inflammatory response when things pass through it.


Curcumin!

Curcumin is a powerful anti-inflammatory effects. It rivals NSAID's. For acute pain take 1 to 2 grams.



Fluoride

Fluoride is toxic to your body. It effects thyroid function and disrupts cellular activity in all of us. Interestingly, it is still added to the water supply. It increases absorption of aluminum and manganese(not good), calcifies the pineal gland, damage the hippocampus(memory center), damages Purkinje neurons and cause hypothyroidism. By the way, Toronto's water is fluoridated, based on recommendations of the Canadian Dental Association, and supported by Toronto Public Health. Fluoride levels vary between 0.5 and 0.6 milligrams per litre.


Xenoestrogens Xenoestrogens are hormone mimickers that are lurking in the things we eat, breathe and slather on our skin. They closely resemble the structure of hormones so they are able to interact with the body like hormones. It's challenging to avoid this shit because they are literally everywhere. Some common ones that people will be familiar with are BPA in plastics, even the stuff that is used in nonstick cookware...but they are legit almost everywhere. We need to make better choices to reduce exposure.


Vaccines

Your immunity is within your control. Vaccines were developed before we knew about DNA. Depression, stress and dysbiosis can load the gun while vaccines pull the trigger on prolonged inflammatory responses and adverse reactions. Some research indicates that depression as result of vaccines....but how to know if one of these will mess you up? You can't know. One size fits all is not appropriate. True informed consent is necessary.



Food is Information


There is a strong relationship between the food you eat and your body and brain biochemistry. Food isn't just fuel. It's not just micro and macro nutrients. Food influences epigenetic expression...it talks to your cells.


Some of her recommendations include:


  • Minimize highly processed foods: Gluten and dairy which trigger an immune response

  • Increase vitally important fats needed for brain health and blood sugar stability.

  • Sourcing of food is important, organic non GMO. Processed vegetable fats, sugars, preservatives and other chemicals cause inflammation. Honor real food, they way it is supposed look taste and feel.

These vitamins / minerals are important (details about supplements are further down):

  • Vitamin A in its usable form.

  • D and K2

  • B6 and B12

  • Choline

  • Zinc

  • Methionine(amino acid)


Weston Andrew Price was a dentist who investigated the heath impacts of indigenous diets. He determined that there is no one diet for health. Humans adapted to a variety of diets for a reason. Traditional cultures where things like depression don't exists all had common traits:

  1. No traditional groups followed a vegetarian diet

  2. No traditional groups followed a low fat diet

  3. A traditional diets were local, natural and whole foods

  4. All traditional groups used some raw food



 

Main components of a depression free diet:


Eliminate processed food:

Anything in a package.

Anything that has:

  • refined carbs and flour,

  • preservatives,

  • unpronounceable ingredients.

Allergens:

Eliminate gluten, soy and corn. These items are becoming more an more allergenic. Wheat has been modified so much it has unrecognizable proteins that can trigger immune response. The Plant Paradox explains this extensively. She recommends eliminating grains for a month. Just do it and see how you feel.

Sugar:

Eliminate all sugar, which includes: evaporated cane juice, corn syrup, high fructose corn syrup, crystalline fructose, fructose, sucrose, malt, maltose, maltodextrin, dextrose, beet sugar, turbinado sugar, invert sugar.


Cereal:

Don't eat these. You're better off eating real food for breakfast.

Eat real foods: Fresh fruits and veggies.

Root vegetables, pastured meats, wild fish, eggs, nuts and seeds. Natural oils.


Organic Foods: When possible, always try to get organic food. These foods are particularly important to buy organic: Apples, celery, strawberries, peaches, spinach, nectarines, sweet bells, grapes potatoes, cherry tomatoes, lettuce, collar greens and kale. These items are not so important to buy organic:

onions, avocados, sweet corn, asparagus, egg plant, kiwi, grapefruit, papaya, mangos, cabbage, cantaloupe, cauliflower.


Avoid foods that have been sprayed with Roundup (glyphosate). It fucks with nature and your micobiome.



Eggs

Pastured eggs are good for you. The cholesterol argument is bullshit. Dietary cholesterol such as saturated fat from beef does not convert directly to blood cholesterol Cholesterol levels in people who eat no eggs are almost the same as the cholesterol in the people who eat lots of eggs. The majority of the cholesterol measured in a blood test is produced in your liver. Consuming more cholesterol keeps your bodys production of cholesterol in balance. Eggs are a perfect food.


Raw dairy:

Make sure your dairy comes from older breeds of cows that do not produce beta-casein alpha 1. A1 protein found in most milk aggravates neurological conditions. Pasteurization destroys important bacteria, folate, Vitamins A, B6 and C. It also inactivates lipase, lactase and phosphatase(which aids in calcium absorption, oxidizes cholesterol and damages omega 3 fatty acids. They also contain exosomes which contain microRna...the ones found in this type of milk can trigger inflammation.


Nuts and seeds:

She says all seeds are good. Do not eat peanuts. If you're going to eat nuts make sure that you soak them before eating them.


Avoid legumes: Legumes contain lectins as they confuse our immune system. Common legumes are: beans, peas, lentils, and peanuts


Don't avoid fat:

Unmodified animal and plant fats are okay!


Liver Powder:

Dr Brogan highly recommends taking a liver powder supplement. It is high in fat soluble vitamins, minerals, antioxidants and b vitamins.


Probiotics and fermented foods:

Gut microbes influence mood and behavior. Administration of probiotics can reverse certain phycological disorders. Eat fermented foods as they are rich in probiotics.

Probiotics:

  • help maintain the integrity of the gut lining

  • balance the body's ph

  • serve as natural antibiotics, antifungals and antivirals

  • regulate immunity

  • and control inflammation

They prevent the growth and invasion of pathogenic bacteria. Also, when they metabolize the things from your diet, they liberate nutrients making them easier to be absorbed.


Lactobacillus acidophilus, lactobacillus casei, bifidobacterium bifidum have been proven to improve mood. Probiotic exposure may not necessarily lead to the growth of good bacteria but it influences vagal nerve signaling and intestinal integrity.

The strains that have been proven to influence the immune system are:

l. paracasei

l. rhamnosus

l. acidophilus

l. johnsonii

l. fermentum

l. reuteri

l. plantarum

b. longum

b. animalis The best studied for anti-inflammatory functions l. paracasei

l. plantarum

p. pentosaceus


You can use this information to aid in shopping for a probiotic supplement or sometimes your yogurt and kefir drinks list the strains. For example, after reading Dr. Perlmutters books I used that information to look for a probiotic supplement that contained bifidobacterium infantis. It's not on Dr. Brogans list but its good to be cognizant of the different strains. She's merely bringing things to your attention so that you can leave no stone unturned on your healing journey.


Eat mindfully

Slow down and focus on eating and enjoying your food.

 

Meditation, Sleep and Exercise


In this section of the book Dr. Brogan says that if you can do these three things it can have a TREMENDOUS effect on your mental well being. The relaxation response is a shortcut to healing.


Meditation cultivates a state of waking relaxation. It has been found to simulate the expression of genes that are extremely anti-inflammatory in nature and helps stabilize blood sugar. We become calm cool and collected on a physical level as well as on a mental level. Meditation quiets your judgmental and analytical self. It puts you in a neutral state that allows you to watch and witness without fixing. Meditation induces a shift in activity from one area of the cortex to another. Right frontal cortex to the left frontal cortex(associated with relaxation).


The biological events that take place during meditation prevent the body from translating phycological worry into physical inflammation. It also helps you cope with stressors in your life and also meet challenges with grace.


It is so unrealistic to match up the reality of your external world to your arbitrary expectations. We create our own distress and we try to use our minds to resolve that distress...it won't work.

Deep Breathing

Deep breathing is a quick way to trigger the parasympathetic nerve response. It triggers a relaxation response. Increases nitric oxide! The lymphatic system also benefits from deep breathing.


Lymph

Lymph is a clear fluid filled with immune cells. It moves around body in a series of vessels. Lymph is important to your immune system because it delivers nutrients, collects wastes and helps destroy pathogens. The deeper you breath the more active the lymphatic system is. The fluid is not actively pumped. Breathing and physical movement moves the lymphatic fluid.

Left Nostril Breathing from Kundalini Yoga.

Left nostril breathing activates ida nadi which relates to calmness and relaxation. This type of breathing is related to the moon energy.


Stress: Dr Brogan mentions the book The Untethered Soul by Michael Alan Singer

This book suggests that happiness and freedom are the result of cultivating witness consciousness. This means you witness your own mind, emotions and behaviors rather than feeing that you ARE these things. Singer also says that focus and awareness are what make disturbances real. He implores readers to experience pain as energy as passing through before the eyes of consciousness and then relax and release and don't engage in a reactionary way. Let the parade of thoughts and emotions pass by without running along with it to see where is going. I also read this book and one of the things he mentioned that caught my attention is that it is so unrealistic to match up the reality of your external world to your arbitrary expectations. We can easily manufacture suffering for ourselves by doing this. We can also use this as freedom when you take in reality as it is. This reminds me of a mantra Adrienne from Yoga with Adrienne says "Trust that everything is as it should be"


Tips:

  • Notice and acknowledge your discomfort

  • Relax and release it no matter how urgent it feels

  • Let the energy pass through you before you try to fix it

  • Imagine sitting up tall in a mental place where you can watch your thoughts, emotions and behavior in a detached compassion.

  • Ground yourself. Connect to the present movement. Feel the earth under your feet. Smell the air.

Kundalini Yoga

The author speaks of the profound importance of kundalini yoga in her life. She says that she took her young children on a retreat so that they could be exposed to this early in life. I really like that concept. Hatha yoga has been a major vehicle of change in my life. Kundalini Yoga combines meditation, mantra and physical exercises and breathing techniques. Kundalini is a technology that enables you to harness your shakti. It is done though 1 to 11 minute kriyas. This type of yoga uses breath and movement to unearth and help release subconscious negative patterns engrained in us. Each kriya is for a specific purpose. They have been handed down with great care from ancient times. The mantras are for the purpose of cultivating vibrational effects for the brain and nervous system. The breath is for accessing the nervous system in ways that we cannot.


Exercise and Sleep


Sleep:

Sleep is not a state of inactivity. It is a phase of profound regeneration. Prolonged sleep deprivation can have profound health impacts, including cardiovascular disease and diabetes, learning a memory problems, weight gain, depression and excess mortality. Sleep effects our hormonal cycles. Our hormonal cycles are basically our internal biological clock(circadian rhythm). Our circadian rhythm is defined by a pattern of reoccurring activity associated with the environmental cycles of day and night (roughly 24 hours) . Our circadian rhythm includes our sleep/wake cycle, shifts of hormones and the rise and fall of body temperature. When you're not aligned with a solar day, you feel off. Our appetite hormones, leptin(we've had enough) and ghrelin(need to eat) are effected by inadequate sleep. Studies have show that after a few nights of inadequate sleep subjects have tremendously higher hunger and gravitate toward high calorie snacks.


One of the lasting effects of antidepressants is the interference with sleep patterns. All SSRIs have been found to decrease REM sleep. During sleep a complex dance of hormones occurs but when it is interrupted immunity function is effected. Women with inadequate sleep have higher levels of pro inflammatory markers in their bloodwork.



Homeopathy

Dr. Brogan mentions potential homeopathy treatments for dealing with sleep interferences. I personally don't know anything about this topic but I do find it a bit interesting.

Nux vomica - for tension and feeling over worked

Ambra grisea - for sleepiness that disappears when you lay down

Arsenicum album- for waking with anxiety between 1 and 3. I haven't tried homeopathy but I recommend people do a few seconds of research to determine if they think it is something that could be effective.



Botanicals:

From experience, I can say that ashwaganda and valerian root are excellent for promoting restfulness. The book also mentions magnolia and passion flower.



Exercise:

Exercise acts as a buffer against depression. Aerobic exercise increases an enzyme called (PGC)-1alpha1. This enzyme protects the brain against depression. (PGC)-1alpha1 changes gene signaling. There are substances that accumulate in the bloodstream after stress and they are capable of crossing the blood brain barrier. These substances are linked to depression because they cause inflammation in the brain. Another protein expressed in response to the signals from (PGC)-1alpha1 breaks down that inflammatory substance that cannot get through the blood brain barrier. So in plain English, when you're stressed there are substances that accumulate in your blood. In its original state these substances can pass into the brain and cause inflammation. Exercise produces an enzyme. In response to that enzymes presence a protein is created that breaks down the inflammatory substances so that they are unable to pass into the brain.


She mentions a bunch of potentially toxic things that women encounter in their daily lives that they should be mindful of. To sum it up, she is saying use natural products and drink pure water. One thing that I ended up bookmarking was hand sanitizers...for obvious reasons(The dreaded Rona!).


Hand Sanitizers

This book was written pre-pandemic but Dr. Brogan warns against the use of hand sanitizers. They enhance the penetration of substances through the skin by 200 fold. There is a paper called "Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA)." The title says it all. Be mindful of touching receipts especially after hand sanitizing.


Testing and Supplementing


These are the tests she recommends getting:


  • TSH

  • FreeT4

  • Free T3

  • Reverse T3

  • Thyroid peroxidase antibody (TPOAb)

  • Thyroglobulin antibody (TgAb)

  • MTHFR mutation test

  • Vitamin B12 in blood

  • Homocysteine levels in blood

  • high-sensitivity C-reactive protein (hs-CRP)

  • Fasting Glucose

  • Fasting Insulin

  • hba1c

  • Vitamin D (250 h. 1,25)

  • Salivary Cortisol

  • Stool PCR testing

  • Urinary Organic Acid Test


Thyroid Function Tests: These tests test how well your thyroid is functioning, whether the brain is sensing hormone levels, what those levels are and whether or not the immune system is mistakenly attacking the gland. Recap: Thyroid hormone production is controlled by a feedback loop between your thyroid glad, pituitary gland and your hypothalamus. The hypothalamus releases thyrotropin-releasing hormone (TRH), which stimulates the pituitary gland to synthesize and release thyroid-stimulating hormone (TSH). TSH then triggers the release of triiodothyronine (T3) and thyroxine (T4) from the thyroid gland. When enough T4 is produced it signals to TRH and TSH that there is enough in circulation and to stop production. About 80 percent of the hormone produced by the thyroid is T4. Only a small amount of the hormone t4 gets converted to T3. T3 then gets converted to FreeT3 or Reverse T3. FreeT3 is important because it is the primary thyroid hormone that can attach to a receptor and affect your physiology. Controls your metabolism, body temperature, maintains movements of your bowels. Most doctors only test for TSH and T4.


Tests to order and optimal value where applicable:

TSH- Optimal value: less than 2uU/ml

FreeT4- Optimal value: more than 1.1mg/dl

Free T3- Optimal value: more than 3.0pg/ml

Reverse T3 - Optimal value: Less than a 10:1 ratio RT3:FT3

Thyroid peroxidase antibody (TPOAb)- Optimal value: Less than 4 IU/mL or negative

Thyroglobulin antibody (TgAb)- Optimal value: Less than 4 IU/mL or negative


If you're already taking Synthroid for under preforming thyroid:

The synthetic T4 is given to attempt to move your TSH within range. This leaves you symptomatic but "treated." Remember that when enough T4 is produced it signals to TRH and TSH that there is enough in circulation and to stop production. You will still be symptomatic because of poor conversion of the T4 to active thyroid hormone T3 and suppression of your natural T3 production because of your now lower TSH.

So you'll still have thyroid symptoms but your lab tests will be normal.


Take a desiccated thyroid supplement



MTHFR- Methylenetetrahydrofolate reductase- Methylation.

The MTHFR gene creates the MTHFR enzyme (Methylenetetrahydrofolate reductase). This enzyme is essential for several bodily processes that directly tie into mental wellbeing. When its working right the MTHFR gene begins a multi step chemical breakdown process called methylation. It helps you make important proteins, use antioxidants, combat inflammation, eliminate toxins and heavy metals, keep homocysteine within normal range, optimize brain function, silence the genes in your body (methylation) whos over expression can cause harm. A defect in the MTHFR gene is highly correlated to psychiatric symptoms. There are two common variants to this gene that result in reduced functioning. One gene variant occurs at the 1298 position in the MTHFR gene. This means at the 1298 position in the MTHFR gene, “A” is the expected DNA base and “C” is the gene variant. The other gene location is at C677. Both mutations reduce your MTHFR enzyme function. Supplementing activated folate (methyl folate and B12)

The actual test is called the MTHFR mutation test.



Vitamin B12- This test measures serum B12 levels. Many people are severely deficient in vitamin B12 Deficiency is defined as below 150-200 pg/ml but you want to be above 600pg/ml

Testing for deficiency in blood level doesn't always give you a good picture of what's going on in the brain or functionally in the body.


It helps to look at homocysteine and methylmalonic acid as well. These are surrogate markers for levels of B12. Homocysteine and methylmalonic acid when these two substances are elevated in the blood its a good indication that B12 is low. Homocysteine is an inflammatory protein that must be metabolized by B12 and folate. Methylmalonic acid is a compound that reacts with B12 to create Coenzyme A (CoA) which is essential for normal cellular function.

Optimal levels Homocysteine between 7-10 micromoles per liter (mcmol/L) Normal levels: Methylmalonic acid 0.08 and 0.56 millimoles per liter (mmol/L)

Typically homocysteine over 8 is indicative of inflammation and may be responsive to b12 supplementation.


hs-CRP Test

High-sensitivity C-reactive protein (hs-CRP)

CRP is a protein that the liver makes when there are general inflammatory messengers in the body. You want to be between 0.00 1.00 mg/l



Fasting Glucose / Insulin / hba1c


These tests check blood sugar control . hba1c is the most accurate because it can give you an average of your blood sugar over the past 90 days. You want to be between 4.8 and 5.2 percent.


Fasting glucose- one time snapshot in fasted state. 70-85 mg/dl with fasting insulin below 6 uIU/mL.



Vitamin D

This test measures serum levels of this hormone vitamin.

Vitamin D test (25 OH) - Normal range 50-80mg/ml

Vitamin D receptor activating metabolite - (1,25 ) should be in normal range


Salivary Cortisol

The body has two adrenal glands, one above each kidney. Testing through saliva and urine can be insightful but usually just confirm what you already know. We are under chronic stress.

Salivary cortisol needs to be measures at 4 points during the day. It doesn't tell you what the hormone is doing at the receptor, how it is being broken down or what cause cortisol production to change. It is useful because it can help explain symptoms and their timing.

Cortisol changes throughout the day but should be higher in the morning and lower at night.


Stool PCR testing

This test evaluates your gastrointestinal function and can test imbalances in your gut microbiota, presence of parasites, gut inflammation and absorption issues. Remember, that we don't know what the optimal microbiome is yet but this test will show levels of beneficial bacteria and notable infections that correlate with inflammatory markers.


Urinary Organic Acid Test

This test tells you if there is a defect somewhere in your body's metabolism. Not really necessary but it is something to consider if you have more complex fatigue and cognitive symptoms.



Supplements:

Core Supplements:

B Vitamins, Minerals, Fatty Acids, Glandular, Digestive Enzymes


B Vitamins: B vitamins: Thiamine(b1), Riboflavin(b2), niacin(b3), perdoxcine (b6), folate b9, b12, biotin, pantothenic acid (b5)


These vitamins help the body convert food into fuel and metabolize fats and protein. They also help the adrenals and nervous system function properly. They are water soluble so body cannot store them. Your gut bacteria produces most of t