Excerpt from "Alcoholism - The Biochemical Connection" by Joan Larson, PhD.
If you have been unsuccessfully battling depression, you are not alone. At least 40 percent of all alcoholics in the United States are affected. I say 'at least' because our Health Recovery Center study found that almost two-thirds of our clients are depressed at entry. In fact, most alcoholics I have treated suffered from some degree of depression.
It is tempting to pin the blame for hopelessness and despair on the external events that can be triggered by alcoholism, such as the deterioration of a marriage or the loss of employment. To be sure, some of the depression alcoholics report is a result of the negative course life can take when you drink too much. You will be relieved to learn that this type of situational depression is self-limiting and will pass when your life begins to improve. Counseling or group therapy can be of enormous value here. But depression among alcoholics usually runs much deeper than the situational variety I have just described.
Depression often has biochemical roots that stem from the destructive effect of alcohol on the normal chemisty of the brain. Research has verified the relationship between biochemistry and depression. Autopsies of people who have committed suicide have revealed biochemical disruptions that may be unique to suicidal depression. In this chapter you will learn to recognize the warning signs of this tragedy in the making.
No amount of counseling or psychotherapy can help people who suffer from biochemically induced depression. I learned this the hard way: watching my son fight the deep sadness and feelings of hopelessness that descended upon him as his depression worsened. The counseling he received was excellent, but words have no power to reverse the biochemical disruption caused by alcoholism and drugs. In fact, therapy's focus on the unhappy or unsatisfactory external events marring the lives of such seriously depressed people only creates more misery.
My search for an explanation for Rob's suicide led me to studies that confirmed the connections between brain biochemistry and depression and offered methods of repair that succeed far more reliably than any form of talk therapy. I learned that there is no single biochemical glitch that explains all depression. At my clinic, we treat seven different sources of depression affecting alcoholics. In this article, you will learn which of the seven may underlie your depression, (in some cases, two or more may be to blame). You will also learn how to overcome your particular chemical problem or problems. This may mean taking more nutrients. It may require further changes in your diet. Or you may need drug treatment to correct a medical condition that can precipitate depression. First, of course, you'll have to confirm that you are depressed. Then you can evaluate the severity of your case.
How Can You Tell if You are Depressed?
Although two-thirds of the clients at my clinic are severely depressed when they enter the program, many do not realize they are affected. Men in particular are inclined to attribute the feelings induced by depression to other causes. Some blame their inability to handle stress well. Others reject being labeled depressed because of the social stigma often unjustly attached to this condition. Some are simply so overwhelmed by alcoholic symptoms that their depression is masked. Even so, depression is not difficult to spot if you know that certain behaviors are red flags to the condition:
How to Tell if Your Depression is Psychological or Biochemical
Biochemical depression has certain symptoms that distinguish it from the depression stemming from negative life events. You have reason to suspect that you are biochemically depressed if any of the markers listed below describes your depression:
How Serious Is Your Depression?
As important as identifying the cause of your depression is determining the depth of your feelings. If you often have suicidal thoughts, please confide in your physician and a close friend or relative. You will recover, but in your present state you need the support of someone you trust. Share this information and together do the detective work needed to discover what is responsible for your continued depression.
The Seven Kinds of Alcoholic Depression
As I noted earlier, at my clinic we have identified seven sources of biochemical depression affecting alcoholics:
[These may not only affect alcoholics but any of us who suffer from depression.] Where do you fit in? Let's begin with the most likely biochemical scenario.
Neurotransmitter Depletion and Depression
Neurotransmitters are the natural chemicals that facilitate communication between brain cells. These substances govern our emotions, memory, moods, behavior, sleep, and learning abilities. Neurotransmitters are manufactured in the brain from the amino acids we extract from foods, and their supply is entirely dependent on the presence of these precursor amino acids. Alcohol destoys these essential precursor amino acids which is probably why alcoholics seem so emotionally muddled and depressed. Without adequate amino-acid conversion, neurotransmitters are no longer produced in sufficient amounts; this deficiency causes "emotional" symptoms, including depression.
The two major neurotransmitters involved in preventing depression are serotonin (converted from the amino acid L- tryptophan) and norepinephrine (converted from the amino acids L- phenylalanine and L-tyrosine). You can resupply the vital neurotransmitter precursors and reverse depression by taking daily amino-acid supplements. Your symptoms will determine which amino acid you will take for depression: L-tryptophan if your symptoms are sleeplessness, anxiety, or irritability; L-tyrosine or L-phenylalanine if your symptoms are lethargy, fatigue, sleeping too much, or feelings of immobility.
Tryptophan to Serotonin
How to Take Tryptophan
Of all the amino acids, tryptophan is least able to cross the blood-brain barrier. It must pass this biological hurdle in order to be converted to serotonin. Always take your tryptophan on an empty stomach.
Safety and Side Effects
Formula for Depression Due to Serotonin Depletion
*Use tryptophan only if the FDA lifts the current ban on its sale.
Who Should Not Take Tryptophan
Tyrosine to Norepinephrine
L-Phenylalanine to Norepinephrine
There is also some evidence that excess L-phenylalanine can cause headaches, insomnia, and irritability. For these reasons, it is important to start with a low dose. L-Phenylalanine doses can range from 500 milligrams to 1500 milligrams daily taken on an empty stomach. Overdose symptoms are headaches, insomnia, and irritability.
Formula for Depression Due to Norepinephrine Depletion
Who Should Not Take Tyrosine or L-Phenylalanine
Another biochemical cause of depression is a genetic inability to manufacture enough prostaglandin E1 (PGE1), an important brain metabolite derived from essential fatty acids (EFAs). The problem is the result of an inborn deficiency in omega-6 essential fatty acid. Alcohol stimulates temporary production of PGE1 and lifts the depression.
If you have been depressed since childhood, your introduction to alcohol was probably an extreme relief. But this relief is short-lived. When you stop drinking, PGE1 levels fall again and depression returns. To banish it, you turn again to alcohol. Thus a deadly spiral begins toward alcoholism.
During the last fifteen years, researchers have learned to restore normal PGE1 levels in alcoholics and eliminate both the depression and the need to drink for relief. A substance called gamma-linolenic acid (GLA) is easily converted to PGE1. I have seen some amazing recoveries from depression within three weeks of GLA treatment. Take the case of Colleen, a high school English teacher:
Colleen described her childhood and teenage years as withdrawn and lonely, "I can't remember not being depressed," she told me. In college, she drank alcohol for the first time and received the shock of her young life. Her world brightened in a way she had never before experienced. She felt different. Friendly. Happy. The effects lingered into the next day, and then gloom closed in again. After experiencing the dramatic lift in her spirits, she was convinced that she had discovered a magic elixir in alcohol. In a short time she was drinking a few beers every day. The alcohol never failed to banish her depression.
As her college years passed, Colleen's alcohol consumption escalated. She needed to drink more and more to get the lift she sought. She also began to experience deep depressions in the days following heavy drinking. After college, she began teaching high school English. Controlling her depression with alcohol became a real balancing act. Eventually, her drinking came to the attention of her peers and her students. Colleen was appalled at the idea that she was a problem drinker. She decided to prove she could live without alcohol. The next ten years were some of the most miserable of her life. She joined AA and sought psychiatric help for her severe depression. Sadly, no antidepressant drug relieved her misery. It was hard to keep teaching, hard to keep living.
Her depression had reached the suicidal stage when she reasoned that alcohol could put an end to her despair. Her decision to resume drinking didn't take much reflection. Predictably, her alcohol intake began to escalate rapidly. This time, no one sympathized. Her principal ordered her to treatment. Three weeks after completing an inpatient program, she was back at employment and drinking again to medicate her depression. A second round of treatment left her temporarily dry and depressed. Colleen was on a merry-go-round she couldn't get off. When she called the Health Recovery Center, she was crying, "I have alienated everyone because I won't stay sober, but being drunk feels better than being depressed."
I often think someone up there does watch over people, it seems more than coincidence that Colleen found her way to one of the few treatment centers in the country that would run tests and restore her chemistry to normal. Within three weeks, her depression had vanished. She no longer needed nor craved alcohol.
Colleen's was a classic case of chronic depression caused by too little PGE1. Although alcohol blocks production of additional amounts of this metabolite, its active effect is to enhance what little is available in the brain. Eventually, a no-win situation develops and alcohol becomes the only way to prevent depression. The solution, of course, is to provide the brain with the PGE1 needed to reverse the depression. If your body can't do this normally, you can correct the problem by taking gamma linolenic acid (GLA) in the form of Efamol ( a trade name for oil of evening primrose). The formula for EFA deficient depression (see table below) includes three supportive nutrients in addition to Efamol: zinc, needed for formation of gamma-linolenic acid (GLA); vitamin B6 for metabolism of cis-linolenic acid; and vitamin C, to increase production of PGE1. When you take GLA and its co-factors, depression magically lifts and won't return as long as you continue to take the formula. Colleen now uses this natural substance daily instead of alcohol, and her world has brightened up permanently.
Do You Have an EFA Deficiency? In his book "Essential Fatty Acids and Immunity in Mental Health, Charles Bates, Ph.D., provides a list of factors that suggest an essential fatty acid deficiency:
Formula for Depression due to EFA Deficiency
The effect of nutritional deficiencies on brain chemisty can cause depression, anger, listlessness, and paranoia. Unfortunately, the connection between depression and vitamin and mineral deficiencies is often missed. At Johns Hopkins University, sixty-nine cases of scurvy (total vitamin C depletion) were discovered at autopsy, and yet the disease had not been diagnosed before death in 91 percent of these patients.
One of the most dramatic cases of vitamin and mineral deficiencies I have seen involved a man I'll name Paul. He had been arrested four times for drunken driving but continued to drink daily. His probation officer brought him to the Health Recovery Center. The three of us had to decide if an outpatient program would be proper for someone as depressed as Paul. The court had just ordered him back to treatment; judging by the miserable look on his face,it was the last place he wanted to be. Paul was thirty, divorced and living alone. He rarely ate more than one meal a day, usually fast food or junk food. He lived on coffee, cigarettes, and beer. Paul confided that he was probably going to lose his sales job because he could no longer motivate himself. He blamed all of his troubles on depression. There were so many aspects of his life-style that suggested a real depletion of the natural chemicals he needed to recover from alcoholism and depression that I urged Paul to let us work with him. Two days later, after receiving his B-complex shots, Paul remarked that we must have injected him with an amphetamine. The effect of restoring these life-giving substances was dramatic. He also made many life-style changes that contributed to his recovery, but one of the most important was the replacement of certain key natural substances that helped relieve his depression.
The B-Complex Vitamins
Here's a rundown of recent finding about the relationship of B-complex vitamins to depression:
The Safety of Supplements
The stress showed on Mary's face as she described how weary and depressed she felt. Her husband and children demanded too much of her and she drank to escape the pressures and responsibilities. Mary had been in our program for two weeks. She was now alcohol free and making life-style changes. Still, she had very little energy and didn't seem to be recovering very fast. As we talked, she inadvertently offered several clues to the source of her problem. She complained that even on her restricted diet she simply couldn't lose weight. Exercise was out of the question. She was just too tired, even though she slept up to ten hours a night. She was wearing a heavy sweater even though it was a warm spring day. She said she had a hard time keeping warm and was very susceptible to catching colds. By the end of our session, I had heard enough to refer her to our physician for a thyroid test. Symptoms of hypothyroidism (low thyroid function) include:
Researchers speculate that hypothyroidism causes depression because there is an insufficient supply of oxygen to the brain, since people with low thyroid function do not use oxygen efficiently. Linus Pauling contends that all depression could be eliminated if brain cells received sufficient oxygen.
In Mary's case, standard lab tests indicated low-normal thyroid function, but her morning temperature never rose above 96.9 degrees. We treated her with Armour Thyroid, a prescription drug. It relieved her depression and eliminated her mental sluggishness and fatigue. She also lost weight. If your home thyroid test shows that your temperature is consistently below 97.8 degrees, see your physician to discuss treatment. If the doctor wants more information on your testing method, refer him or her to Dr. Barnes's book "Hypothyroidism: The Unsuspected Illness". Another useful book is "Solving the Puzzle of Illness" by Steven Langer, M.D. Dr. Barnes has published more than a hundred papers and several books on the role of the thyroid gland in human health. He treats thyroid disorders with natural desiccated thyroid rather than synthetic thyroid preparations. The advantage of natural thyroid over synthetic is that all thyroid hormones are replaced with the natural product, whereas synthetics have not yet been able to duplicate nature completely and do not affect two troublesome symptoms of hypothyroidism, dry skin and water retention.
In his studies of twelve hundred hypoglycemic patients, Stephen Gyland, M.D., found that 86 percent were depressed. More recently, positron emission tomography (PET) scans have verified that glucose metabolism is often reduced in the brains of patients suffering from depression. The table below, which is based on Dr. Gyland's studies, compares the symptoms of hypoglycemia and depression. It is no accident that both conditions are so common among alcoholics. If hypoglycemia underlies your depression, you should begin to notice an improvement soon after you adopt a better diet that no longer supports the hypoglycemia.
Symptoms of Hypoglycemia and Depression
The connection between food allergies and depression was a revelation to me. I was treating a young woman who was both alcoholic and depressed. I expected to find some food or chemical sensitivities because she had a terrible withdrawal hangover when she stopped drinking, indicating an allergic/addicted response to alcohol. But I was not prepared for the Jekyll and Hyde changes that I witnessed.
By the end of the week-long modified fast, Carol was feeling much better. Her depression was gone and her energy had returned. Then she tested wheat. Within two hours she crashed. Crying over the telephone, she told me she was too depressed to continue the program. The next day she apologized. We were both grateful to find a major trigger to her depression. After her severe reaction, I expected Carol to avoid wheat religiously. At the time, I didn't understand the addiction aspect of the allergic/addicted response. Carol had enormous cravings for breads and pasta, so her resolve lasted only a few days. Then she succumbed to temptation and ate pizza for lunch. An hour later, she arrived at her treatment group sobbing inconsolably while the others groped for emotional explanations for her behavior. After her wheat reaction wore off, her depression again lifted.
Wheat is not the only substance capable of triggering a maladaptive reaction within the brains and nervous systems of sensitive people. Alcohol, certain foods (particularly the grains from which alcohol is made), and many chemicals (particularly hydrocarbon-based products like gasoline and paints) can also cause reactions. Food addiction keeps us coming back for more of certain foods. We love the initial mild energy they provide as they bring us out of our withdrawal state. We don't understand that the downside of this addiction is depression, anxiety, and mental confusion, the result of the inevitable withdrawal in the nervous system and the brain. So be suspect of foods that you feel you cannot do without.
During the last five years, we have seen a steady parade of clients who are fighting an internal war with an overgrowth of a common intestinal yeast called Candida albicans. I can usually tell on the basis of a first interview who is a probable candidate for treatment of candida-related complex (CRC). People suffering from this problem appear depressed, tired, anxious, and so spacey that they can't follow what I'm saying. They tell me they continually crave sugar as well as alcohol, and they have telltale signs of yeast invasion throughout their bodies. Their immune systems are so depressed that most foods cause bloating and produce allergic/addictive responses. If you suffer from CRC, your depression won't lift until these yeast colonizers are brought under control.[Visit your nutrition consultant for a full program to handle this all-too-common condition.]
Suicide and Depression
Before we leave the subject of depression, I want to discuss a painful subject: suicide, the final solution to depression. If your life, like mine, has been seared by the suicide of a family member, you may find the answers you have been seeking. And if you have been trying to cope with overwhelming depression and are plagued with thoughts of suicide, you will find a welcome warning that can help you avert tragedy. Over the years, I've learned that alcoholics often conceal the fact that family members have taken their own lives. But if I tell them about my son's suicide, the truth comes rushing out: "My father shot himself" or "Several times, my mother took a deliberate overdose of pills" or "My son hung himself." The pain of these tragic deaths is often compounded by a family code of silence.
Often, those touched by the tragedy are tormented by guilt. They can't stop wondering whether they could have done something to prevent the suicide, whether they missed warning signs that tragedy was approaching. Recent scientific findings provide some of the answers to these agonizing questions and offer comfort and insight.
Most people experience some major disappointment or stress in the course of life, but suicide is rarely the outcome. And, there is no good evidence suggesting that most depression predates alcoholism or that any personality traits underlie alcoholism. Indeed, researchers have so far failed to find genetically transmitted depression among most alcoholics. Instead, studies suggest that the prolonged use of alcohol causes biochemical changes in the brain associated with depression and suicide. The most striking of these findings (from the National Institute of Mental Health) shows that the neurotransmitter serotonin is almost depleted in all the brains of suicides examined during autopsies. Since alcoholism causes the destruction of tryptophan and other precursor amino acids needed for production of the antidepressant neurotransmitters, it's not surprising that many alcoholics are prone to depression and even suicide. As I have explained earlier in this chapter, alcohol can also precipitate depression by destoying a number of other natural chemicals, including
A cerebral allergic reaction to alcohol or other substances can cause suicidal depression. High levels of toxins from Candida albicans overgrowth can also affect the brain and central nervous system and induce suicidal depression. Alcoholism promotes both proliferation of candida and escalation of cerebral allergies. Since alcohol can inflict so much biochemical damage on the brain and nervous system, it should not be surprising that many alcoholics attempt suicide. One recent study found that up to 40 percent of all alcoholics try to take their own lives at east once; another study found that 26 percent of the deaths of treated alcoholics were suicides. If you feel that you or someone close to you is a suicide risk, please re-read this chapter carefully and encourage the changes recommended to restore normal balance and banish depression once and for all.
Where Do You Fit In?
Now that you are familiar with the various problems that can underlie depression, it's time to determine what to do about the one(s) that may be responsible for your own state of mind. Here are the options:
Don't be surprised if you fit several of these seven categories. Heavy alcohol use wreaks havoc on your biochemical balance. But with a repair program you can restore your health. In some cases you'll need a physician's help or the help of a nutrition consultant. I can't overemphasize the importance of expert medical advice when you are dealing with depression, especially if it is severe. It is equally important to choose a professional attuned to your special needs. Orthomolecular MDs are experts in both allopathic and nutritional science who treat disorders at the cellular level with biological weapons--nutrients that nature has provided in its own system of defense for millions of years. An orthomolecular psychiatrist or physician can help you address the following problems:
For a list of such physicians in your area, contact the American Academy of Environmental Medicine, P.O.Box 16106, Denver, CO 80216, (303) 622-9755.
|Last Updated on Thursday, 17 January 2013 00:33|