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Author: Dr Bernard Brom
Article:
There is clearly a place for
drugs in our present understanding
of psychological disorders. I know
of friends, family members and many
patients who have benefited – these
drugs have changed their lives and
made it possible for them to
function again and even be happy.
Yet this comes with a price. Many of
the drugs cause emotional blunting,
making the stress of everyday living
apparently so much easier to live
with. As one patient said to me, ‘a
bus could go over me and I would not
get too excited about it’. Another
patient who stopped antidepressants
was greatly relieved at having her
emotions back, and although the
downs were difficult to work with,
she was in a good supportive
relationship, preferred to feel all
her emotions, and was learning to
cope more appropriately.
Coming off drugs should only be
started with professional help and
may take many months. I know of some
patients who have stopped suddenly
on their own and had no problems,
but generally this is not a good
idea and many months of slow
withdrawal is advisable. There are
many therapeutic approaches
available for treating milder
psychological problems and when drug
withdrawal is contemplated. In this
article I discuss some of these
options.
Lifestyle management
This is the easiest place to start
and should never be dismissed as too
light-weight to make much of a
difference. In today’s world too
many individuals consume refined
foods, excess sugar, alcohol,
coffee, and a variety of drugs; do
no exercise; and have little
understanding of stress management
and developing skills around
interpersonal, social and business
relationships and communication.
Food intolerance, candida overgrowth
and allergies can all contribute to
mood disorders and should be
corrected through dietary changes,
while even a small increase in
exercise can cause a shift towards a
sense of wellbeing. Pets can make
life meaningful again, open the
heart and lift the spirit.
Nutritional therapy
Inositol
Inositol is a not-so-well-known
nutrient of the vitamin B family. A
study published in the American
Journal of Psychiatry suggested that
inositol is effective in the
treatment of panic disorders in
doses of 6 g twice daily.1 Other
research has indicated a role for
inositol in obsessive-compulsive
disorders, bulimia and binge-eating
and/or depression. It may also be
useful in various mood disorders.2
The dose range is from 12 to 18 g
per day.
Lithium orotate
While lithium carbonate (30 mg
capsules) is used by psychiatrists
to treat bipolar and other
psychiatric disorders, lithium
orotate is used by doctors of
integrative medicine to treat a
range of other problems. Lithium is
a mineral and even occurs naturally
in drinking water. In low doses (10
- 20 mg per day) lithium orotate can
be used to improve brain function
and protect brain cells against
damage caused by toxic molecules
naturally formed in the course of
brain metabolism, or toxins from
outside the body such as drugs and
aluminium. Research suggests that
anyone on mind-altering drugs such
as prescribed by doctors for
psychological problems, as well as
alcohol and marijuana abusers,
should be taking low-dose lithium to
protect brain cells against damage.3
Lithium may also protect against
potential Alzheimer’s disease, and
slow progression in existing cases.
Not only does lithium inhibit beta-amyloid
secretion, but it also prevents
damage caused by beta-amyloid
protein once it has formed. It may
also slow the damage caused by an
increasingly poor blood supply as
people age.4
Amino acids
The amino acids tryptophan,
5-hydroxy tryptophan, tyrosine,
GABA, methionine and phenylalanine
have all been used to affect mood in
a positive way.
My favourite is still tryptophan,
although 5-hydroxy tryptophan may be
more effective in some people.
However the latter has a higher risk
of side-effects. Both these hormones
are precursors to the manufacture of
serotonin in the brain. Instead of
blocking serotonin as many drugs
such as Prozac do, the practitioner
can use one of these amino acids to
increase serotonin production by
increasing the supply of its
building blocks. This is very useful
in people with depression and sleep
disorders. In sleep disorders
tryptophan can be combined with
melatonin for better results.
According to Dr Atkins (of Atkin’s
diet fame) tryptophan is more useful
in the agitated, overwrought type of
depression (2 - 4 g per day), while
tyrosine is more appropriate in the
depression characterised by apathy,
lethargy and listlessness. Both
amino acids can be used in the mixed
type of depression. The recommended
tyrosine dose is 600 - 2 000 mg per
day. The dose for 5-hydroxy
tryptophan is 300 - 400 mg per day.
High doses can cause nausea,
vomiting and diarrhoea.
GABA is both an amino acid and a
neurotransmitter enabling the
transmission of nerve impulses
between cells in the brain. It is
especially useful in anxiety states
and panic disorders, and is a good
natural tranquillizer. Doses range
between 500 mg and 4 g per day.
Phenylalanine is an amino acid
required for the synthesis of
endorphin-like neurotransmitters
that promote alertness and a
positive disposition. In one study
of depressed patients 500 - 3 000 mg
phenylalanine together with vitamin
B6 was found to be more effective
than the antidepressant Imipramine.5
SAM (s-adenosyl methionine) is being
used increasingly to treat
depression. One study found that a
dose of 800 - 1 600 mg per day
helped elevate mood among people who
were moderately clinically
depressed.6
Amino acids are best taken on an
empty stomach for maximum absorption
otherwise there is competition with
protein in the food.
Omega-3 fatty acids
Major changes in our diet have
shifted the ratio of omega-3 and -6
such that there are now major
deficiencies in omega-3 and an
excess of omega-6. Our bodies
evolved on diets providing a maximum
of 4 parts of omega-6 to 1 part of
omega-3. The ratio is now 20:1
possibly due to the increasing
intake of refined vegetable oils
high in omega-6. Healthy brain and
eye development is dependent on a
good supply of DHA, an omega-3 fatty
acid. Children supplied with high
doses of omega-3 fatty acids derived
from cold-water fish show
improvement in attention deficit
hyperactivity disorder (ADHD)
without the use of Ritalin, and the
same is true for adults with
depression.7 Please remember to
change the diet and especially to
decrease the consumption of sugars
and refined foods. High insulin
levels due to increased sugar and
refined foods are known to disrupt
essential fatty acid metabolism.
Other nutrients
Orthomolecular physicians use
high-dose vitamins and minerals to
treat various psychological
conditions. Dr Hoffer, a
psychiatrist in Canada, has been
using high dose nutrients to treat
even schizophrenia with a
combination of vitamin B3 (niacin)
up to 3 g per day together with
magnesium, zinc and other nutrients
where appropriate. In these high
doses vitamin B3 should only be used
under medical supervision because of
possible liver toxicity. (Refer to
an interview with Dr Hoffer in issue
6, 2002 of the Journal.)
Vitamin B12 is probably underrated
as an important nutrient in mood
disorders.8 It is well known that
severe deficiencies cause dementia,
even without anaemia. What is less
well known is that this deficiency
can be the cause of bipolar
disorders and especially psychotic
depression and also other atypical
depressions.9 Vitamin B12 injections
are not essential as it has been
shown that 1 000 mcg enables the
absorption of 10 mcg, which is an
ample amount to maintain normal
tissue levels (even when intrinsic
factor is missing). The sublingual
form may be more effective in doses
lower than 1 000 mg.
Folic acid deficiency is also not
well recognised as a cause of
depression. Folic acid is required
in certain vital enzyme reactions
that occur in the brain, especially
important in the formation of
various neurotranmitters such as
serotonin, dopamine and
noradrenaline.10
There is clearly not enough
recognition of subliminal effects of
borderline deficiencies and how they
may affect human behaviour when
coupled with other deficiencies,
poor diet and the impact of
environmental toxins.
Herbals
The use of herbs in treating ill
health has become increasingly
sophisticated especially as more
information spreads around and herbs
used in different parts of the world
become better known. Even drugs used
to treat psychological disorders do
not always work immediately, so
don’t expect rapid results with
herbal medicines either.
Nevertheless, herbs have the power
to make an enormous difference to a
person’s sense of wellbeing without
the severe side-effects seen with
many of the drugs prescribed by
doctors for depression, anxiety,
panic disorders and insomnia.
My most common recommendations in
this category of herbs are St John’s
wort and valerian. The former is
excellent for mild to moderate
depression, and the latter useful
for anxiety and insomnia. Other
useful herbs for restlessness and
sleep disorders include hops, lemon
balm, passion flower and lavender.
Gingko biloba is another useful
herb, especially in the treatment of
cognitive deficits (cerebral
deficiency disorders) due to organic
brain disorders. Symptoms include
forgetfulness, poor concentration,
dizziness, rapid fatigue, mood
swings, restlessness, anxiety, etc.
The dose range is 120 - 240 mg crude
extract per day. Long-term treatment
is advisable.
Psychotherapy
Laughter is physically and
emotionally good for everyone. It
also boosts the activity of T cells,
natural killer cells and antibodies.
There is an increase in blood
circulation, and even blood pressure
falls. Dr Fry, a psychiatrist at
Stanford Medical School, found that
children laugh an average of 300
times per day, while adults only
laugh between 15 and 100 times per
day (reported in the Townsend Letter
for Doctors and Patients
August/September 1996 p. 10).
There is general agreement among
most psychiatrists that appropriate
psychotherapy is equal in outcome to
pharmacotherapy. The main reasons
for the vast overuse of drugs is
ease of use, expense of long-term
psychotherapy and simple laziness on
the part of the person involved. We
want quick fixes and expect a quick
fix from drugs. If the drug works
then it becomes easy to justify its
use, and a long-term habit or
addiction soon develops.
Other therapies
Flower essences
Dr Edward Bach, a physician who
practised in Harley Street London,
came to believe that all illnesses
have a psychological root. After
retiring into the hills and
observing nature he developed the
first of the flower remedies. These
delicate essences subtly influence
mood, leading to greater balance and
stability. Mustard, for example, is
given for depression and deep gloom.
In this country we have our own
South African Flower essences,
developed to help children and
adults through difficult times.
Homeopathy
Homeopathic over-the-counter
products are available in chemists
and health shops, but for difficult
problems consult a homeopathic
specialist.
Aromatherapy
No one should dismiss the power of
aromatherapy oils. Just the smell of
many oils is extremely relaxing. A
few drops of lavender placed near
the bed of a restless child will
often help him or her fall asleep
quickly. Clary sage, bergamot,
lavender and neroli have uplifting,
antidepressant effects. A drop of
rose oil rubbed onto the hands and
held over the face soothes grief.
Brain wave technology
Modern technology and the use of
sophisticated tools has led to the
development of very interesting and
useful equipment for changing and
stabilising brain wave patterns. Two
approaches in particular deserve
mention.
Cranial electrical stimulation:
Using a small device applied to both
ear lobes, gentle electrical
stimulation may be used to treat
patients with insomnia, anxiety and
depression. Best results are
obtained when this is combined with
a change in diet and
supplementation.
Audio technology utilising CDs and
stereo ear phones has been shown to
help people with insomnia, anxiety,
lack of motivation and poor
concentration. (See advert on page…)
Conclusion
While this article is not
comprehensive, hopefully it allows
one to gain some new ideas for the
treatment of psychological
disorders. Generally doctors of
integrative medicine use multiple
approaches. Psychotherapy is
essential in all cases. My
impression is that few people today
are trained or knowledgeable about
stress management and generally take
the line of least resistance, ending
up with moodiness, anger,
withdrawal, panic states and anxiety
rather than seeing the stress
situation as an opportunity to grow
or seeing the person standing in
front of them as a mirror of their
own inability to meet the situation
in a creative way.
Lifestyle changes, especially diet
and exercise, are so simple yet can
have profound effects.
Learning to be joyful and to see
situations as opportunities rather
than problems, and as stepping
stones rather than stumbling blocks,
may require a real effort in the
beginning. However the results are
so worthwhile that it seems strange
how few people take this path –
instead they choose drugs which
involve major risks.
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