[Ayoob]

This has been a really fascinating year for me. I finally finished my masters and will test for NP in a couple weeks. I found some interesting stuff about medication for depression and how an electroencephalogram can help with narrowing the possible choices for a given patient. There is a set of measurements and calculations that can be made that reveal biomarkers for depression. One of those biomarkers is cordance http://en.wikipedia.org/wiki/Cordance. The measurement of cordance can help a provider decide whether serotonin-type drugs are going to work for a given patient. It can also help a provider find out whether the patient is responding to the placebo effect, or if it is in fact the drug that is working. If it's the placebo effect, then the patient will probably be better off in talk therapy, so add that and taper off the serotonin medication. If the patient does not respond to a serotonin medication, then the provider can switch to a medication with a different mechanism of action and see whether that works. Sorted according to these measurements and steps, providers can see about a doubling of the effect of these medications and more correctly guide a patient to a talk therapy option that will work for them.

Also important is a change in the expectation of outcomes. Instead of settling for "well at least you don't want to kill yourself anymore," providers can aim for remission (HAM-D17<7 or a verbal report from the patient that "I'm not depressed anymore.")

A measurement of cordance that rises and falls, and rises and falls again, is possibly indicative of a rapid cycling that could indicate that a mood stabilizer would help.

Some people are victims of sexual abuse as children. There isn't a pill for that. It is very painful and shaming, and talk therapy can help to some extent. Once talk therapy has done its part, serotonin medication might help a little as adjunctive therapy. However, serotonin drugs alone would provide very little benefit on their own.

Diet, exercise, sleep, nutritional supplements, habit and routine, and probiotics can all play a part in the treatment of depression. Lose a few pounds and you might feel better. Enhancing your sleep by being really tired at night can help. Turn off the computer, phone, and TV a couple hours before bed to stop messing with your body's natural production of melatonin with blue light. Consume tart cherries or tart cherry juice to support your body's natural production of melatonin. Take a melatonin pill. Don't smoke crack for at least two hours before bedtime. Turn off the display on your alarm clock.

Exercise.

Vitamin K2, vitamin D, calcium, and fish oil all help with your body's use of vitamin D. Getting enough K2 in your diet isn't easy, but leafy greens can help. There's this Japanese breakfast dish called natto that has phenomenal amounts of K2. A diet rich in K2 can metabolize a lot of vitamin D. A lack of vitamin D can cause depression all on its own. Get your D level drawn at your provider's office and see how the D3 is doing.

Fish oil in capsules, it turns out, isn't metabolized very well by the body. You need other fatty acids from fish in order to get your bang for the buck. The single best source of fish oil that I have found so far is Wild Planet albacore tuna, and the best price I have found is at Costco. It's about $5 a can retail, but six for $12 or $2 a can at Costco. It has about 3.5mg of DHA/EPA (not the ALA omega 3 from flax and walnuts) (I so wanted ALA to be beneficial but it's crap) in a 5oz serving. The really great thing about DHA/EPA is that shit is deLISH. You taste every milligram of that fat. I need no mayo with this tuna. A dash of Tabasco and a short pour of soy sauce and nom nom nom. Sorry kitty, no leftovers from this stuff. I drink every last drop of the water it's canned in, there's DHA/EPA in the liquid, too. There may be a possibility that taking fish oil capsules when you eat fatty fish might cause more of the fish oil capsule to be absorbed. I don't have any evidence to support this. I'm reading between the lines of some things I read.

The reason to get that DHA in your body is that it is a major building block for your brain. There is some weak evidence that DHA helps the brain recover from physical injury. Sometimes, the cause of depression is the death of neurons in the brain. That is the pain with no cause. I speculate that having a ready supply of DHA might help the pain with no cause. I can't prove this. However, your brain records memories by building new neurons. You need new neurons to learn new skills. If you are learning and remembering stuff, then your brain is laying down new tracks. If you have easy DHA laying around then maybe your body doesn't have to work so hard to build new brain tissue for you. If you have easy DHA laying around, maybe the process that kills neurons won't kill them so easily.

K2 regulates your body's habit of depositing calcium in your bones. Take K2 and you can fight osteoporosis. This isn't much of a speculation. Population studies of the Japanese show that the natto-eaters have fewer hip fractures in their elderly. Kimchi provides K2 from the cabbage. Diluting the stinky and pungent natto with the also stinky and pungent but NOM NOM kimchi helps the medicine go down. K2 also helps your body use D3, and the use of D3 fights depression.

My research into probiotics is in the beginning stages. Here are my preliminary findings. Low level inflammation causes something called "sick behavior." Sick behavior is what your body wants you to do when it detects infection. You feel tired, can't get off the sofa. You just want to sleep. Your appetite decreases. It kind of feels like depression, but you actually have the flu. When the flu is gone so is the "depression." Rheumatoid arthritis is a low-level inflammation. Lupus. Tick-borne diseases. Maybe cystic fibrosis. A respiratory infection you can't shake. Sometimes your intestinal flora is part of the problem. Probiotics might help with all of those things. Some say that people have less than a quarter of the healthy flora they should have. I ordered a batch of probiotics that claim to have all kinds of health benefits, I'll report on that when I learn something. Academic journals have hundreds and hundreds of fairly decent clinical trials regarding probiotics. Foster Farms is ditching antibiotics in their chickens and is using probiotics. Foster Farms isn't using probiotics because their spiritual advisor told them it was more natural. Those cold-hearted motherfuckers are using probiotics because they make money selling chicken.

Part of why sugar isn't so good for you is because it's great yeast-food. Apparently you don't want yeast in your gut.

OK, done with my rant for now. If you would be so kind, please attack this post with criticism. I have sources for everything, and I want to figure out which are the best sources to use in supporting the above.

The only thing that will help me learn how to amend this post for eventual inclusion in my role as a nurse practitioner is criticism. Please alert me to anything in there that is not true, could be coming from a bias, something that you have seen anecdotally to fail, etc.

Thanks

[SeaGypsy]

Very important about the crack before bedtime .
I blame SSRI's for destroying my wifes mind & our marriage.maybe saved her from suicide, but I hate the fact she will very likely be on this soul numbing crap forever. There were a few. She now is stuck on Zoloft
I really hate these drugs.

[Ayoob]

One of the reasons I use EEG biomarkers and attempt to detect the placebo response is because there are terrible side effects from antidepressant medications. If a person does not benefit from that medication I want to take them off ASAP rather than try to justify the continuation of the medication.

Thank you for bringing this up.

At the same time, I believe that it's not always possible for modern scientific treatment of psychiatric disorders to successfully treat people with depression. Sometimes complementary/alternative medication, or lifestyle modification, or nutritional support, would be more helpful.

I am sorry for your loss.

[jedrider]

A psychologist once explained to me that Depression can be caused by one's thoughts and so should be dealt with by changing one's thoughts. He explained what happens to one species of monkey when the alpha male who can mate with all the females is suddenly transferred to a cage of a larger species of monkey where the monkey is now at the bottom of the hierarchy, that the monkey begins to start showing all the signs of depression.

I was silent after that. My thoughts were that I would gladly toss a knife to that dejected monkey so he can adequately deal with his state of depression.

Anyway, I believe in drugs, just don't make them one's master.

[PrestonSturges]

A psychologist once explained to me that Depression can be caused by one's thoughts and so should be dealt with by changing one's thoughts. He explained what happens to one species of monkey when the alpha male who can mate with all the females is suddenly transferred to a cage of a larger species of monkey where the monkey is now at the bottom of the hierarchy, that the monkey begins to start showing all the signs of depression.

I was silent after that. My thoughts were that I would gladly toss a knife to that dejected monkey so he can adequately deal with his state of depression.

Anyway, I believe in drugs, just don't make them one's master.

http://youtu.be/HfuWe1N09qI

[PrestonSturges]

A psychologist once explained to me that Depression can be caused by one's thoughts and so should be dealt with by changing one's thoughts. He explained what happens to one species of monkey when the alpha male who can mate with all the females is suddenly transferred to a cage of a larger species of monkey where the monkey is now at the bottom of the hierarchy, that the monkey begins to start showing all the signs of depression.

I was silent after that. My thoughts were that I would gladly toss a knife to that dejected monkey so he can adequately deal with his state of depression.

Anyway, I believe in drugs, just don't make them one's master.

http://youtu.be/HfuWe1N09qI