A Mind of Your Own by Kelly Brogan, M.D. and Kristin Loberg by Kelly Brogan, M.D. and Kristin Loberg - Read Online

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A Mind of Your Own - Kelly Brogan, M.D.

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Dedication

To the legacy of Dr. Nicholas Gonzalez

and to all of the light workers

who illuminate the path for my daughters,

and everyone’s daughters.

Contents

Dedication

Introduction: Psych—It’s Not All in Your Head

PART 1: THE TRUTH ABOUT DEPRESSION

1    Decoding Depression

It’s Not a Disease: What You Don’t Know About This Syndrome and How It Manifests

2    Truth Serum: Coming Clean About the Serotonin Myth

How You’ve Been Misled, Misdiagnosed, and Mistreated

3    The New Biology of Depression

What Gut Microbes and Silent Inflammation Have to Do with Mental Health

4    The Great Psychiatric Pretenders

Two Common, Resolvable Conditions That Can Lead to a Psychiatric Diagnosis

5    Why Body Lotions, Tap Water, and OTC Pain Relievers Should Come with New Warning Labels

Common Exposures and Drugs That Can Lead to Depression

PART 2: NATURAL TREATMENTS FOR WHOLE-BODY WELLNESS

6    Let Food Be Thy Medicine

Nutritional Recommendations to Heal Your Body and Free Your Mind (Without Feeling Like You’re on an Impossible Diet)

7    The Power of Meditation, Sleep, and Exercise

Three Simple Lifestyle Habits That Can Enhance Mental Health

8    Clean House

How to Detoxify Your Environment

9    Testing and Supplementing

Supporting the Healing Process

10  4 Weeks to a Natural High

A 30-Day Plan of Action

Closing Words: Own Your Body and Free Your Mind

Recipes

Acknowledgments

Notes

Index

About the Author

Credits

Copyright

About the Publisher

INTRODUCTION

Psych—It’s Not All in Your Head

All along the history of medicine, the really great physicians were peculiarly free from the bondage of drugs.

—SIR WILLIAM OSLER (1849–1919)

If you’ve picked up this book, then chances are you can relate to any of the following: persistent distress, malaise, anxiety, inner agitation, fatigue, low libido, poor memory, irritability, insomnia, sense of hopelessness, and feeling overwhelmed and trapped but emotionally flat. You might wake up most mornings unmotivated and uninspired, and you drag yourself around all day waiting for it to end (or waiting for a drink). Maybe you feel a sense of dread or panic without knowing why. You can’t silence the negative thoughts, which puts you on edge. Sometimes it seems like you could let loose an endless stream of tears, or perhaps you can’t remember the last time you cared enough about something to cry. All of these descriptions are symptoms that typically fall under a diagnosis of clinical depression. And if you were to seek help through conventional medicine, even if you don’t consider yourself depressed, you’d likely be handed a prescription for an antidepressant, joining the more than 30 million users in America. You might already be part of this community and feel like your fate is now sealed.

It doesn’t have to be.

Over the past twenty-five years, ever since the FDA approval of Prozac-type medications, we’ve been taught that drugs can improve the symptoms of or even cure mental illness, particularly depression and anxiety disorders. Today they are among the most prescribed, best-selling drugs.¹ This has led to one of the most silent and underestimated tragedies in the history of modern health care.

I am a practicing psychiatrist with a degree in cognitive neuroscience from MIT, an MD from Weill Cornell Medical College, and clinical training from NYU School of Medicine, and I care deeply for women struggling with their well-being. I’m compelled to share what I’ve learned from witnessing the corruption of modern psychiatry and its sordid history while investigating holistic methods that focus on nutrition, meditation, and physical activity—what some practitioners are calling lifestyle medicine because the approach involves changes in everyday lifestyle habits, not the use of pharmaceuticals. While such drug-free methods are entirely evidence-based, they are virtually unknown in this age of the quick fix.

Let’s get a few facts straight from the get-go. I’m not a conspiracy theorist. I’m not even that politically minded, but I do like to think for myself. I’m a natural skeptic and pragmatist. These days, there are a couple of issues in my line of work that are making my blood boil, and I’m working to connect the dots between them to help establish a framework for a truth in science sniff-test. For one, symptoms of mental illness are not entirely a psychological problem, nor are they purely a neurochemical issue (and, as we’ll see shortly, not a single study has proven that depression is caused by a chemical imbalance in the brain). Depression is merely a symptom, a sign that something is off balance or ill in the body that needs to be remedied.

And two, depression is a grossly misdiagnosed and mistreated condition today, especially among women—one in seven of whom is being medicated. (For reasons we’ll be exploring, women experience more than twice the rate of depression as men, regardless of race or ethnic background. One in four women in their forties and fifties use psychiatric drugs.)² Although I was trained to think that antidepressants are to the depressed (and to the anxious, panicked, OCD, IBS, PTSD, bulimic, anorexic, and so on) what eyeglasses are to the poor-sighted, I no longer buy into this bill of goods. And after reading this book, you too may think twice about all you thought you understood about the causes of depression.

We owe most of our mental illnesses—including their kissing cousins such as chronic worry, fogginess, and crankiness—to lifestyle factors and undiagnosed physiological conditions that develop in places far from the brain, such as the gut and thyroid. That’s right: you might owe your gloominess and unremitting unease to an imbalance that is only indirectly related to your brain’s internal chemistry. Indeed, what you eat for breakfast (think whole wheat toast, fresh OJ, milk, and multigrain cereal) and how you deal with that high cholesterol and afternoon headache (think Lipitor and Advil) could have everything to do with the causes and symptoms of your depression. And if you think a chemical pill can save, cure, or correct you, you’re dead wrong. That is about as misguided as taking aspirin for a nail stuck in your foot.

While it’s well documented that multiple forces—such as a tragic life event or the fallout from hormonal shifts—can trigger symptoms labeled (and treated) as depression, no one has explained the potential for antidepressants to irreversibly disable the body’s natural healing mechanisms. Despite what you’ve been led to believe, antidepressants have repeatedly been shown in long-term scientific studies to worsen the course of mental illness—to say nothing of the risks of liver damage, abnormal bleeding, weight gain, sexual dysfunction, and reduced cognitive function that they entail. The dirtiest little secret of all is the fact that antidepressants are among the most difficult drugs to taper from, more so than alcohol and opiates. While you might call it going through withdrawal, we medical professionals have been instructed by Big Pharma to call it discontinuation syndrome, which is characterized by fiercely debilitating physical and psychological reactions.

So unlike most psychiatrists, I’m not one to diagnose a permanent condition, write a prescription, and send my patient on her merry way—the knee-jerk gold standard in my field today. Nor do I have her sit on a couch and talk about her problems endlessly. Much to the contrary, my first item of business is to discuss her medical and personal history, including questions that give me a sense of her life’s exposures since birth, from noxious chemical encounters to whether or not she was born through the birth canal and breast-fed. I also order lab tests that help me take in the bigger picture of her total biology; these are noninvasive screenings that most psychiatrists and general practitioners don’t even think about doing (and in this book you’ll be learning about these easy-to-obtain tests as tools to help you personalize your path to healing).

While I acknowledge my patient’s past experiences, I also focus on what’s unfolding today from a cellular standpoint and the potential impairment (dysregulation) of her immune system. The medical literature has emphasized the role of inflammation in mental illness for more than twenty years. I listen closely and ask her about her current lifestyle, a dismissed and neglected variable in conventional medicine. I reflect on her entirety, considering factors like how much sugar she consumes and other dietary habits, how well her gut and its microbial communities are collaborating, hormone levels such as thyroid and cortisol, genetic variants in her DNA that can put her at a higher risk for symptoms of depression, her beliefs about health, and her intentions for our work together. (And, yes, this takes hours.)

All of my patients share similar goals: they want to feel physically vibrant and emotionally balanced, which I believe is everyone’s birthright—not perpetually drained, unsettled, mentally foggy, and unable to enjoy life. Under my guidance, they achieve these goals through very simple and straightforward strategies: dietary modifications (more healthy fats and less sugar, dairy, and gluten); natural supplements like B vitamins and probiotics that don’t require a prescription and can even be delivered through certain foods; minimizing exposures to biology-disrupting toxicants* like fluoride in tap water and fragrances in cosmetics; harnessing the power of sufficient sleep and physical movement; and practicing behavioral techniques aimed at promoting the relaxation response. These basic lifestyle interventions facilitate the body’s powerful self-healing mechanisms, and there’s plenty of science to support these protocols. This isn’t New Age medicine; I will prove my claims and back my recommendations with current peer-reviewed studies from the world’s most esteemed publications.

I do not deny that I have developed a sometimes belligerent relationship with much of conventional medicine over the past several years. After having witnessed the devastation this paradigm has wrought upon the lives of hundreds of my patients, I’m convinced that the pharmaceutical industry and its bedfellows, concealed behind official titles such as certain medical societies and associations, have created an illusion of science where none exists, in the service of profit over professional responsibility. I will myth bust just about everything you think you know about the role of drugs in the treatment of depression and anxiety. It’s time to turn the lights on in this dark room. Let’s open up this conversation and embrace a perspective on depression that radically challenges mainstream assumptions and theories. If I do my job well, you’ll never look at another ad for an antidepressant again in quite the same way.

Admittedly, I haven’t always been militant about my now unshakable, passionate belief in the effectiveness of holistic, drug-free medicine to heal women’s minds, moods, and memory. I’ve crossed over from the other side in many ways, having once been a dyed-in-the-wool allopathic doctor. I’m from a family that regards conventional medicine as a guiding light. I was always interested in neuroscience and the promise of understanding behavior and pathology, and I pursued psychiatry for that reason. My inner feminist wasn’t totally satisfied, however, until I began to specialize in women’s health. There’s a growing field in psychiatry called perinatal or reproductive psychiatry that focuses on the risk-benefit analysis of treating women during their reproductive years. This is a uniquely vulnerable time period, particularly if a woman is contemplating taking drugs while simultaneously planning a pregnancy or is already pregnant. I soon began to feel constrained by the medication and/or talk therapy model of treating depression, and I delved into how to cultivate better options for not just women in their reproductive years but all women across the entire life cycle.

The further I stepped away from traditional psychiatry, the more I started to ask questions few others in my field were raising, principally Why? Why have the body and mind become dysfunctional in so many millions of women? Are we inherently broken? Why have we gotten so much sicker in the past century when our DNA—the same DNA we’ve had for millions of years—hasn’t changed? Or are doctors just getting better at labeling symptoms under the wastebasket diagnosis that is depression?

These are among the many questions addressed in this book; the answers pave the way to a revolutionary—and by that I mean extremely self-empowering!—new approach to well-being.

I’ve seen extraordinary turnarounds in health. Take, for instance, the fifty-six-year-old woman who entered my office complaining of low energy, pervasive pain, dry skin, constipation, weight gain, and forgetfulness. She was taking an antidepressant and a cholesterol-lowering statin but feeling progressively worse and desperate for answers. Within months, she was off all meds, her cholesterol level optimized, and her depression vanished. Or consider the thirty-two-year-old woman with a history of premenstrual syndrome (PMS) for which she’d taken birth control pills until trying to become pregnant. When she came in to see me, she was on an antidepressant for her flat mood and fatigue and was unable to conceive despite two years of trying. What followed next was not a miracle but rather something I witness every day in my practice. With a few easy changes to her diet and a combination of other lifestyle strategies—the same ones outlined in this book—she was soon prescription-free and pregnant. She also was symptom-free for the first time in her life.

You’ll be meeting many women in this book whose stories speak for themselves and are emblematic of millions of others who live with unnecessary, life-depleting depression. And I trust that you’ll relate to one or more of them. Whether you’re currently taking antidepressants or not, this book has something for every woman who struggles to feel like the radiant self she deserves to be. I see a lot of patients who have tried everything and have been to the country’s top doctors. In fact, a good percentage of my practice involves treating other physicians and psychiatrists.

Many women credit me with the initiation of life transformation. Because I believe passionately in the power of lifestyle medicine to produce changes that are greater than the sum of their parts—bigger, bolder shifts in how we relate to life, spirituality, the environment, and even authorities—I see myself as an ambassador to a new way of experiencing health and well-being. This way of being may be built on the ashes of suffering, but may be the way to rise up, phoenix-like, emboldened, and stronger than ever. That strength and resilience is yours, and it follows you everywhere you take it.

I’ve divided the book into two parts. Part 1: The Truth About Depression, takes you on a tour of your mental health’s friends and enemies, from everyday foods to common prescription and over-the-counter medications. You’ll soon be consuming more saturated fat and cholesterol and shopping differently in the grocery store and drugstore. In compelling detail, backed by science, I’ll expose the stunning relationship between your gut’s health and mental health. And I’ll do so within the context of inflammation, an overused buzzword today that most people still don’t truly comprehend, especially when it comes to its critical role in depression. I will prove that depression is often a result of chronic inflammation—simple as that. I also will explain the underlying responsibilities of your immune system in orchestrating all matters of mental health.

Part 1 includes an overview of the latest research on how we can dramatically alter our genetic destiny—how our genes express themselves, including those directly related to mood—through the everyday choices we make in food and activities. The goal of Part 1 is to prep you for the program you’ll embark on in Part 2: Natural Treatments for Whole-Body Wellness. This is where I guide you through my program, a program designed both for women not taking medications and those who are and perhaps are dreaming of tapering off. Included is a four-week plan of action, complete with menu plans and strategies for incorporating new lifestyle habits into your day.

For support and ongoing updates, you can go to my website, www.kellybroganmd.com. There you’ll be able to read my blog, watch my instructional videos, access the latest scientific studies, and download materials that will help you tailor the information in this book to your personal preferences.

Once you apply to your life what you learn in these pages, you will reap more than the reward of mental stability. My patients often list the following side benefits to my program: feeling in control of their lives and bodies (including effortless weight management); clarity of mind and spirit; enhanced energy; and an unwavering tolerance for distress. Who wouldn’t want these results? The time has come for you to have a mind of your own.

Let’s get started.

PART ONE

THE TRUTH ABOUT DEPRESSION

CHAPTER 1

Decoding Depression

It’s Not a Disease: What You Don’t Know About This Syndrome and How It Manifests

Depression can result from bodily imbalance rather than brain chemical imbalance.

The medicalization of distress obliterates meaning and creates profit.

When I talk about medicine and mental health to large audiences, I often start with the following imagery and facts: think of a woman you know who is radiantly healthy. I bet your intuition tells you she sleeps and eats well, finds purpose in her life, is active and fit, and finds time to relax and enjoy the company of others. I doubt you envision her waking up to prescription bottles, buoying her way through the day with caffeine and sugar, feeling anxious and isolated, and drinking herself to sleep at night. All of us have an intuitive sense of what health is, but many of us have lost the roadmap to optimal health, especially the kind of health that springs forth when we simply clear a path for it. The fact that one in four American women in the prime of their life is dispensed medication for a mental health condition represents a national crisis.¹

Humans have used mind-altering substances to try to dull and deaden pain, misery, sorrow, and suffering since time immemorial, but only in the last few decades have people been persuaded that depression is a disease and that chemical antidepressants are the remedy. This is far from the truth. Many of my patients have been to multiple doctors, bumping up against the hard ceiling of what conventional medicine has to offer. Some have even tried integrative medicine, which aims to combine both traditional medicine (i.e., prescriptions) with alternative treatments (e.g., acupuncture). After all, they are told that there are great natural complements to all the wonders pharmaceutical products have to offer. But the reason they can’t find a solution is because nobody has asked why. Why are they unwell? Why are their bodies creating symptoms that manifest as depression? Why didn’t they stop to ask this important and obvious question the first time they experienced a flat mood, anxiety, insomnia, and chronic exhaustion?

Before I even get to the answers, let me be the first to tell you that the only path to a real solution is to leave the medical world you know behind. This, the journey I will take you on, is not just about symptom suppression, it’s about health freedom. First let me tell you that I was once a typical doctor, not to mention a typical American who loved pizza, soda, birth control, and ibuprofen. My message is from a personal journey and thousands of hours of research that has compelled me to share the truth about prescription-based care: we’ve been duped.

Yes, my entire training was based on a model of disease care that offers patients only one tool—a drug—and never a shot at true wellness. We’ve handed over our health to those who seek to profit from it, and we’ve been buying into a paradigm based on the following notions:

We are broken.

Fear is an appropriate response to symptoms.

We need chemicals to feel better.

Doctors know what they are doing.

The body is a machine requiring calibration (via drugs). A little too much of this, too little of that.

I call this collective set of notions the Western Medical Illusion. It sets up a vicious system that ushers you into lifelong customer status, dependent and disempowered.

As you can likely guess by now, I love to rant. But I do so with the best evidence science can offer, and there’s a lot we know today about the real root causes of depression—and how to treat the condition safely and successfully—without a prescription pad. If there’s one lesson I will drive home, it’s this: shed the fear, take back your inner compass, and embrace a commitment to your best self, medication free. Even if you don’t already take a prescription drug, I bet you still doubt living the rest of your life prescription free and reliant on your own inner intuition to know what’s best for you. The idea of supporting your body’s innate wisdom may sound quaint at best, or like dangerous hippie woo-woo at worst. From now on, I want you to embrace these new ideas:

Prevention is possible.

Medication treatment comes at a steep cost.

Optimal health is not possible through medication.

Your health is under your control.

Working with lifestyle medicine—simple everyday habits that don’t entail drugs—is a safe and effective way to send the body a signal of safety.

How can I make these statements, and what do I mean by lifestyle medicine? You’re going to find out in this book, and I’ll be presenting the scientific proof to answer questions you may have and to satisfy the doubtful. When I meet a woman and her family, I speak about how to reverse her anxiety, depression, mania, and even psychosis. We map out the timeline that brought her where she is and identify triggers that often fall under one or more of the following categories: food intolerances or sensitivities, blood sugar imbalances, chemical exposures, thyroid dysfunction, and nutrient deficiency. I forge a partnership with my patient and witness dramatic symptom relief within thirty days. I do this by teaching my patients how they can make simple shifts in their daily habits, starting with the diet. They increase nutrient density, eliminate inflammatory foods, balance blood sugar, and bring themselves closer to food in its ancestral state. It’s the most powerful way to move the needle, because food is not just fuel. It is information (literally: "it puts the form into your body"), and its potential for healing is a wonder to me, every single day.

Achieving radical wellness takes sending the body the right information and protecting it from aggressive assault. This isn’t just about mental health; it’s about how mental health is a manifestation of all that your body is experiencing and your mind’s interpretation of its own safety and power. It’s also about how symptoms are just the visible rough edges of a gigantic submerged iceberg.

Note that none of these concepts connects with substances in the brain that might be low. If you had to define depression right now, before reading further, chances are you’d say something about it being a mood disorder or mental illness triggered by a chemical imbalance in the brain that probably needs to be fixed through a medication like Prozac or Zoloft that will lift levels of brain chemicals associated with a good mood. But you would be mistaken.

So many patients today who are being shepherded into the psychiatric medication mill are overdiagnosed, misdiagnosed, or mistreated. Indeed, they have brain fog, changes in metabolism, insomnia, agitation, and anxiety, but for reasons only loosely related to their brain chemicals. They have all the symptoms that are mentioned in a Cymbalta advertisement that tells them to talk to their doctor to see if Cymbalta is right for them. But it’s like putting a bandage over a splinter in the skin that continues to stir inflammation and pain. It’s absolutely missing an opportunity to remove the splinter and resolve the problem from the source. And it’s an iconic example of how conventional medicine can make grave mistakes, something the pharmaceutical industry is more than happy to encourage.

In holistic medicine, there are no specialties. It’s all connected. Here’s a classic case in point: Eva had been taking an antidepressant for two years but wanted to get off it because she was planning to get pregnant. Her doctor advised her not to stop taking the drug, which motivated her to see me. Eva explained that her saga had begun with PMS, featuring a week each month when she was irritable and prone to crying fits. Her doctor prescribed a birth control pill (a common treatment) and soon Eva was feeling even worse, with insomnia, fatigue, low libido, and a generally flat mood dogging her all month long. That’s when the doctor added the Wellbutrin to pick her up, as he said, and handle her presumed depression. From Eva’s perspective, she felt that the antidepressant helped her energy level, but it had limited benefits in terms of her mood and libido. And if she took it after midnight, her insomnia was exacerbated. She soon became accustomed to feeling stable but suboptimal, and she was convinced that the medication was keeping her afloat.

The good news for Eva was that with careful preparation, she could leave medication behind—and restore her energy, her equilibrium, and her sense of control over her emotions. Step one consisted of some basic diet and exercise changes along with better stress response strategies. Step two involved stopping birth control pills and then testing her hormone levels. Just before her period, she had low cortisol and progesterone, which were likely the cause of the PMS that started her whole problem. Further testing revealed borderline low thyroid function, which may well have been the result of the contraceptives—and the cause of her increased depressive symptoms.

When Eva was ready to begin tapering off her medication, she did so following my protocol. Even as her brain and body adjusted to not having the antidepressant surging through her system anymore, her energy levels improved, her sleep problems resolved, and her anxiety lifted. Within a year she was healthy, no longer taking any prescriptions, feeling good—and pregnant.

I require my patients and I implore you to think differently about health-care decisions and consumerism. Part of my motivation in writing this book was to help you develop a new watching, questioning eye that you can bring to every experience. For my patients to be well, I know they will need to approach their health with an extreme commitment to the integrity of their mind and body. Personally, I have no intention of ever returning to a lifestyle that involves pharmaceutical products of any kind, under any circumstances.

Why?

Because we are looking at the body as an intricately woven spiderweb—when you yank one area of it, the whole thing moves. And because there is a more powerful way to heal.

It’s so simple that it could be considered an act of rebellion.

You might think of yourself as averse to conflict—someone who wants to keep the peace, keep your head low, and do what’s recommended. To be healthy in today’s world, however, you need to access and cultivate a reliance on yourself. And you’re going to do that by first shifting your perspective forever. Look behind the curtain and understand that medicine is not what you think it is. Drug-based medicine makes you sick. I will go so far as to say that hospital care makes you sick; though estimates vary, it’s reasonable to say that hospital care claims tens if not hundreds of thousands of lives annually due to preventable medical mistakes such as wrong diagnoses and medications or surgical errors, infections, and simply screwing up an IV.² The Cochrane Collaboration, a London-based network of more than 31,000 researchers from more than 130 countries, conducts the world’s most thorough independent analysis of health-care research. Based on data from the British Medical Journal, the Journal of the American Medical Association, and the Centers for Disease Control, it has found that prescription drugs are the third leading cause of death after heart disease and cancer.³ And when it comes to psychotropic drugs, the Cochrane Collaboration’s conclusions are compellingly uncomfortable. In the words of the Collaboration’s founder, Dr. Peter Gotzsche, Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good.

By and large, doctors are not bad people. They are smart individuals who work hard, investing money, blood, sweat, and tears into their training. But where do doctors get their information? Whom are they told to trust? Have you ever wondered who’s pulling the strings? Some of us in the medical community are beginning to speak up and to expose the fact that our training and education is, for the most part, bought.

Unfortunately in the balance between benefits and risks, it is an uncomfortable truth that most drugs do not work in most patients.⁵ Before I read this quote in the prestigious British Medical Journal in 2013, I had already begun to explore the evidence that there really isn’t much to support the efficacy of most medications and medical interventions, particularly in psychiatry, where suppressed data and industry-funded and ghostwritten papers hide the truth. Another 2013 study published in the equally respected Mayo Clinic Proceedings confirmed that a whopping 40 percent of current medical practice should be thrown out.⁶ Unfortunately, it takes an average of seventeen years for the data that exposes inefficacy and/or a signal of harm to trickle down into your doctor’s daily routine, a time lag problem that makes medicine’s standard of care evidence-based only in theory and not practice.⁷ Dr. Richard Horton, the editor in chief of the much-revered Lancet at this writing, has broken rank and come forward about what he really thinks about published research—that it’s unreliable at best, if not completely false. In a 2015 published statement, he wrote: The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.

In 2011 the British Medical Journal performed a general analysis of some 2,500 common medical treatments. The goal was to determine which ones are supported by sufficient reliable evidence.⁹ The results:

13 percent were found to be beneficial

23 percent