a worsening of their depression, as these drugs have been proven in rigorous studies to be mood destabilizers (contrary to what conventional wisdom says).35 I should also add that they’ve recently been labeled as carcinogens.36 In a major review published by the Australian and New Zealand Journal of Psychiatry, a group of researchers from a variety of institutions including Tufts University, Harvard University, and the University of Parma in Italy reported that the vast majority of psychotropic drugs can cause cancer in animals.37 Although the animal-based results are not enough to draw definitive conclusions in humans, these same animal studies are often used to justify drug and chemical safety, and therefore they are enough to warrant caution and appropriate informed consent. Unfortunately, these conversations are not happening.
Don’t panic if you’re taking an antidepressant now.
The information in this book will help you take control of this symptom once and for all, and if tapering is right for you, I’ll be sharing my personal guide for doing just that in Chapter 10. For now, accept the fact that we are all designed for depression as humans. It can be a warning sign that something isn’t right within. And just as we are designed to feel glum, we are also designed to self-heal and feel great.
DEPRESSION ISN’T GENETIC, IT’S EPIGENETIC
One of my favorite practice-changing papers was a 2003 case report of a lifelong vegetarian who experienced a month and a half of progressively worsening depression.38 Eventually she began to hear voices and feel paranoid. The fifty-two-year-old postmenopausal woman ultimately became what’s called catatonic, which meant she was awake and alive but nonresponsive, and largely in an otherwise vegetative state. One would automatically assume this was a serious case of severe pathology. She was treated with electroconvulsive therapy and antipsychotics to no avail. And then she was transferred to another hospital, where they happened to test her levels of vitamin B12. They found that she was a tad on the low side, and after receiving a vitamin B12 injection, she fully recovered. Coincidence? I think not. While it may be one of the more extreme cases, it’s emblematic of how a simple but critical deficiency can be at the causal root of psychiatric manifestations. Later on, we’ll see how vitamin B12 deficiency has long been implicated in the development of depression. It’s a classic example of how we are not just puppets at the mercy of our encoded DNA, but rather products of the complex interactions between our genes and our environment. And it’s now well established that our health outcomes are dominated more by our environment than our inheritance. As I like to remind my patients, depression is epigenetic, not genetic.
Even though genes encoded by DNA are more or less static (barring the occurrence of mutation), the expression of those genes can be highly dynamic in response to environmental influences. This field of study, called epigenetics, is now one of the hottest areas of research. Epigenetics, defined more technically, is the study of sections of your DNA (called “marks,” or “markers”) that essentially tell your genes when and how strongly to express themselves. Like conductors of an orchestra, these epigenetic marks control not only your health and longevity, but also how you pass your genes on to future generations. Indeed, the forces acting on the expression of your DNA today can be passed on to your future biological children, affecting how their genes behave in their lives and whether or not their children will face a higher risk of certain diseases and disorders, depression included. But, by the same token, these marks can be changed to read differently, making it fully possible to reverse certain diseases.
We in the scientific community believe epigenetic forces affect us from our days in utero until the day we die. There are likely many windows during our lifetime when we are sensitive to environmental impacts that can change our biology and have major downstream effects such as symptoms of depression. At the same time, the multitude of neural, immune, and hormonal actions that are controlled by the microbiome—and that in turn command our entire physiology—are susceptible to disruption and adaptation, especially by environmental changes.
One of the most important takeaways from this first chapter is to understand that depression is not about the brain per se. Of course, there are brain events and biochemical reactions occurring when a person feels depressed, but no research has ever established that a particular brain state causes, or even correlates with, depression. Many different physical conditions create psychiatric symptoms but aren’t themselves psychiatric. We think (because our doctors think) that we need to “cure” the brain, but in reality we need to look at the whole body’s ecosystem: intestinal health, hormonal interactions, the immune system and autoimmune disorders, blood sugar balance, and toxicant exposure. And we need natural, evidence-based alternatives to psychiatric medications—treatments that target what’s really awry in our bodies. That means strategic dietary supplementation and noninvasive remedies like light therapy and cranial stimulation, but also smart (i.e., biologically compatible) food protocols and exercise choices, restful sleep, a detoxed environment, and meditation/relaxation practices. The best way to heal our brains is to heal the bodies in which they reside. Or, as I also like to put it, free your mind by healing your whole body. Hence the whole purpose of this book. The potential for lifestyle-based interventions and healing is immense.
When I get asked about the main triggers of depression, I often think of the three types of patients I generally see: the woman with blood sugar issues and nutritional deficiencies due to the standard American diet (high in sugar, low in healthy fats); the individual with a misbehaving thyroid, which plays into all matters of hormones that in turn affect mental health; and the person with either medication-induced depression (think statins, birth control pills, proton-pump inhibitors like Nexium and Prilosec, and even vaccines). We’re going to be exploring all of these potential triggers in detail in the upcoming chapters.
Although scientists are now trying to identify drivers of different types of depressive syndromes, the medical industry still offers a one-size-fits-all solution (read: one drug, one disorder model). This is akin to studying all the different sources of, say, back pain—from a torn muscle or a herniated disc to cancer or a kidney infection—but using the same treatment protocol on all cases. It doesn’t make sense, and there can be unintended consequences if that singular treatment entails risky drugs or surgery. And when it comes to using antidepressants for all signs of depression, this can be very tricky terrain, as the next chapter shows.
Truth Serum: Coming Clean About the Serotonin Myth
How You’ve Been Misled, Misdiagnosed, and Mistreated
There’s no such thing as an antidepressant.
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The chemical imbalance theory of depression is heavily promoted but remains unfounded.
Do you take antidepressants? Do you know someone who does? Maybe you even have friends and family members who swear they have been lifesaving. Antidepressants might seem like a reasonable option, particularly if things are dire. But do you know the whole story?
At the risk of sounding extreme, let me give you an example from my own case files that sets the tone for this chapter. Kate had never been on an antidepressant and never suffered from depression, but she felt overwhelmed and frazzled after the birth of her first baby. At her six-week postpartum follow-up appointment, her obstetrician prescribed Zoloft. Within one week of starting it, she had written a suicide note and was planning to jump off of her fifteenth-floor Manhattan balcony. She said to me, “It just made sense at the time. And I felt really detached about it, like it was nothing.”
Kate’s experience is not an outlier. She is among millions of women who are reflexively prescribed
