Dr Kelly Brogan: When it comes to treating depression & anxiety, we’ve had it all wrong
The following is a guest post written by Kelly Brogan, MD, a New York City based holistic women’s health psychiatrist and author of A Mind of Your Own: How Women Can Heal Their Bodies to Reclaim Their Lives for ParsleyHealth.com: 7 facts about Depression that will Blow You Away March 16, 2016 ParsleyHealth.com By Kelly Brogan MD “A silent tragedy in the history of modern health care is happening right now in America, but no one is talking about it. We have been told a story of depression: that it is caused by a chemical imbalance and cured by a chemical fix—a prescription. More than 30 million of us take antidepressants, including one in seven women. Millions more are tempted to try them to end chronic, unyielding distress, irritability, and emotional “offness”—trapped by an exhausting inner agitation they can’t shake. “The human body interacts in its environment with deep intelligence. Your body creates symptoms for a reason. “It is time, even according to leaders in the field, to let go of this false narrative and take a fresh look at where science is leading us. The human body interacts in its environment with deep intelligence. Your body creates symptoms for a reason. Depression is a meaningful symptom of a mismatch, biologically, with lifestyle—we eat a poor diet, harbor too much stress, lack sufficient physical movement, deprive ourselves of natural sunlight, expose ourselves to environmental toxicants, and take too many drugs. Inflammation is the language that the body speaks, expressing imbalance, inviting change. We usually suppress these symptoms with medication but that is like turning off the smoke alarm when you have a fire going on. “LET’S GET THE FACTS STRAIGHT: “1. Depression is often an inflammatory condition a manifestation of irregularities in the body that often start far away from the brain and are not associated with so-called “chemical imbalances.” The medical literature has emphasized the role of inflammation in mental illness (1) for more than twenty years (unfortunately, it takes an average of 17 years (2) 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 practices). Not a single study has proven that depression is caused by a chemical imbalance in the brain. (3). “That is about as misguided as putting a bandage over a nail stuck in your foot and taking aspirin. It’s absolutely missing an opportunity to “remove the splinter” and resolve the problem from the source. “2. Antidepressants have the potential 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, bleeding, weight gain, sexual dysfunction, and reduced cognitive function 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. “3. The effect is not a cure. Even if we accepted the proposition that these drugs are helpful for some people (82% of which is due to the placebo effect according to Dr. Irving Kirsch), extrapolating a medical cause from this observation would be akin to saying that shyness is caused by a deficiency of alcohol, or that headaches are caused by a lack of codeine. And what about a genetic vulnerability? Is there such thing as a depression gene? In 2003, a study published in Science (4) suggested that those with genetic variation in their serotonin transporter were three times more likely to be depressed. But six years later this idea was wiped out by a meta-analysis of 14,000 patients published in the Journal of the American Medical Association (5) that denied such an association. “4. Most prescriptions for antidepressants are doled out by family doctors—not psychiatrists, with seven percent of all visits to a primary care doctor ending with an antidepressant (6) prescription. What’s more, when the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health did its own examination into the prevalence of mental disorders, it found that most people who take antidepressants never meet the medical criteria for a bona fide diagnosis of major depression, and many who are given antidepressants for things like OCD, panic disorder, social phobia, and anxiety also don’t qualify as actually having these conditions. “5. The Great Pretenders. Many different physical conditions create psychiatric symptoms but aren’t themselves “psychiatric.” Two prime examples: (8). We 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 “6. Basic lifestyle interventions can facilitate the body’s powerful self-healing mechanisms to end depression: 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, chemicals in common drugs like Tylenol and statins, and fragrances in cosmetics; harnessing the power of sufficient sleep and physical movement; and behavioral techniques aimed at promoting the relaxation response. “7. Depression is an opportunity. It is a sign for us to stop and figure out what’s causing our imbalance rather than just masking, suppressing, or rerouting the symptoms. It’s a chance to choose a new story, to engage in radical transformation, to say yes to a different life experience. “Join the revolution. Find out more in A Mind of Your Own: How Women Can Heal Their Bodies to Reclaim Their Lives. “Kelly Brogan completed her psychiatric training and fellowship at NYU Medical Center after graduating from Cornell University Medical College, and has a B.S. from MIT in Systems Neuroscience. She is board certified in psychiatry, psychosomatic medicine, and integrative holistic medicine, and is specialized in a root-cause resolution approach to psychiatric syndromes and symptoms. She is a mother of two. References:
Kelly Brogan, MD
PARSLEY HEALTH Parsley Health, whose website is where Dr Brogan’s post appears, was founded by Functional Medicine doc Robin Berzin, MD, as a membership-based wellness practice. Berzin’s site describes her novel approach to the practice of medicine this way: “Parsley Health is a high-tech, holistic medical practice and wellness center. We offer detoxes, gut healing programs and medical memberships to help you live your healthiest life. “WE’RE A MEMBERSHIP-BASED WELLNESS PRACTICE AND WE BELIEVE IN YOUR POTENTIAL TO THRIVE. “We get to know our members as individuals. We help you cleanse and renew your body, embrace a healthier lifestyle and live better. “Our comprehensive testing reveals how your body is functioning today and helps you discover the underlying causes of chronic pain and disease. “Dr. Robin Berzin founded Parsley Health because she believes health care can and should be different.” Robin Berzin, MD, founder of Parsley Health
Here’s information on Parsley Health’s membership program in case you live in the NYC area and are interested in subscribing. The practice is located at: PARSLEY HEALTH 120 E 23RD ST, 5TH FLOOR NEW YORK, NY 10010 Website: parsleyhealth.com
Many thanks to Colleen Hodgetts for sending Dr Kelly Brogan’s article my way. REFERENCES Brogan, K. (2016). 7 facts about Depression that will Blow You Away. See: https://parsleyhealth.com/holisticdepression/ Brogan, K. & Loberg, K. (2016). A Mind of Your Own: How Women Can Heal Their Bodies to Reclaim Their Lives. See: http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=A+Mind+of+Your+Own%3A+How+Women+Can+Heal+Their+Bodies+to+Reclaim+Their+Lives
Parsley Health. (2016). See: parsleyhealth.com © Copyright 2016. Joan Rothchild Hardin. All Rights Reserved.
DISCLAIMER: Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.
Comments submitted prior to 8/25/2021
I couldn’t help, reading this, wondering how odd it is to have someone say it is not an imbalance but then offer natural remedies to supposedly rebalance one’s brain and body (or aren’t these supplements meant to ‘rebalance’?). It is … well … confusing. Can depression be caused by many different things? Absolutely. Are diet, lifestyle, and identifying reasons for chronic stress and improving management of that stress helpful? Without a doubt. However, claiming depression ‘is an inflammatory response’ without offering no actual proof of it (not
really, and this is replacing ‘one issue fits all’ with another ‘one issue fits all’), or saying that it is not about an imbalance in the brain while chronic stress (and depression IS stressful and is reactive to stress and so on in a feedback look) is known to creates imbalance in the brain, and any thing that affects the body affects balance in the brain AND the body … It find it misleading to claim it is NOT about imbalance.
Oh, I am all for using natural remedies (many medications were in fact based on natural remedies, so might as well take the original, IF one can get in with sufficient reliability and dosage and proper monitoring for impurities and interactions and so on), but I am not against medical interventions.
Balance is key.
Not all depression is created equal, not all treatments of it are the right ones for everyone, and vitamin B, while lovely, is no more a cure-all than Prozac. People died from depression, and people can sometimes be stuck in depression. Treating it is important, and sometimes people are too frozen to manage any insight (let alone get to therapy) without chemical help–be it ‘natural’ or ‘medicinal’ or ‘westernized’.
Comprehensive assessment of the INDIVIDUAL, and attending to both the chemical and the relational and the perceptual, nutritional, developmental and so on is important. Cookie cutter views of ANY kind (including demonizing all anti-depressants and making it as if taking them will by definition prevents one from gaining insight to the issues in their lives and what can be finessed), is not my cup of tea.
In reply to Na'ama.
Thank you, Na’ama. All very good points. Insightful, as usual.