Unmanaged depression raises risk of dementia later

Although we are conditioned to see depression as an antidepressant deficiency, the truth is people can have depression for many different reasons. It’s important to figure out the root cause of your depression — research shows letting it go unmanaged or simply masking it with drugs can speed brain degeneration and raise your risk for dementia. This is because depression is often a symptom of runaway inflammation in the brain.

The study showed suffering from depression for more than a decade leads to lasting biological changes in the brain that increases the risk for dementia. The study also mirrors previous studies linking depression to brain inflammation.

These understandings could lead to new more therapeutic treatments for depression that mitigate the risks of dementia and other degenerative brain diseases such as Parkinson’s and Alzheimer’s disease.

In the study, 80 participants had their brains scanned to assess the level of brain inflammation. The subjects were divided into three groups — those with untreated depression for more than 10 years, less than 10 years, and a control group.

The study showed that the participants who had been suffering from depression the longest showed the most brain inflammation. The area of the brain most affected was the prefrontal cortex.

The prefrontal cortex is the area of the brain primarily associated with depression. In functional neurology, we see depression as decreased firing in this and other areas of the brain. The question is, why is there decreased firing causing symptoms of depression?

What’s also interesting is research showing the prefrontal cortex in depressed people exerts more control over other areas of the brain. The prefrontal cortex is involved in self-appraisal — meaning depressed people think more often about themselves and in a negative light.

The brain scan study builds on past research that shows people suffering from depression had 30 percent higher levels of a systemic inflammatory marker, C reactive protein, compared to non-depressed people.

Functional neurology for depression

In functional neurology, we look for the root cause of your depression and rehabilitate that. The cause can be different for everyone, but inflammation is often involved. Starting with an anti-inflammatory diet, stabilizing blood sugar, repairing leaky gut, and addressing and minimizing lifestyle stressors are ways to make a sizeable dent in inflammation.

Although inflammation in both the body and the brain serves a protective function, chronic inflammation damages and destroys tissues. The brain has an added burden of not having an “off-switch” for inflammation like the body’s immune system does. Instead, it relies on a healthy hormonal, nutritional, and metabolic environment, something few people seem to be able to provide for their brains these days.

As a result, inflammation can set it and slowly ravage brain tissue unchecked.

Sometimes depression can also be the result of a brain injury or concussion you never fully healed from, or repetitive hits to the brain and body through contact sports or extreme sports. The impacts to the brain trigger an inflammatory cascade that can start to degenerate the brain, leading to symptoms of depression.

Depression is never a cry from your body for antidepressants, although you may find medication helps you function better. It’s a red flag your system is out of balance and your brain is suffering as a result. Ask my office for more advice on a customized protocol to relieve you of chronic depression.

It’s important to find the cause of dizziness and vertigo

Vertigo can seem to come out of nowhere and feel life-threatening, making it scary to drive or walk down the stairs. The bad news is there are many causes of dizziness and it can take some sleuthing to figure out which one is affecting you. The good news is functional neurology can help you identify what kind of vertigo you have and help you quickly rehabilitate it.

For instance, benign paroxysmal positional vertigo (BPPV) is one of the most common causes of dizzy spells and is easy to treat. By defining each word in this complex sounding condition, we can see it is not as grave as it sounds:

• Benign: Not life-threatening.
• Paroxymal: Comes on suddenly and is brief.
• Positional: Usually happens in response to a head position or movement.
• Vertigo: Dizziness, or a sense of things spinning either inside or outside your head.

BPPV occurs when small crystals in the inner ear become dislodged and travel to areas in the ear canals where they don’t belong. In most cases the Epley maneuver or another similar maneuver can move the crystal back to where it belongs.

Sometimes vertigo can be caused when the individual eye muscles do not work together because one or more of them is weak. This weakness causes the eyes to move abnormally. This abnormal movement sends incorrect visual information to the brain and vestibular system, an area of the inner ear vital for balance. This can cause dizziness and light-headedness.

Although a person usually doesn’t notice this eye muscle weakness, in functional neurology we can spot it during a neurological exam and provide exercises that target areas needing rehabilitation.

The vestibular system plays an important role in balance and the prevention of vertigo. However, it is a fragile system and vestibular dysfunction is more common than people realize. For instance, if you’ve had a mild concussion, whiplash from a car accident, falls or hits from sports, or other impacts to the head or body, you may have damaged your vestibular system.

Inflammation or infection can also affect the vestibular system and provoke vertigo.

The cerebellum, an area at the base of the brain, works with the vestibular system in balance and the prevention of vertigo. If the cerebellum is damaged from a brain injury, stroke, or an autoimmune disease (a disorder in which the immune system attacks and destroys tissue), this can cause dizziness.

Other symptoms of compromised cerebellum function may include poor balance, being unsteady on your feet, poor coordination, and anxiety (because the unsteadiness is a perceived as a constant stressor).

Other brain-related causes of dizziness can include an imbalance between the hemispheres of the brain or neck issues that hinder proper communication between the body and brain — always take whiplash seriously, it could impact your brain health.

If you are having dizzy spells, it’s important to identify the source of your vertigo because it will determine the best course of treatment. You need to know whether your vertigo stems from the vestibular system or the brain because each is rehabilitated differently.

Make note of other symptoms (below) you have in addition to vertigo; they can help your functional neurology doctor customize the right treatment for the cause of your dizziness.

Symptoms and signs often associated with vertigo, dizziness, and imbalance include:

• Feel easily overwhelmed in areas with a lot of sensory input (grocery store, walking through a parking lot, movie theater, etc.).
• One eye is higher than the other
• Migraines
• Hearing loss
• Disturbances with your vision
• Feeling disconnected from your body; confusion
• Depression
• Anxiety

Withdrawals from antidepressants and anti-anxiety meds serious

The drug companies won’t call it withdrawal, but “discontinuation syndrome” is a serious and sometimes debilitating problem for many people trying to wean off antidepressant or anti-anxiety meds. What’s worse, most patients are not warned about this possibility when they start taking the drugs.

A New York Times analysis revealed that long-term use of antidepressants, a class of drug that has only been studied for use for two months, is surging in the United States. Almost 25 million Americans have been on antidepressants for two or more years, an almost 60 percent increase since 2010.

The use of anxiety meds, or benzodiazepines such as Valium and Xanax, have increased by about 30 percent since 1996. However, overdose deaths related to benzos quadrupled during that time. Also, long-term use has been linked to Alzheimer’s disease.

Withdrawing from your antidepressant

Few patients are warned about the risks of withdrawal symptoms, or “discontinuation syndrome,” when they begin taking antidepressants. In fact, the drugs were approved for short-term use with studies lasting just two months. Yet many people stay on them for years.

Many people can taper off their antidepressants with few problems. For others, however, the effects can be so debilitating they can’t work or function normally.

Symptoms may include dizziness, confusion, fatigue, flu-like symptoms, insomnia, nausea, hyperarousal (overstimulated easily), brain “zaps and shocks,” and more.

For some, it only takes a couple of weeks to taper off with some mild discomfort during that time. For others, it’s a months-long process with symptoms so bad that some throw in the towel and remain on the antidepressant. In a study of 180 long-term users of antidepressants, 130 reported withdrawal symptoms coming off and about half said they felt they were addicted to them.

Benzo risks and withdrawals

Withdrawing from benzos is a documented hell from which some never recover.

Like antidepressants, short term use of benzodiazepines can provide much needed relief that allows a person to function. However, it’s easy to quickly become dependent on and tolerant of benzos, with the user needing ever increasing doses. Withdrawals from powerful, fast-acting benzos such as Xanax are said to be worse than heroin withdrawal and quitting cold turkey can even be fatal.

A slowly tapered benzo withdrawal can last more than a year with some people never fully recovering. Symptoms include fatigue, anxiety, insomnia, disorientation, malaise, severe panic and startle reactions, nerve pain, muscle aches, and memory loss.

Functional medicine alternatives for depression and anxiety

It’s not always easy to alleviate or reverse depression and anxiety, but it’s frequently doable, often with astounding results when you address the root causes.

Depression is simply decreased firing of the frontal lobe. The reasons for its under activity can differ for different people. In functional neurology, we do both neurological and metabolic screening to find what is driving your depression, and then we create a custom rehabilitation program tailored to your underlying causes. This can involve functional neurology exercises along with dietary and lifestyle adjustments. Many people experience profound results when their brain gets the support it needs.

Likewise, anxiety can have myriad causes. For instance, even poor balance can be a cause. When the areas of your brain and vestibular system (inner ear system) are damaged or compromised, this can create chronic anxiety as the brain is in a state of feeling continually unsure and on the edge.

By identifying and addressing the root causes of depression and anxiety, many people are able to not only banish or significantly relieve symptoms, but also improve many other aspects of their well being. Ask how functional neurology can help you with your depression and anxiety.

Want to improve and maintain your brain? Walk often — in nature

While popular brain training gadgets and apps have their place, don’t overlook an age-old strategy to optimize brain health: Walking.

Humans are unique from the rest of the animal kingdom because of our ability to walk upright on two legs, a development that profoundly evolved our brains compared to our finned and four-legged friends.

Learning to walk freed our hands to do all manner of things and allowed us to conserve energy while moving over long distances, giving us more endurance than any other animal on the planet. The ability to walk also stimulated the development of the human brain into the most evolved in the animal kingdom.

Because walking played such an important role in the development of the human brain, it improves brain health in ways other physical activities don’t. Research shows that walking grows an area of the brain called the hippocampus, the seat of learning and memory. This makes it an excellent way to lower the risk of dementia and Alzheimer’s.

Also, the impact of the feet on the ground while walking has been shown to send more blood to the brain, improving oxygenation of the brain.

Maybe this helps explain why so many great thinkers and authors over the centuries were fans of long walks.

The many ways walking benefits the brain

Although walking confers myriad benefits, if you really want to super charge your brain, walk in nature.

A recent study found that walks in nature significantly decrease the obsessive, negative thoughts associated with depression and anxiety.

Researchers found that study subjects who walked through nature for an hour and a half showed less rumination and reduced activity in the subgenual prefontal cortex, an area of the brain associated with depression and mood and mental disorders.

The study subjects who took their walks in urban environments did not show the same results.

Another study showed getting kids with ADHD into a natural green environment significantly reduced symptoms.

If you’re stumped for a creative solution to a problem, walking has been shown to increase your creativity by 60 percent compared to sitting. Many people report arriving at their “aha” moment while walking it out.

Walking better connects the various regions of the brain and improves memory and learning abilities.

In fact, one of the more interesting reasons walking is so good for creative problem solving is that its steady rhythmic pace facilitates and enhances our thinking abilities.

If you’re ever had a functional neurology exam, then you know we ask you to walk as part of the exam. Sometimes we also ask you to walk while reciting every other letter of the alphabet or counting backwards by 7s.

This is because looking at how you walk, especially if you are multitasking, gives us insight into how different parts of your brain are working (or aren’t). Your walking gait, your arm swing, your leg stance, and your posture all give valuable information about what’s going on in your brain.

Any exercise is good, and certainly better than no exercise; but even if you work out regularly, don’t miss out on the brain benefits of walking. And if you don’t exercise, walking is perhaps the most inviting way to significantly improve your brain health.

Ask my office how functional neurology can help your brain better function.