Change Your Brain Every Day - Skills or Pills: When Are Antidepressants Right for You?

Episode Date: June 4, 2019

For some people, antidepressants can help improve the quality of life. For others, it only makes things worse. In the second episode of the “Skills or Pills?” series, Dr. Daniel Amen and Tana Amen tackle depression. They discuss at what point antidepressants are a reasonable choice, and when other natural methods should be tried, such as exercise, nutrition, mediation, or supplements.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we have been transforming lives for 30 years using tools like brain spec imaging to personalize treatment to your brain. For more information, visit amenclinics.com. The Brain Warriors Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com. Skills or pills. We're going to talk about depression. What's the one thing you do that boosts your mood quickly? We'd love if you post the answer to that question. And the use of antidepressants has skyrocketed since 1987.

And that's the year Prozac was approved by the FDA. And is it marketing or has the level of depression skyrocketed in the United States? Despite we have more, we feel less. Right. So interesting question, because when people just go to their doctor and get on, we've talked about this over and over and over. And this is something I've certainly experienced firsthand. And I just talked to someone yesterday who experienced the same thing. So when I was really depressed, when I was 24 and had just gone through all the problems with thyroid cancer and then all sorts of other problems, as a result of that, I went into this

deep depression, wanted to die. So went to see a psychiatrist. They put me on Prozac because that was the prominent antidepressant at the time. And it made me numb. It didn't make me feel good or bad. At least I didn't want to die. But what I found was in that numb state, I found myself behaving in ways that were never like me before. I definitely had less empathy. I definitely was more impulsive. And so when you talk about should you go on pills or should you do should you do things naturally i think i mean a big part of it right skills in my mind it really depends number one you definitely can't just go get on the first antidepressant without knowing what antidepressants do and how they affect the brain and what kind of a brain you have and i know this firsthand so and i know

so right because you have sleepy frontal lobes this firsthand. And I know so many people- Right, because you have sleepy frontal lobes. And it made my frontal lobe sleepier. How it works is it calms down your emotional brain, but also the front part of your brain. And so you're happier, but also more impulsive. And I didn't really care about much. And as you don't care, it can negatively impact your empathy. And your relationships. Which can impact your relationship. Whereas something like, well, Buterin might have been a better option for someone like me. But if you don't know and you don't know your brain type, so I took myself off of it. Exercise was the thing that works for me and meditation.

Those two things combine, prayer, meditation. For me, they're the same. I use them together. So prayer and meditation and exercise are my go-to, like, must. I must do those things. They're not even an option. So let's talk about, so when should you think about medication? And when should you think about skills? And, you know, I've been doing this 40 years. And if I had my way, if I was a good ruler, I would start teaching the skills to counteract depression in second grade.

And some of the skills, and you listed one, which is exercise critically important learning how to not believe every stupid thought you have learning how to kill the ants the automatic negative thoughts absolutely essential I think it's as important as English and everywhere we go class and logic really that is so important because it's just a class in logic, really, that is so important. Because it's so insidious. Everywhere we go, people struggle with this. Nutrition. Yeah.

There's this great study in Australia, it just came out, where researchers went to two of the outer islands. One of the outer islands had fast food restaurants. The other outer island didn't. And they measured a random group of people on both islands. And the group that had fast food restaurants had lower levels of omega-3 fatty acids. And five times, five times the level of depression. And so given the standard American diet that has overrun America, including the White House, the White House had one of the national champion teams, and for the fifth time, he served fast food. And I'm like, that's insane because we know that

increases depression. And let me just really quickly, because people will say, well, I take omega-3 fatty. I take a fish oil pill. So what? I can eat fast food. It doesn't quite work like that. So if you are eating a lot of processed food and fast food, it's loaded with omega-6 fatty acids. What the problem becomes is the ratio.

It will help a little bit to take your fish oil, definitely. You definitely don't want to not take it. But that ratio, if your omega-6s far outweigh your omega-3s and you're overloading your system with the omega-6s, that's where inflammation happens. That's what drops that ratio and that's why you don't want that to happen. Okay. So simple things, learning how to not believe every stupid thing you think, exercise, getting your diet right. So the more colorful vegetables you can put in your diet, the better that is. And when it comes to depression, if it has come and stayed and you do the skills, then maybe, like in your case, you have a genetic history of depression. Well, and I also was going through a medical issue. So if we just look at some of the factors that may lead to medication is pretty intense family history of depression on your dad's side.

Trauma growing up, trauma can actually reset the limbic or emotional system of the brain. And those things make it more likely if the natural things don't work. And in my mind, do the natural things first. And then based on your brain type, we talk about, you know, do you have a brain that works too hard? So then we use our serotonin interventions, either supplements or medications. If your brain doesn't work hard enough, we use the more stimulating supplements like SAMe or medications like Wellbutrin.

But there's also, and it's part of what we teach you in all of our books and even in the podcast, there's also the acute stuff. In my case, I just had thyroid cancer for which I had to be off of all thyroid medication. I had no natural thyroid in my body at all. But they don't do that anymore. No, they don't. But you don't know what your state is unless you get your blood tested. You might have low thyroid. So you need to know all of that stuff because biological markers can also make a difference. So you want to make sure that you're checking all of that. No one told me that, oh, by the way, you're going to get depressed because we're taking you off your thyroid. And once they replaced it, you would have been better.

So looking back that if they would have warned you and replaced it like they're doing now, and then optimized your C-reactive protein, your vitamin D level, your hormone markers, that you might have been able to skip medicine, but maybe not, at which point then targeted medications to your brain then make sense. But still, we're in this part of psychiatry where nobody looks at your brain which you know I continue to argue is insane it's like how do we know unless we actually look and you know that's been my brain war for the last remember the first I just it cracks me up thinking back to that you looked at my the first time you saw my brain scan and you're like, huh, when did you have trauma, emotional trauma? And I'm like, never, I'm fine. When did you have a,

when did you have a brain injury? Never, I'm fine. And you're like, you looked, I remember you looked at me going, hmm, well, I'm going to change the word, but fouled up, insecure, neurotic, and emotional. And I'm like, what? Did I really say you were fine? No, I said I was fine. You said I was fouled up, insecure, neurotic, and emotional. You didn't even know me that well. That was in one of the game things where I was putting you down in order to get you to attach to me. Oh, that would never work. I can spot that a mile away. All right, so skills always. If you struggle with depression, your first thought, if you come at it from a place of love and experience,

the first thought is what skills do I need? And even when you feel like staying in bed, get up. Because what we have discovered on our imaging work is people with depression have often really low blood flow to the front part of their brain at rest. But when they try to concentrate, it gets better so they feel really really bad and if they lay in bed they just continue to feel really bad and even though they feel like they don't have the energy to get up and go do something when they get up and go do something they actually feel better and from an exercise standpoint which you brought up head-to-head against Zoloft.

Yeah. After 12 weeks, walking like you're late, 45 minutes, four times a week, was equally effective. And after 10 months, it was more effective. Interesting. So over 400 years ago, Hippocrates said, if you feel down, get up and go for a walk. And if you still feel bad, go for another walk. So not 400 years ago, my love.

When was it? It was for about 2,500 years ago. Yeah, 2,500 years ago. Sorry. Then what was it? No, Socrates was. Socrates was before. Galen was about 170 AD.

Dear Lord. And Galen, who was the Roman physician physician so that's who he was 170 a.d he completely believed in what hippocrates believed in which was diet exercise laughing now they also added bloodletting which is a bad thing something bc is that what i'm thinking yeah yeah so um but galen was actually the first one who believed you should talk about it so he's sort of the father of psychotherapy it's really not freud uh the physician galen thought talking about uh the problems in your life can actually make a big difference.

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