I received a request recently from a young woman in her twenties who wanted me to give her a diet plan to help her lose weight. She was suffering from depression, anxiety and night terrors and the drugs she was taking had made her gain 10kg in eight months.

She told her doctor she was concerned about the weight gain and his reply was that the drugs were important because:

1. the brain is just beginning to rewire brain patterns and coming off the drugs will have drastic reverse results
2. it is better to be mentally healthier that to be worried about a bit of weight
3. she was too small for her height anyway.

The young lady whom I’ll call Beth had been trialing a different mixture of medications with her doctor and she felt that the mixture she was on was helping.  She was taking Efexor-xr and murelax oxazepam, otherwise known as serepax. She was also having therapy sessions.

Efexor XR capsules contain venlafaxine hydrochloride, the antidepressant belonging to the class of drugs (SNRIs). The pills also contain: iron oxide yellow CI 77492, iron oxide red CI 77491, cellulose-microcrystalline, ethyl cellulose, hypromellose, gelatine, talc, purified, titanium dioxide and red ink.

I was a little disturbed by what Beth’s doctor said regarding what the drugs were doing to brain wiring having said that this may have been the interpretation of Beth.

Neither of these drugs rewire brain patterns. One is a SNRI (serotonin noradrenaline reuptake inhibitor) – which helps keep the neurotransmitters, serotonin, noradrenaline and to a lesser extent dopamine, in the synapses (the gap between nerve cells across which chemical messages are sent from one nerve cell to another). This is important as it allows nerve cells to communicate with each other for longer, which in turn helps control mood.

Studies have shown that in the short term these medications work, but they do not work long term and they become “the problem” when taken over a long period of time.

An explanation that has been put forward by drug companies is that SNRI’s act in the brain to correct the chemical imbalance caused by a lack of certain neurotransmitters (brain chemical that allows nerve cells to communicate)that is thought to be one of the major causes (not proven just a thought) of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood.

My question to this explanation is; if it is a chemical imbalance then why do we not have blood tests to test this imbalance and secondly why is the body not making enough neurotransmitters in the first place?

It is interesting to note that not only does the brain produce neurotransmitters, but so does your GUT. The enteric nervous system uses more than 30 neurotransmitters, just like the brain, and in fact 95 percent of the body’s serotonin is found in the bowels produced in part by the enteric nervous system in the gut and by the microbes colonizing the gut. When GUT bacteria are in dysbiosis or there is an inflammatory bowel disease present then you may not be making enough neurotransmitters.  If your gut bacteria have been so badly decimated that you can’t convert fructose via the shikimate pathway to aromatic amino acids and onto neurotransmitters, then you will have firstly a lack of neurotransmitters, but also probably fructose mal-absorption which presents with a whole list of issues including bloated tummy and if the problem is chronic, non alcoholic fatty liver disease.

It has also been found that SNRI’s and SSRI’s not only effect serotonin in the brain but also the gut and people on these medications may suffer from GUT issues as a result.

The second drug Beth is taking is a sedative known as serepax. It has the ability to slow down the electrical impulses in the brain but it does not rewire the brain. It definitely helps a lot of people, but it should only be used in the short term, but I’m sure her doctor has informed her of that.

After asking Beth a bunch of questions to gauge her health history, I found that she had bad skin at the age of 15 and was put on the pill, and had been on it ever since.

We know that the pill, antibiotics, antacids and some herbicides compromise the integrity of the gut bacteria. When coupled with poor diet, it’s not surprising that Australia is a country with one of the biggest issues with IBS – inflammatory bowel syndrome.  Beth told me that after eating she always had bloating.

Inflammatory Bowel Syndrome/Disease encompasses diseases of the bowel from chronic to acute. Bloating after every meal would come under the chronic banner, along with SIBO (small intestinal bacterial overgrowth), parasites, dysbiosis, ulcerative colitis, coeliac, crohn’s, leaky gut, alkaline stomach medium to name but a few. IBS is merely the umbrella of these diseases, pinpointing the exact problem in the bowel is not always easy to diagnose and thus treat.

The more we learn about the interconnections in the body and our relationship with the microbes that live within and around us, the more I realise that a holistic approach is important with both mental and physical health issues.

The connection between the gut and the brain is well established, via the vagus nerve.  Ninety percent of the fibers in the vagus carry information from the gut to the brain and not the other way around. The blossoming field of neurogastroenterology will likely offer some new insight into the workings of the connection between the gut and brain—and its impact on the body and mind.

After just a brief history of Beth’s health, my answer to Beth went as follows:

To do a simple diet plan would not be effective to relieve your weight issues.  I believe you need to first fix your dybiosis (bloating) – gut issues. The pill, antibiotics and antacids disturb the important balance between the microbiome (your gut bacteria) and you.

The impact of the above is not an immediate result but over time it slowly erodes the health of the microbiome and thus your ability to be healthy mentally and physically.  I’m sure if you think back over your life since 15 you will have seen signs of this and it will all fall into place.

Your skin issue in the beginning and hormone imbalance (so it seems) tells us there are problems, but most people/doctors don’t address the problem just the symptoms – thus the pill prescribed, but this exacerbates your issues as you are now seeing.

As a result you would not cope with stress, and then the more stress you are under the more dysbiosis until finally it all comes to a head and you don’t cope with much happening in your life at all. Anxiety, depression, night terrors are a symptom of a long standing issue that you have probably had since you were 15 or younger, as you may have been given antibiotics in your early years of life which begins the chain of events.  You may have also been exposed to herbicides through some foods consumed or from playing at play grounds and on sporting fields that are sprayed for weeds.

It’s a vicious cycle, one feeding the other.

You have to nip it in the bud now, because it won’t get better until you make a solid change in what is happening and what you are doing.

Your scenario is very familiar to me and the nutritionists at Changing Habits. To get better you sometimes need to get worse, so be prepared.  There will never be a good time to do this, believe me I know, as you will always think I’ll do it after……  Staying on your medication is best for now, but hopefully that will change and you will be able to talk to your doctor about it.

The drugs will be relieving your issues but they are a short term fix, not a long term fix and if you stay on them long term they become the problem.  Just ask your doctor, he will know this and if he hasn’t told you then I would read the insert of the medication you are taking – don’t put your head in the sand on this issue. So you have a choice, either you continue down that route and hope for the best or you do something NOW and change.  If you continue to do the same thing you will get the same result and it will not get better. I’m sorry if you feel I’m harsh, but I’m seeing too many beautiful young girls in this predicament and it breaks my heart.

Living your best life is possible but you have to put the work in, it is not a one pill wonder. It’s important to look at your health both physically and mentally, one influences the other, so both must be addressed.

So my question to you is: What are you prepared to do to get better?

If you are prepared to make changes and they will include; diet, sleep patterns, sunlight, thinking, movement, lifestyle, no alcohol, then we can help you on your journey, but if you want a magic pill then we are not able to assist.

Cyndi

NB: It’s important to note that I’m not offering a cure, but rather the possibility of getting the body to function better to in turn have a greater chance of finding its homeostasis and health mentally and physically. Anxiety, depression and night terrors are not healthy and to only address the brain is not looking holistically at the problem.

References
http://www.scientificamerican.com/article/gut-second-brain/
https://www.inhousepharmacy.vu/p-388-efexor-xr-75mg.aspx
http://www.nytimes.com/2015/10/11/opinion/sunday/should-we-bank-our-own-stool.html
http://www.medscape.com/viewarticle/852496?nlid=89038_3681&src=wnl_edit_dail&uac=196099SK&impID=856490&faf=1
Why Isn’t My Brain Working?: A Revolutionary Understanding of Brain Decline and Effective Strategies to Recover Your Brain’s Health by Dr. Datis Kharrazian 
Grain Brain and Brain Maker by Dr David Perlmutter
http://undergroundwellness.com/?s=kelly+brogan  The Serotonin Myth with Dr Kelly Brogan episode #335
The Depression Sessions with Sean Croxton and 30 experts
http://www.nature.com/news/the-tantalizing-links-between-gut-microbes-and-the-brain-1.18557