Depression

Depression impacts 1 in 6 individuals over the course of a lifetime. It tremendously impacts the
life of the individual. Areas impacted are social, work, family, and relationships. One of the
most devastating things is the feeling of hopelessness and not being able to identify the cause.

Depression

Traditionally depression has been viewed from a neurochemical perspective.  Treatment has been mainly directed at improving the levels of serotonin as well as norepinephrine.  We know that this is not the only mechanism involved as many patients do not respond to a variety of different medications.  A variety of factors are believed to play a role such as diet, head injuries, inflammation, genetics, stress, and altered hormone levels.  I am going to highlight causes of depression: brain connectivity (head injuries), hormone-driven, and gut health.


Common Symptoms:
  •  Hopelessness
  •  Loss of Pleasure
  •  Fatigue
  •  Difficulty Focusing
  •  Sleep Changes
  •  Cognitive Changes (Memory and Decision Making)

Factors that Contribute to Depression

Brain Connectivity

The first one I want to talk about is brain connectivity.  This simply refers to how each neuron communicates with the other to efficiently perform a job.  Connectivity can be negatively impacted by concussions, TBI, PTSD, and neurodegenerative disorders (Parkinson’s, Alzheimer’s, and Multiple).  A thorough history and functional exam will identify areas of dysfunction in the brain.  By treating the areas impacted there is the ability to resolve depression.  
One of the best ways we are learning it is a problem with connectivity is the positive benefits from rTMS for those with treatment resistant depression.  Another thing that is well established is the positive benefits in improving depression.  Exercise has many positive benefits in the brain such as decreasing inflammation and promoting connectivity.
 
Hormone Driven

One of the first labs traditionally ordered upon presentation of depression is TSH and T4 to evaluate for decreased thyroid function.  The only problem is that this is only considered significant if outside of labs ranges and a medication can prescribed.  This test is not a comprehensive thyroid test and does not evaluate for autoimmunity.  There are many who have autoimmune thyroid who will still feel bad with or without medications.  Remember any autoimmunity is going to drive up inflammation which will be also be mentioned in regards to gut health.
The other set of hormones that plays a major role in depression or depression like symptoms are sex hormones (testosterone in males and estrogen/progesterone in females).  These hormones not only play a role in sexual function, but are essential for energy and proper brain connectivity.  There are many things that can done from a dietary perspective to increase hormone levels in addition to medications if needed.    

Gut Health

Gut health is one of the most researched topics.  It is especially being evaluated for its role in neuropsychiatric, autoimmune, and neurodegenerative disorders.  I am going to consider depression as a neuropsychiatric disorder due to not only emotional but cognitive symptoms that are present.  One of the things being researched about gut health is the impact of probiotics on depression.  Research continually shows a positive impact of probiotics on depression.  Probiotics help change the microbiome.  Diet is one of the most important things to change the microbiome and has profound impact on depression symptoms.
Why does your gut microbiome matter?  A very crucial part of the immune system is in the gut.  When the gut is not healthy it will release a tremendous amount of inflammatory chemicals that ultimately will reach the brain.  Our body can react to foods as well.




Why Our Approach Is Different

As you can see from the previous section, we evaluate many factors that can lead to depression.  This can include nutrient status, hormones, gut health, brain health, and much more.  Our team is constantly searching and implementing the most current research to help with depression.  
Ultimately what makes us different is that our approach is 100% centered around the patient.  This includes focusing on the physical, cognitive, emotional, and spiritual domains of health.  We perform a comprehensive history to identify the cause: stress, head injuries such as a concussion), diet, and gut health.  It is important to note that many individuals have concussions or sub-concussive injuries that they feel they have recovered from.  We have seen this to be a common reason for unresolved depression.  

Treatment Options:

  • rTMS (Repetitive Transcranial Magnetic Stimulation)
  • Cognitive Exercises (Eye Movements and Hand-Eye Coordination)
  • Balance and Coordination Training
  • Diet
  • Supplements
  • Stress Reduction Techniques
  • Physical Exercise



Our Unique Process for Your Unique Situation

We have created a unique process that is built to maximize time and results.  To reach your personal healthcare goals, it is imperative that your physicians and care providers precisely know your individual story and needs.  Your individual goals are the focal point of the comprehensive treatment plan which is based off your exam, diagnostics, and lab results.  Your treatment plan is designed specifically for you and is not a protocol.

This plan is executed over 10 days.  Many patients see measurable improvement over the time in our office.  When you leave, we create a plan to help you continue on your journey.  Our goal is to see each patient continue to build upon the initial results they achieved in office.  


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