Depression – Diagnosis and Treatment

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Depression can have medical or emotional roots.

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In episode 56 of the BioBalance Healthcast we talk about some of the medical and emotional causes of depression. The discussion is in part based on a chapter of my book, Testosterone, The Secret Female Hormone. Following is an excerpt of the draft manuscript.

Most women know what the terms Anxiety and Depression mean. These terms are used commonly in casual conversation, and are two of the most common complaints in doctors offices all over America. We all know that these two symptoms are much more common in women than in men. We also may be aware that the onset of anxiety and depression is most common after 40 years of age. It may enter our emotional state for no definable reason, or it may be related to a life event that stressed us, followed by a chemical imbalance that continues long after the situation resolves. Why do life events impact us more severely after we turn 40, and why can’t we bounce back? Why do these symptoms occur when our lives are going well, and there is no identifiable reason for these feelings to overwhelm us? The reason is simply that we are losing our hormones with every birthday after 40, and with them go our neurotransmitters that supplied the energy, and emotional stamina that allowed us to withstand the stresses of life.

Here are the common symptoms of depression:

  • Lack of energy
  • Hopelessness
  • Waking at 2–3 am every night
  • Excessive worrying
  • Change in appetite
  • Sadness
  • Lack of libido
  • Irritability
  • Loss of motivation

Everyone thinks of the neuro-transmitter serotonin when they hear depression because that is the chemical that is needed in the brain for us to maintain our cheery mood. The end of the process is serotonin, but what begins the process that leaves us depressed? That is what we should be looking to, for a preventive treatment. Testosterone is one of the hormones that drop after 40, and the free form of the hormone that crosses to the brain is less available to stimulate the production of serotonin. Testosterone also stimulates the secretion of norepinephrine in the brain that gives us energy, and improves mood as well. When we add the stress of modern life to the mix, testosterone drops faster and to a lower level because of elevated adrenal hormone, cortisol. The modulating hormone testosterone works wonders when plentiful, but leaves us more vulnerable to stress and over-work when we are over 40.

Depression may be augmented or caused by deficient levels of other hormones such as progesterone, thyroid and melatonin. If you ask most PMS patients, they say that they are depressed two out of every four weeks a month. This type of depression is generally from low testosterone, and lower than normal progesterone. Both these hormones stablilize the brain and improve serotonin levels. The second half of the cycle is dependent on progesterone, so when the ovary makes a lower than necessary amount of progesterone, estradiol increases and depression is the outcome. Thyroid is another hormone responsible for mood, and when deficient thyroid hormones are secreted, for any reason, patients feel depressed. This type of depression is generally described as a type of slow motion or fatigue and depression combined that feels like walking through a bowl full of jello. Lastly hormone dependent depression secondary to decreased light, as in winter when there are fewer than 10 hours of light per day, is a shortage of melatonin that suppressed the secretion of serotonin. This cyclis depression is called seasonal affective disorder (SAD), and it becomes more severe as we age from a lack of testosterone leading to lower neurotransmitters.

Your impression of what depression actually is may not be accurate because the word has been used in many ways that dilute the meaning of true depression. When someone is medically depressed, they are not sad today, and ok tomorrow. Depression is not considered mourning for a loved one lost, as everyone who misses someone they love is sad and emotionally in shock, but not necessarily, depressed. The symptom of depression includes daily low mood for more than three months, that in most cases is unrelated to an identifiable cause. It can occur long after an event that normally causes sadness but the depression lasts longer than a year after the loss of a loved one, or a major life event like divorce. Other common symptoms included in the overall label depression includes interrupted sleep, around 2 am, irritability, and poor concentration. Most women who suffer from depression ask, “Is this all there is?”. People who are depressed believe that their happiest experiences are not fulfilling, or enjoyable. They believe that life is dull and humorless. True depression is evident in the eyes of the depressed patient; dull and emotionless. Depression is a chemical imbalance, with the final physiologic effect resulting in lack of serotonin. The initial trigger in women over 40 is the loss of testosterone and thyroid, which makes them much more susceptible to chemical depression.

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