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“The pill” is one of the most popular forms of birth control in the world. Statistics show that in the U.S., approximately 1 in 4 women aged 15-44 who are using contraception are taking oral contraceptives, also known as birth control pills. What many of these women don’t know is that the birth control pill can cause an imbalance of hormones, which have negative impacts on brain function and mental health.
In fact, many women have misconceptions about how these hormonal contraceptives affect the brain and body and how they influence overall health. It’s time to clear up the confusion.
WHAT ARE ORAL CONTRACEPTIVES?
Oral contraceptives are most commonly associated with preventing pregnancy. However, they are also frequently used to reduce symptoms that may occur with menstruation, such as:
- Irregular periods
- Premenstrual syndrome (PMS)
- Premenstrual dysphoric disorder (PDD)
- Pain and cramping
- Heavy flow
- Endometriosis
- Polycystic ovarian syndrome (PCOS)
- Fibroids
Because the pill can effectively decrease symptoms of these conditions, it is commonly prescribed.
HOW BIRTH CONTROL PILLS WORK INSIDE THE BODY
Most oral contraceptives are made with combinations of synthetic estrogen and progestin, a synthetic form of the hormone progesterone. After taking the pill, these synthetic hormones enter the brain and act as endocrine disruptors, interfering with the signaling process that is necessary for ovulation.
In particular, they prevent the hypothalamus from signaling to the pituitary gland (which regulates your hormones) to secrete the hormones that cause an egg to be released. In the unlikely event ovulation does occur and an egg is fertilized, the synthetic progestin thins the uterine lining, making it more likely that the egg will be shed.
Many birth control pills include a week of placebo pills that induce monthly breakthrough bleeding, but this is not a real menstrual period. It is an artificial pattern that eliminates the natural ebb and flow of estrogen and progesterone throughout the cycle.
HOW HORMONES WORK IN THE BRAIN AND BODY
In order to feel happy and healthy, you need to have balanced hormones. Here is some important information to note about the differences between natural and synthetic hormones.
Natural hormones bind to specific receptors and keep your body in balance:
- Estrogen binds to the estrogen receptor.
- Progesterone binds to the progesterone receptor.
- Testosterone binds to the testosterone receptor (yes, women produce testosterone, just not as much as men).
- There is no cross-reactivity.
Synthetic progesterone (progestins) acts differently on the body:
- Progestins do not limit binding to just the progesterone receptor, rather, they bind to many other receptors as well.
- When a synthetic hormone binds to the wrong receptor, that receptor may convey inaccurate signals, which throws the body off balance.
Because synthetic hormones may bind to the wrong receptors, birth control pills may cause hormonal imbalances and detrimental side effects. Not all women experience these problems, but for those that do, side effects can be quite miserable.
THE HEAVY TOLL OF ORAL CONTRACEPTIVES ON THE BRAIN
You may already know that birth control pills have been shown to cause problems with blood pressure. They also increase the risk of blood clots and strokes, especially if you smoke or have a history of migraine headaches. But did you know that birth control pills also affect your brain and mental health?
Research shows that taking birth control pills causes structural changes in the brain, alters neurotransmitter function, and messes with mood regulation.
- Brain structure: A 2019 study found that the hypothalamus in women taking oral contraceptives was about 6% smaller than in women who weren’t on the pill.
- Neurotransmitters and moods: Scientists from Denmark found that women ages 15-34 taking oral contraceptives were 23% more likely to start taking antidepressants for the first time than those who weren’t taking the pill. In fact, bouts of depression have been reported by 16%-56% of women taking the pill, which depletes the neurotransmitter serotonin.
- Other neurohormones: Birth control pills also elevate cortisol levels (hello, stress!) and lower testosterone levels (goodbye, sex drive!). And low-testosterone problems can remain even after stopping oral contraceptives, putting you at increased risk for long-term sexual, brain health, and mental health disorders.
- Microbiome disruption: Synthetic birth control can also disrupt the gut microbiome.
The gut—your gastrointestinal tract (GI)—is often called the second brain because it is lined with about 100 million neurons. That’s more neurons than you have in your spinal cord or in your peripheral nervous system.
Research shows that gut health problems, such as leaky gut, are associated with mood and anxiety disorders. A 2017 article explored the connection between gut health and ADD/ADHD.
- Micronutrient depletion: Birth control pills interfere with the absorption of essential vitamins and minerals, which can lead to nutritional deficiencies, according to a 2013 study.
In particular, key nutrient depletions have been seen in folic acid, B vitamins (B2, B6, and B12), vitamins C and E, and the minerals magnesium, zinc, and selenium—micronutrients that are important for healthy brain function. If you’re taking oral contraceptives, it’s a good idea to take nutritional supplements to avoid deficiencies.
SYMPTOMS OF HORMONAL IMBALANCE
Many women have no idea that their birth control pills may be causing the following issues:
To find out if your birth control pills are contributing to your symptoms, it’s important to get tested. However, simple standard blood tests will rarely detect this problem.
A better option is a 24-hour urine hormone collection, which is the gold standard for looking at all the hormones and their metabolic byproducts. An integrative medicine physician, also called a function medicine physician, can be helpful in assessing hormone levels, nutrient deficiencies, and other issues related to hormonal birth control.
ARE YOU READY TO STOP TAKING BIRTH CONTROL PILLS?
Going off the pill isn’t necessarily a quick-fix solution. Some women experience a rash of symptoms—including mood swings, anxiety, and depression—in the months following cessation of hormonal birth control. Some hormonal experts have started calling this effect “post-birth control syndrome.”
In addition, it’s important to remember that if you started taking the pill because you were experiencing irregular periods, fibroids, endometriosis, or other symptoms, the pill doesn’t actually address those issues. It only masks the problem. When you stop taking oral contraceptives, that original issue may return with a vengeance.
If you were experiencing menstrual Irregularities, take note that taking natural progesterone can be quite effective for some women—without any of the side effects of synthetic progestin in hormonal contraceptives.
If you’re concerned about unplanned pregnancy, there are other non-synthetic, non-hormonal birth control options available that you can discuss with an integrative physician.
HOW TO GET BACK INTO HORMONAL BALANCE
If you have been taking birth control pills for many years, it can take several months to rebalance your natural hormone levels. This is due to the chronic suppression of your own hormone production. It is often helpful to supplement hormones during this recovery period.
If you must stay on the pill for any particular reason, consider asking your physician about using natural progesterone and/or testosterone to improve quality-of-life issues while taking the pill.
Depression, anxiety, and other issues related to hormonal imbalances can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
Depression rates in the U.S. have reached historic highs. According to a 2023 Gallup survey, 29% of American adults have been diagnosed with the mental health condition at some point in their lifetime. It’s hitting men hard.
Among men, over 1 in 5 will be diagnosed with clinical depression, which is roughly twice the rate in 2017. And more than 11% of men are currently living with depressive disorder. What’s making so many men depressed? In some cases, it may be a sign of low testosterone.
WHAT IS TESTOSTERONE?
Testosterone, which is referred to as an androgen, is a male hormone. This important hormone fuels the development of the male brain. It is responsible for the deep voice, facial hair, muscle strength, and other traits we usually associate with being a man.
Although testosterone is considered a male hormone, it is also produced in the female body, simply in lower amounts.
In general, optimal levels of testosterone support a man’s brain health, strength, energy, motivation, and sex drive. It helps safeguard the nervous system and protects against mood disorders, cognitive decline, and dementia, including Alzheimer’s disease.
Testosterone is also thought to help prevent inflammation, which some researchers believe is why men are less likely to suffer from inflammatory conditions such as rheumatoid arthritis and autoimmune disorders such as lupus.
If testosterone levels decline, however, these protective properties are diminished.
WHAT IS LOW TESTOSTERONE?
Low testosterone, known as male hypogonadism, occurs when the body doesn’t produce enough of the hormone. Testosterone levels typically peak during the late teenage years and remain high throughout a man’s 20s. However, starting at about age 30, testosterone levels gradually decrease. Research shows that the aging process can leave some men with low testosterone levels that contribute to anxiety and depression symptoms, as well as other issues.
COMMON SYMPTOMS OF LOW TESTOSTERONE
Low testosterone (low T) levels can cause a variety of symptoms that affect a man’s quality of life. Common low testosterone symptoms include:
- Depression
- Anxiety
- Moodiness
- Lack of motivation
- Low libido
- Lack of energy
- Difficulty concentrating
- Trouble sleeping
- Erection problems
- Increased body fat
- Decreased lean muscle mass
- Low bone density
- Hot flashes
- Hair loss
- Weight gain
The symptoms of low T are most common in older men, but they can appear at any age.
COMMON CAUSES OF LOW TESTOSTERONE
Normal aging is the most common cause of low testosterone. However, researchers at the Yale School of Medicine found that over the past few decades, testosterone levels are also declining in adolescent and young adult men (AYA).
Their findings suggest that approximately 1 in 5 men aged 15-39 have testosterone deficiency. The researchers expect hormone levels to continue dropping in young men, in part due to rising rates of diabetes and body mass index, poor diet, decreased exercise, marijuana use, and exposure to environmental toxins.
Concussions, which are more common in men, are another common yet often unrecognized cause of low T.
This is because head trauma can damage the pituitary gland, which is situated in a vulnerable area of the skull. When this occurs, it can impact the production of hormones, such as testosterone. This can lead to hormonal imbalances.
The brain SPECT imaging work at Amen Clinics reveals damage to the brain due to head injuries. In fact, SPECT scans show that 40% of patients at Amen Clinics have experienced a significant brain injury.
What’s surprising is that many of them don’t recall being hurt, or they think their head injury was too insignificant to mention. What these individuals don’t realize is that a mild traumatic brain injury (mTBI) can negatively impact hormone production and lead to mental health symptoms like depression.
Other causes of low testosterone include:
- Testicular injury
- Cancer treatments
- High iron levels
- Mumps
- Obesity
- Diabetes
- Obstructive sleep apnea
- Opioid medication use
- HIV/AIDS
- Tuberculosis
Additional factors that contribute to low testosterone include too much belly fat, high stress levels, a high-sugar diet, eating too many processed foods, low zinc levels, and excessive alcohol consumption.
IS IT DEPRESSION OR LOW T?
Research shows that depression symptoms are common in men with low T. Many of the symptoms of low T are similar to those in depression, such as low energy, lack of motivation, low sex drive, moodiness, and trouble concentrating.
Because of this, it’s critical to know if your symptoms are due to depression or low T. This is where functional brain imaging with SPECT can be so valuable.
SPECT measures blood flow and activity in the brain. It shows areas of the brain with healthy blood flow/activity, as well as those with too much or too little blood flow/activity.
On SPECT, people with depression tend to have too much activity in the deep limbic system. And people with hormonal deficiencies or head trauma often have areas of decreased blood flow. Seeing the brain patterns can help you get a more accurate diagnosis, which leads to more effective treatment.
HOW TO TREAT LOW TESTOSTERONE
Testosterone replacement therapy (TRT) is an effective treatment option that helps restore hormonal balance. TRT is available in many forms, including injections, topical gels, and patches. It’s important to work with your physician to determine if TRT is right for you.
Other ways to support healthy testosterone levels include:
- Lift weights: Resistance training can boost testosterone levels naturally, according to several studies.
- Consume adequate protein: Getting enough protein is critical for healthy testosterone production. However, a 2023 study shows that very high protein diets (>3.4g/kg/day) may decrease T levels.
- Manage your stress: Practicing stress-management techniques promotes healthy hormone production.
- Get your zzz’s: Adequate sleep is necessary for optimal hormonal balance. Aim for 7-8 hours per night.
- Take nutritional supplements: To support testosterone, take vitamin D (get your level tested and optimize it if necessary), zinc (25mg a day) and DHEA (start with about 10mg and increase from there).
Keeping testosterone levels healthy can help men maintain more positive moods, greater energy levels, and increased motivation and sex drive. Ultimately, these enhance a man’s overall quality of life at any age.
Depression, anxiety, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
There’s a cool crispness in the air, the scent of fall spices in the kitchen, and the holidays right around the corner. For many people, it’s the most wonderful time of the year. For others, it’s the dawn of the worst time of year when sadness sets in.
It isn’t uncommon for shorter days, cold weather, and a lack of sunshine to trigger mild winter blues, which affects about 14% of American adults. For approximately 6% of people, however, a type of depression called Seasonal Affective Disorder (SAD) descends like a dark cloud.
Be aware that SAD isn’t solely restricted to the winter months. A much smaller percentage of people develop seasonal depression in the summer.
SYMPTOMS OF SEASONAL AFFECTIVE DISORDER
SAD shares many of the same symptoms as major depressive disorder, including persistent sadness, negative moods, loss of interest in usually pleasurable activities, and difficulty concentrating. However, SAD has some atypical features compared with depression, such as:
SAD Symptoms Depression Symptoms
Oversleeping Insomnia
Weight gain Weight loss
Appetite increase Loss of appetite
Agitation Feeling slowed down
If you have SAD, you’re likely to feel lethargic, irritable, and have trouble waking up in the morning. You probably feel like you never get enough rest even though you’re sleeping more than usual. You may tend to eat more, especially sweets and high-glycemic carbohydrates, which contributes to weight gain. It’s harder to concentrate, and you don’t feel like socializing with friends and family. Some people describe the feeling as being a grouchy bear that needs to hibernate for the winter. It’s no surprise that this can lead to problems at work, at school, and in relationships.
In general, the holiday season is difficult for many people. Financial pressures and the expectations of family members are high. For those of us who have lost a loved one or are alone, grief reactions can intensify during the holidays. Typically, the winter blues or “holiday blues” resolve rapidly with social support or without intervention after the first of the New Year.
SAD, on the other hand, continues to intensify during the holiday season, into the New Year, and into early spring. Without intervention, the symptoms don’t begin to abate until early to mid-spring, or until summertime for some people, when the days are longer.
SEASONAL AFFECTIVE DISORDER IN THE BRAIN
Experts are still researching what causes SAD, but findings so far suggest there may be multiple neurobiological factors, including the following.
- Pineal gland disruption: Sunlight detected by the retina of the eye sends signals to the more primitive parts of the brain, one of which is the pineal gland. The pineal gland plays a vital role in hormone regulation, and one of the hormones it controls is melatonin. Disruption of the pineal gland hormone axis due to light deprivation is thought to be a primary cause of SAD. Support for this line of thought comes from several observations. First, SAD is decidedly more common in parts of the world that are more deprived of sunlight. In the U.S., for example, the rate of SAD is much highest in Alaska and is higher in the Pacific Northwest and in Maine than in southern states. The rate of SAD is higher in Scandinavian countries than in southern European countries. Second, people with SAD who travel to a more southern location experience improvement in their symptoms.
- Melatonin disruption: Melatonin helps set the body’s biorhythms. According to a 2015 overview of SAD in Depression Research and Treatment, people with SAD may produce abnormally high levels of melatonin, which drains energy and provokes sleepiness.
- Serotonin regulation problems: Research shows that people with SAD have trouble regulating serotonin, a “feel-good” neurotransmitter that is believed to be involved in mood control. A 2014 study in European Neuropsychopharmacology found that people with SAD have seasonal fluctuations in SERT, a protein that is involved in serotonin transport. In the winter months, they have 5% more SERT, which translates into lower serotonin activity, which is believed to be related to depression.
- Reduced vitamin D levels: During the winter months, when sunshine is in shorter supply, people with SAD may produce less of this important vitamin. Having low levels of vitamin D, which is known as the “sunshine vitamin,” has been linked to depression and bipolar disorder. Vitamin D is also believed to play a role in serotonin activity, and lower levels may impact this important neurotransmitter.
In people who experience SAD during the summer months, it is often too much heat or too much light that triggers the onset of depressive symptoms.
HOW TO STOP FEELING SO SAD
If you experience SAD, there is hope. Many natural therapies can be helpful in reducing symptoms of depression, including the following.
- Bright light therapy: A growing body of research shows that using bright light therapy, especially in the morning, is effective in treating SAD. Bright light therapy is full-spectrum light that has to be at least 10,000 lux or higher to be effective. “Full-spectrum” is important terminology. It means that the light is the same color spectrum as sunlight. Other types of light won’t do for the treatment of SAD. For this therapy, aim for 20-30 minutes of exposure in the morning.
- Vitamin D supplementation: If you experience SAD, it’s critical to check your vitamin D levels and optimize them with a nutritional supplement if necessary.
- Kill the ANTs: It’s common for people with SAD to fall into unhealthy negative thinking patterns. Learning to kill the ANTs (automatic negative thoughts) by challenging your thoughts can be helpful. Psychotherapy can be beneficial in showing you how to change your thinking habits.
- Happy foods: Resisting the cravings to consume high-glycemic carbohydrates can help. As the winter months approach (and ideally year-round), focus your diet on foods that fight depression.
In some cases when natural treatments aren’t enough, medications may be helpful. It’s also important to look into other factors that may be contributing to depressive symptoms.
Depression, seasonal affective disorder, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.
At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Can you guess what mental health condition is associated with confusion, forgetfulness, poor concentration, slowed speech, apathy, and decreased energy? If you answered dementia, you’d be correct. And if you answered depression, you’d also be right. Indeed, depression symptoms and dementia symptoms often overlap, which can lead to misdiagnoses and incorrect treatments.
Thankfully, research involving brain SPECT imaging has shown some clear distinctions between the two conditions. We now have clearer signs to distinguish differences, help resolve confusion, and improve both diagnoses and effective treatments.
Here’s what you need to know to help recognize the indicators of dementia or depression in yourself or a loved one.
UNDERSTANDING DEPRESSION
Depression (also known as clinical depression or major depressive disorder) is a mood disorder characterized by persistent feelings of sadness, emptiness, and hopelessness. It can range in intensity from milder transient states of low mood to severe, persistent symptoms that permeate one’s thoughts, feelings, and actions.
Clinical depression may disrupt one’s ability to participate in daily life activities and progress into a variety of emotional and physical problems. It’s not a simple bout of the blues or something that one can snap out of, however, it is highly treatable.
Depression is not just one thing. The brain-imaging work at Amen Clinics shows that there are 7 types of depression. Major depressive disorder symptoms may include any of the following:
- Feeling of sad, empty, or hopeless
- Inability to find pleasure in hobbies, work or activities once enjoyed
- Sleep problems (too much or too little)
- Changes in appetite (too much or too little) with weight gain or loss
- Decreased energy, tiredness, or general fatigue
- Being highly agitated or feeling slowed down
- Feelings of worthlessness or guilt
- Trouble making decisions or making poor decisions
- Difficulty with concentration or focus
- Experiencing physical symptoms of pain such as headaches, body aches, or upset stomach
- Contemplating death or dying, suicidality
- Forgetfulness and confusion
- Slowed speech
WHO IS AT RISK FOR DEPRESSION?
Clinical depression affects approximately 17.3 million U.S. adults, more than 7% of the adult population. Twice as many women than men and almost three times as many teenage girls than boys are affected by depression.
While the CDC estimates depression rates to be as high as 13.5% in the elderly, it also notes that depression in older age is often undertreated and misdiagnosed. Indeed, a recent published report estimates the rate of elderly depression to be considerably higher at 30-45%.
Even though older age may bring chronic health issues, loss, and disappointment, depression is not a normal part of growing older. When it goes untreated, it can have a profound negative impact on one’s life including an increased risk of the following:
DEPRESSION AND DEMENTIA SIMILARITIES
One reason depression is often mistaken for dementia is that depression manifests differently as people grow older. Instead of sadness, they may feel generally “numb” or show a loss of interest in activities. They may be more reluctant to express or talk about feelings, and more likely to complain about physical ailments such as headaches or arthritis.
Depressive symptoms later in life can look so much like dementia, the clinical term “pseudodementia” is used to describe it. As mentioned, depression and cognitive impairment often occur together among the elderly population, making correct diagnosis difficult.
ABOUT DEMENTIA
Dementia is a blanket term used for a group of progressive neurodegenerative diseases that negatively impact significant brain functions and lead to memory problems, impaired cognition, trouble with language, and changes in behavior and personality.
When remembering things becomes increasingly more difficult and thinking skills are considerably less sharp, it might be a sign of developing dementia. Signs of dementia vary from person to person. They typically develop over time, at first appearing subtle and then becoming more noticeable. They may include any of the following:
- Forgetting where you’ve put something
- Trouble recalling people’s names or events
- Memory loss that is noticed by someone else
- Repeating questions
- Trouble making decisions or solving problems
- Changes in mood (may include anxiety, depression, or agitation)
- Trouble finding words or expressing one’s thoughts
- Losing track of time
- Difficulty with daily tasks or requiring help to do them
- Struggling with movement, coordination, or balance
- Difficulty with planning, organizing, or performing more challenging tasks
- Visual and spatial problems, such as getting lost when walking or driving
- Confusion and disorientation
- Changes in personality
- Exhibiting inappropriate behavior
- Seeing things that aren’t there (hallucinations)
- Being suspicious (paranoia)
WHO IS AT RISK FOR DEMENTIA?
Dementia can be both devasting and debilitating as it worsens. About 55 million people around the world live with some form of dementia, and it is the 7th leading cause of death in the U.S. and globally.
The most common form of dementia is Alzheimer’s disease, which accounts for 60-80% of memory loss cases. Vascular dementia, frontal-temporal lobe dementia, and alcohol-related dementia are among some of the lesser-known forms of dementia.
While more uncommon, some types of dementia, such as early-onset Alzheimer’s disease, affect younger populations as well. Dementia risk can be lessened with lifestyle changes. Once one is diagnosed with dementia, it can be managed but not cured. Untreated dementia worsens more rapidly.
HOW TO DIFFERENTIATE BETWEEN DEPRESSION AND DEMENTIA
Depression and dementia are highly entangled disorders. Nearly half of elderly individuals with depression also have cognitive impairment. Conversely, anywhere from 9-65% of people with dementia also have depression.
On a brighter note, research conducted by Dr. Daniel Amen and colleagues and published in the Journal of Alzheimer’s Disease has helped to differentiate the two disorders. The study, which used brain SPECT imaging on more than 4,500 patients (847 with some form of dementia, 3,269 with depression, 425 with both conditions) showed marked physiological differences between the groups.
Primarily, people with dementia showed overall lower blood flow to the brain (compared to depression), especially in the hippocampus temporal, and parietal lobes. In depressed patients, there was overactivity observed in the limbic system, which is the emotional center of the brain.
What’s more, the brain SPECT imaging could distinguish depression from cognitive disorders with 86% accuracy, and correctly diagnose them with 83% accuracy. In the cases of comorbidity (when both disorders were present), the accuracy rate was even higher.
Of course, not everyone can have a brain scan to correctly diagnose dementia or depression. Here’s what to look for in terms of symptomology to help differentiate the two.
SIGNS MORE LIKELY ASSOCIATED WITH DEMENTIA
- Memory loss comes on more slowly and gradually
- Increasingly misplace things
- Decreased judgment
- Personality changes
- Trouble performing familiar tasks
- Difficulty with words and language (using the wrong words)
- Disorientation regarding time and place
- Diminished abstract thinking
- Show little initiative, apathy
- Suicidal thoughts are rare
SIGNS MORE LIKELY ASSOCIATED WITH DEPRESSION
- Have had depression in the past or family history of depression
- Generally sad or negative
- Persistent worrying or frequently feeling anxious and panicky
- More prone to complain of physical symptoms (such as aches and pains)
- Feeling like life has no point and is not worth living
- Spells of crying with no understandable reason
- Trouble doing simple chores
- Decreased energy
- Feelings of loneliness or boredom
- Suicidal thoughts are common
Keep in mind that pseudodementia (depression masquerading as dementia) typically manifests with confusion, trouble with concentration, slower speech, forgetfulness, a decrease in energy, and apathy.
SEEK TREATMENT EARLY FOR DEPRESSION OR DEMENTIA
Memory loss and depression are not a normal part of aging. If you recognize signs of either in yourself or a loved one, seek the help of a qualified professional. Better outcomes are associated with accurate diagnosis and early treatment.
Depression, dementia, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Bipolar disorder (BD) is a brain disorder that results in significant and severe changes in mood, activity, and energy levels, and ability to carry out the routine tasks of daily living. It is also considered one of the most heritable mental health conditions. New research led by scientists at the Broad Institute of MIT and Harvard University has pinpointed a specific gene as a strong risk factor for bipolar disorder and schizophrenia for the first time.
Unlike previous genetic links to the disorder, this new gene was found to have a significant effect on bipolar disorder risk. Scientists are hopeful that this discovery will help them develop new treatments for this complex mental health condition.
Having a bipolar disorder genetic risk factor, however, does not mean one will develop the condition. There are many other risk factors that play a strong role in its development.
Here’s a closer look at bipolar disorder and its genetic underpinnings.
ABOUT BIPOLAR DISORDER
Bipolar disorder (BD), formerly called manic-depressive illness, is characterized by dramatic shifts in mood states and energy levels. However, these shifts are not the normal ups and downs that most people experience. They are more akin to intense emotional states or mood episodes that occur over a distinct period of time—sometimes days or weeks.
BD’s mood states are either manic/hypomanic (extreme happiness) or depressive (sad or low mood) and shift in a cyclical pattern, which creates a wide range of symptoms. Yet, people with bipolar disorder commonly have periods of neutral mood too.
Manic states can be intensely happy or highly agitated and typically involve a decreased need for sleep, grandiose ideas, or racing thoughts. Depressive states include low mood, loss of interest in activities once found pleasurable, and sometimes, suicidal thoughts (see a more comprehensive list of signs of manic/depressive episodes below).
When left untreated, bipolar disorder can greatly impact one’s quality of life. It can cause major problems such as:
- Self-esteem issues
- Poor performance in school
- Job performance issues
- Relationship troubles
- Substance abuse
- Hospitalization (39%, the highest rate of all mental health disorders)
- Shorter life expectancy (more than 9 years)
- Increased risk of suicide (15x greater than the general population)
Bipolar disorder is a serious mental health condition, ranking sixth on the list of the world’s leading causes of disability, according to the World Economic Forum.
Close to 6 million U.S. adults are affected by bipolar disorder, but it can affect children and adolescents too. The disorder typically begins in young adulthood (late teens to mid-20s), but it can start earlier in childhood or in mid-life as well.
WHAT CAUSES BIPOLAR DISORDER?
There is no exact cause of bipolar disorder, but experts have identified several risk factors for the condition, including heritable risk factors.
You may wonder, is bipolar disorder genetic? Indeed, it is—in part. Having one or more family members with bipolar disorder is a key risk factor and there have been genetic links to BD discovered in recent years, which are discussed below.
That said, there are other strong, non-genetic determinants in the development of BD. A history of emotional trauma, high stress, substance abuse, and changes in the structure and function of the brain can all play a role in BD.
Additionally, any of the following can factor into the development of BD, according to research:
BIPOLAR DISORDER GENETIC RISK FACTORS
Twin, family, and adoption studies suggest that bipolar disorder has a significant hereditary component. About 15 years ago, researchers found that individuals with a first-degree relative (parent, sibling, or child) with bipolar disorder had a 7 times greater risk of developing the condition than the general population.
Indeed, a study involving twins found that the estimated heritability of bipolar disorder is more than 70% without shared family environmental effects.
Around the same time, researchers identified 2 genes—ANK3 and CACNA1—associated with bipolar disorder. Since problems with calcium signaling are associated with BD and these two genes contribute to the regulation of calcium, it was believed that they may play a role. However, it is still unclear, according to research.
More recently, a study published in the American Journal of Medical Genetics found a number of genetic variations linked to the condition. And just last year, in the research mentioned earlier, scientists identified the first strong genetic link to bipolar disorder, called AKAP11.
Still, the discovery of AKAP11 does not reveal too much about genetic risk for the general public. Its greater value may be what it reveals about the roots of BD. Researchers believe this gene may provide clues as to lithium’s effects on the body and open up the discovery of new therapeutic targets.
Lithium is one of the most widely used medications for the treatment of BD, although it comes with some undesirable side effects and safety concerns.
Though this evidence for genetic risk factors is strong, mental health experts have noted that in clinical practice, a positive family history of bipolar disorder is actually not very common. Of course, this underscores the influence of non-genetic factors in the development of BD.
SIGNS AND SYMPTOMS OF BIPOLAR DISORDER
If you suspect you or a loved one may have bipolar disorder, here are more detailed lists of symptoms for manic and depressive episodes.
Signs of a Manic Episode
- Unusually elevated mood
- Inflated self-esteem
- Less need for sleep
- An influx of goal-oriented activity
- Difficulty turning off the mind
- Lack of good judgment, which results in risk-taking behavior
- Grand ideas and plans
- Talking more or faster
- Unusually increased appetite
- Social behavior that’s inappropriate
- Aggression or irritability
- Hallucinations or delusions
- Racing thoughts
- Compulsive sexual or hyper-religious behavior
Signs of Depressive Episodes
- Sad or negative mood that persists
- Loss of interest in activities that normally bring pleasure
- Changes to sleep, getting either too much or too little, or waking too early
- Feeling “slowed down,” fatigued, decreased energy
- Trouble concentrating
- Feeling guilty, worthless, helpless, and hopeless
- Morbid or suicidal thoughts, or suicide attempts
Of course, like so many mental health disorders, BD is not a simple condition or just one thing. Experts recognize at least 4 types of bipolar disorder, including the following:
- Bipolar I disorder
- Bipolar II disorder
- Cyclothymic disorder
- Bipolar disorder not otherwise specified (NOS)
The distinction between each type has to do with the severity of symptoms. For instance, bipolar 1 disorder is viewed as the most severe form of the disorder.
BIPOLAR DISORDER IS HIGHLY TREATABLE
If you recognize the signs of bipolar disorder in yourself or someone you love, reach out to a qualified mental health professional. There’s great hope with BD. The National Institute of Mental Health (NAMI) reports that with proper treatment, 70% to 85% of patients recover.
Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Depression appears to be spreading like cancer. That’s according to a recent Gallup poll that surveyed more than 5,000 U.S. adults about their depression diagnoses. The poll found that reports of clinical depression have reached a new high, with 29% of respondents having been diagnosed and 17.8% having been treated for it. That’s a hefty 10% and 7% increase, respectively, since these numbers were reported in 2015.
What’s behind this significant increase? On the positive side, Americans now have more awareness about depression. That usually leads to more people seeking help than in years past. It also means that more medical professionals are taking it seriously and screening for it.
On a less optimistic note, however, there are several potential culprits that may have created this uptick in depression. Some, such as COVID-19, were not present in previous years. Let’s look at 7 hidden causes that may be contributing to depressive symptoms, and how they affect the brain and mental health.
5 LESSER-KNOWN CAUSES OF DEPRESSION
1. Inflammation
Inflammation is a silent cause of depression. That’s because inflammation is an internal symptom, one we can’t necessarily see. But we can think of it as a fire that’s burning at a low level behind the scenes. This common health problem affects everything in the body, including the brain, which then can create depressive symptoms.
Experts have studied and established the link between inflammation and mood disorders. Research has found that cytokines (pro-inflammatory molecules) can affect levels of the mood stabilizer hormone serotonin, for example.
This study hypothesized that other reasons for this inflammation-depression link may include “dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, pathologic microglial cell activation, impaired neuroplasticity, and structural and functional brain changes.” More research is needed to find out further details about the connection between inflammation and depression, but we know it exists.
2. COVID-19
It will take years to determine just how deeply COVID-19 impacted our world. But the Gallup poll noted that depression stats have climbed higher than ever after the pandemic. Reasons for this, the report explained, may be due to many factors.
For example, social interruptions have led to increased isolation and loneliness. Then there are the additional psychological burdens, such as fear of catching COVID, or the exhaustion experienced among healthcare workers. Finally, there have been factors like increased substance abuse and pandemic-related disruptions in mental health care and other services.
Physical changes are a factor, too, among those who have had COVID—especially those who experience symptoms of long COVID. The virus creates inflammation, which (as noted above) is associated with signs of depression.
Brain SPECT imaging scans at Amen Clinics show that changes in the brain take place after COVID. For example, some post-COVID scans reveal increased activity in the emotional centers of the brain. Overactivity in this area of the brain is often associated with depression.
3. Hypothyroidism
This condition, which is far more common in women, occurs when the thyroid gland does not make enough of the thyroid hormone. This may cause memory loss, fatigue, weight gain, and, yes, depression. On SPECT scans, hypothyroidism is associated with overall decreased blood flow in the brain. This is often linked to cognitive impairments as well as mental health issues like depression.
Unfortunately, too many people living with thyroid issues are not receiving the medical attention and treatments they need. Though the American Thyroid Association estimates 20 million Americans have some form of thyroid disease, as many as 60% of those with the condition are unaware of it.
If you experience the onset of depression and can find no other obvious cause, it is wise to get your thyroid levels checked out by a medical professional.
4. Head trauma
Traumatic brain injuries are strongly associated with major depressive disorder. One review that analyzed dozens of studies noted that it’s the most common psychiatric disorder to appear after these injuries.
According to these studies, the likelihood of developing depression within the first year after sustaining a head injury is between 33% and 52%. Surprisingly, an increased risk of depression is found not only in those with severe head trauma but also in mild cases. This leads to an increased risk of more serious post-injury effects, including suicide.
Researchers suggest depression may be related to damage to brain tissue as a result of a head injury. Certain people, such as those with a previous depression history or those with outside adverse factors like unemployment, may be more at risk.
5. Exposure to toxins
Toxins in our environment can poison the brain and lead to mental health conditions like depression. Toxins destroy the body in many ways. Like many of the concerns listed here, they reduce blood flow to the brain, which is associated with depression.
They also interfere with hormone production, disrupt the immune system and the gut’s microbiome, and contribute to obesity. DNA damage via toxin exposure also ages the brain and can impact both mood and memory. Any of these issues can be associated with depressive symptoms.
6. Heart disease
Research shows there’s a strong connection between heart disease and depression. People who have experienced a heart attack, stroke, or heart failure are at increased risk for mood disorder. Approximately 20%-30% of cardiac patients experience depression, according to research. This means cardiac patients are 2-3 times more likely to develop depression compared with the general population.
Experts suggest that cardiac events can trigger depressive symptoms for a variety of reasons. These include pain as well as fears about dying, disability, or financial troubles. Impaired blood flow, commonly seen in heart disease, can also play a role in mental health conditions. SPECT imaging shows that decreased blood flow negatively impacts the brain and mental well-being.
7. Certain medications
Some prescription drugs have been linked to depressive symptoms, such as sadness, hopelessness, and negativity. Medications associated with an increased risk of depression include oral contraceptives, corticosteroids, isotretinoin (acne medication), interferon-alpha (an anti-viral drug), high blood pressure drugs, and statins.
A 2023 study using data from 264,557 women found that an alarming number of those who use oral contraceptives develop depression. Women who were teenagers when they started taking the pill had a 130% higher rate of depressive symptoms. For those who began taking the pill as an adult, there was a 92% increase in mood disorder.
DEPRESSION SYMPTOMS AND TREATMENT
Even though depression is more widespread than ever, there is a silver lining. As more awareness of this mental health condition grows, more people can get the diagnosis and help they need. Those who have not been diagnosed or treated, however, may not know whether they need help.
Here are some symptoms and signs of depression to watch out for:
- Persistent sadness or negativity
- Hopelessness
- Restlessness
- Irritability
- Changes in sleep patterns (oversleeping or too little sleep)
- Changes in appetite (weight loss or gain)
- Lower energy levels
- Difficulty concentrating or memory loss
- Loss of interest in pleasurable activities
- Suicidal thoughts or attempts
These symptoms are only a fraction of the ways in which depression can hamper our functioning. Also keep in mind that there are 7 types of depression, each with its own manifestations and effects on the brain and body.
Finally, depression often co-occurs alongside other mental health concerns. For example, depression and anxiety co-exist 75% of the time. PTSD and substance use disorder also commonly occur with mood disorders, such as depression or bipolar disorder.
It’s crucial to seek medical help to diagnose this serious disorder. Untreated, it can wreak havoc on all areas of a person’s life, from work and school to family and physical health.
Most importantly, it’s critical to remember that depression is a symptom. You need to find out what’s causing it to treat it effectively. Be sure to find a mental health professional who looks at all the biological, psychological, social, and spiritual issues that may be contributing to depressive symptoms.
A comprehensive evaluation that includes lab work, brain SPECT imaging, psychological testing, and more can be invaluable. This can help determine the type of depression at work and its causes, which allows for more targeted treatments for depression. This is an especially helpful step when depression is associated with one of these hidden reasons, which are too often overlooked.
Depression and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. The stigma around mental health disorders may be lessening, but far too many people still do not seek the help they need because of shameful feelings. They do not understand that anxiety, depression, problems with focus or memory, and other mental health issues are, in fact, very common, normal occurrences. How normal? More than 50% of the world’s population will experience a mental health issue at some point in their lifetime, according to data from the World Health Organization.
That figure is greater than the number of Americans who will experience heart disease during their lifetime, yet heart disease is not hidden under a cloak of shame and misunderstanding like mental health disorders are.
Your brain can have problems just like your heart can. People who have a family history of heart health issues, too much visceral fat, or blood pressure that’s too high will see a doctor and make changes because they don’t want to have a heart attack. For mental wellness, it’s important to take similar measures to support and protect your brain health.
The cost of failing to do so is great. In addition to causing personal distress, fractured relationships, isolation, and poor quality of life, the National Alliance of Mental Illness (NAMI) reports that untreated mental health issues can lead to unnecessary disability, job loss, substance abuse, homelessness, inappropriate incarceration, and suicide.
HOW COMMON ARE MENTAL HEALTH ISSUES?
In today’s post-pandemic world with widening political divisions, inflation rising, deep concerns about the future of our planet, greater isolation due to social media and other factors, poor diet, and stressful lifestyles, mental health issues are more common than ever before.
In fact, surprisingly, improving mental health was the top new year’s resolution for 2023. According to a Forbes survey, 45% of respondents made improved mental health one of their top resolutions—above weight loss, improved diet, more exercise, and improved finances—marking a seismic shift in the value placed on mental well-being.
Just three years earlier, mental health was fifth after improved finances, diet, exercise, and weight loss, according to data. What’s more, young people value mental health even more. In the Forbes survey, 51% of Gen Z respondents placed improved mental health at the top of their list.
OVERVIEW OF MENTAL HEALTH IN AMERICA
Indeed, Americans are likely prioritizing mental health because so many of us are struggling with it. Here’s a snapshot of key findings from the 2021 Substance Abuse and Mental Health Services Administration survey:
General Mental Illness
Depressive Episode
- 1 in 5 adolescents aged 12-17 experienced a depressive episode in the last year.
- More than 20 million adults experienced depressive episodes in the last year.
Suicide
- 3 million adolescents aged 12-17 had serious thoughts of suicide, 1.5 million people made a suicide plan, and 892,000 attempted suicide.
- 3 million adults had serious thoughts of suicide, 3.5 million made a suicide plan, and 1.7 million attempted suicide.
- Additionally, the National Institute of Mental Health lists suicide as the second leading cause of death among kids and young adults ages 10-34.
Substance Abuse
- 3 million people aged 12 or older had a substance use disorder (SUD) in the past year.
- Additional research found that in 2021, there were over 106,600 deaths due to drug overdose in the U.S.—the highest on record, largely driven by substances laced with synthetic opioids, such as fentanyl.
Anxiety and Depression
Additionally, new survey research updated in March 2023 found remarkably high rates of anxiety and depression in adults.
- 3 % of all adults (and 49.9% of young adults aged 18-24) reported experiencing anxiety and depression.
Even though we have more mental health awareness than ever and mental health issues are so prevalent, more than half of people with mental illness don’t get the help they need according to a 2022 report from Mental Health America. It may be time to transform the way we think about mental health struggles.
SMART PEOPLE SEEK HELP FOR MENTAL HEALTH ISSUES
If you’re having trouble with your mental well-being—whether it’s your negative thinking, stress, anxiety, low self-esteem, self-harm, substance use, addictive behavior, sleeplessness, mood, motivation, focus, or memory—consider letting go of the false idea that you’re not normal and get the help you need.
It’s a bright person who seeks help, not a weak one. Imagine you’re an entrepreneur with a struggling business. Wouldn’t you seek the advice of the smartest consultant you could find to help you? Failing to get expert advice might mean losing your business—or worse—bankruptcy.
Prolonged, needless mental suffering serves no one. Seeking the best mental health support you can find is smart. When you seek support and discover there are many others who struggle with mental health issues too, isolation, shame, and pain diminishes.
MENTAL HEALTH IS BRAIN HEALTH
Looking at mental health through the prism of brain health can be supremely useful for proactively taking charge of your mental well-being. Few people want to be labeled defective or abnormal. Seeing mental health issues as brain health issues shifts the focus in a constructive way. With our brain SPECT imaging work at Amen Clinics, people can see their brains, and they begin to see that mental health is a medical issue, not a moral one.
Looking at mental health as a brain health issue lessens shame and guilt, increases self-acceptance, and promotes forgiveness, compassion, and greater understanding among an individual’s family and friends too. It’s also more accurate to acknowledge mental health is a brain issue, which elevates hope and stokes the desire to get help and make the necessary lifestyle changes.
It’s profoundly empowering when an individual begins to see that the brain is in charge of everything, and taking good care of it will help improve not just mental health, but life in general.
Mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Do you feel confused, unclear, forgetful, fatigued, or have a hard time multitasking? It could be brain fog, which isn’t considered a medical condition but rather a symptom of other issues, such as cognitive dysfunction, which affects about 600 million people worldwide. Brain fog has been in the news recently as it is a common symptom of long COVID, but that’s not the only reason people experience it. Other causes of mental fuzziness aren’t talked about as much but have the same impact on day-to-day life. In this blog, you’ll discover 12 causes of brain fog and 12 brain fog remedies that can help you clear the fog.
12 CAUSES OF BRAIN FOG
1. Obesity
It is common knowledge that obesity increases the risk of type 2 diabetes, high blood pressure, joint issues, and heart disease. Did you know it can negatively impact your brain health too? Inflammation is a major factor associated with obesity and is directly linked to brain fog. A 2015 study published in Frontiers in Neuroscience reviewed the connection between mast cells, which play a role in how fat is metabolized. This relationship can impact inflammation in the brain, resulting in brain fog.
Clear the Fog: Learn to love foods that love you back. Adopt a brain-healthy diet that supports cognition—think fish high in omega-3 fatty acids (salmon), protein for better focus, berries, and nuts.
2. Stress
Life changes, whether exciting or difficult can cause stress, overwhelming the brain and leading to the fuzzy thinking and dullness associated with brain fog. If you’re undergoing intense change or dealing with a traumatic situation, you might struggle with symptoms of brain fog. If the stress you’re under requires you to make important decisions, you might have a harder time doing so. Research shows that chronic stress results in reduced blood flow to the brain, which contributes to brain fog and other adverse symptoms.
Clear the Fog: Reduce stress with relaxation techniques like deep breathing and meditation.
3. Untreated depression
Depression is strongly associated with memory loss, which is considered a common brain fog issue. Untreated depression can also result in fatigue, confusion, and an inability to focus—all of which are also linked to brain fog. Because the cognitive effects of depression are so far-reaching, it is imperative to seek help from a mental health professional with a brain health specialty.
Clear the fog: Discover which type of depression you have so you can get treatment targeted to your needs.
4. Hormonal imbalances
Brain fog and hormone issues go hand-in-hand. Hormonal causes of brain fog include hypothyroidism, perimenopause/menopause, and abnormal cortisol levels. Brain fog can be so extreme when hormonally related that it’s not uncommon for people to think they have early-onset Alzheimer’s disease and get tested for memory loss.
Clear the Fog: Have your healthcare provider check your hormone levels and balance them if necessary.
5. ADD/ADHD
Lack of focus, being easily distracted, and having trouble concentrating are all symptoms of ADD/ADHD that can contribute to brain fog. A study in Frontiers in Psychiatry found that people with ADD/ADHD have higher levels of cytokines, which have an inflammatory effect on the brain. A spike in cytokines can interfere with your working memory, slow your reaction time, and cause brain fog.
Clear the Fog: Find out which of the 7 types of ADD/ADHD you have and look for natural solutions to help and take medication if necessary.
6. Food allergies
Your diet can either make you feel focused and sharp or slow and sluggish. A study published in Behavioural Brain Research found a correlation between food allergies and cognitive impairment, including brain fog. More mile food sensitivities and food intolerances can also mess with your brain. The typical American diet is riddled with commonly allergenic foods such as gluten, corn, soy, sugar, dairy, and food additives and dyes.
Clear the Fog: Eliminate potential food allergens for 30 days and see if your foggy thinking improves.
7. Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) has a host of symptoms involving digestive issues, sore lymph nodes, muscle weakness, food allergies, and irregular heartbeat. Another challenge of the condition is brain fog and overall difficulty with information processing, attention, and working memory.
Clear the Fog: Seek treatment for CFS from an integrative or functional medicine physician.
8. Long COVID
According to the World Health Organization, people suffering from long COVID have symptoms such as fatigue, shortness of breath, chest pain, loss of smell and taste, muscle aches, depression, and anxiety. In a 2022 study, 71 percent of participants reported brain fog as a symptom of long COVID, and it is one of the top three symptoms including fatigue and shortness of breath.
Clear the Fog: Get on a brain-healthy program to help combat long COVID and its symptoms.
9. Early-onset Alzheimer’s disease
Mild cognitive impairment (MPI) found in early-onset Alzheimer’s is different from brain fog but might feel similar. Keep in mind the distinction is that dementia symptoms include memory loss that is more profound than the mental cloudiness seen with brain fog, and as Alzheimer’s progresses will interfere dramatically with everyday life.
Clear the Fog: Get screened to rule out Alzheimer’s disease if more pronounced memory loss is a factor.
10. Medications
The blood-brain barrier weakens as we age, which can allow medications to seep into the brain. Over-the-counter and prescription medications that can cause brain fog include pain relievers, sleep aids, anti-anxiety drugs such as benzodiazepines, antidepressants, high blood pressure medication, allergy medication, and drugs that lower cholesterol (statins).
Clear the Fog: Check your medicine cabinet to see if you are taking anything that may interfere with cognitive function and talk to your doctor about it.
11. Sleep issues
There’s no way around it: we need our sleep. Without it, every aspect of life suffers. The idea that you can “get away with” a few hours of sleep every night or interrupted sleep is just not true. Lack of sleep – even one night – can cause brain fog and a host of other symptoms. Chronic lack of sleep is another source of inflammation that can wreak havoc on cognition.
Clear the Fog: Make sleep a priority in your life. Set a sleep schedule and stick with it, even on weekends.
12. Inflammation
The connection between brain inflammation and cognitive dysfunction is found throughout research on brain fog and applies to ADD/ADHD as well as obesity, depression, long COVID, anxiety, food allergies, sleep issues, and other causes listed here. A study conducted in 2021 found that even low levels of chronic neuroinflammation can have an impact on clear thinking and result in chronic brain fog.
Clear the Fog: Consider taking anti-inflammatory supplements, such as fish oil, curcumin, and probiotics.
Given the wide range of issues that cause brain fog, it’s crucial to seek professional help to find what’s at the root of your problems.
Brain fog, memory problems, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Perhaps you’re one of the many people worldwide who, at the midpoint in your journey of life, have found yourself suddenly “within a forest dark, for the straightforward pathway had been lost,” to quote the great Italian writer Dante Alighieri. If so, the question before you may be: Are you depressed, or are you just having a midlife crisis? It’s not uncommon for anyone between the ages of roughly 40 and 60 to experience uncomfortable feelings associated with one or both.
Finding the answer may require navigating a bit of nuance, for while depression can serve as a handmaiden to a midlife crisis, that is not always the case. In fact, the two states are not one and the same.
WHAT IS DEPRESSION?
Depression is a brain-based disorder, which can be characterized by some or all of the following symptoms:
- a loss of interest in possessions or activities you once held dear
- a loss of or an increase in appetite, often featuring weight loss or gain
- difficulty sleeping
- lapses in concentration
- listlessness, with a drop in energy
- persistent negative thoughts or hopelessness
- suicidal ideation
It’s not a state that anyone should have to endure, unaddressed, whether at the midpoint in life or at any other age. Decades of clinical practice at Amen Clinics have shown that treatments, including talk therapy, physical exercise, diet, natural supplements, bright light therapy, neurofeedback, and medication (when necessary), may be beneficial for depressive symptoms. Additional treatments include transcranial magnetic stimulation therapy, an FDA-approved treatment that does not involve drugs and is non-invasive.
The brain-imaging work at Amen Clinics has also found that depression is not one single or simple disorder; there are multiple types. Knowing your type of depression can be helpful in finding the most effective treatments for you.
WHAT IS A MIDLIFE CRISIS?
By contrast, a midlife crisis is a form of identity crisis in which a person judges their own life path and selfhood as inadequate. It may feature a creeping or sudden:
- feeling of inadequacy when comparing one’s life to others
- sense of time slipping away
- conviction that you’ve failed to live up to your potential
- pronounced fear of mortality, followed by urges to make dramatic changes, such as divorcing, marrying, moving across the globe, or buying the proverbial sports car
If depression is part of the bargain, then the treatment methods cited above can help. But addressing the thoughts driving a midlife crisis may call for some counterintuitive thinking to help you refresh your perspective.
RETHINKING YOUR LIFE IN A MIDLIFE CRISIS
“The death dragon,” as Dr. Amen puts it, “is always with us. As a psychiatrist for 40 years now, I’ve seen midlife crises over and over and over again.”
To wrangle with this inner “mental” dragon, Dr. Amen urges patients not to shy away from the prospect of their own demise, but to face it head-on, as he did when he was in college. At that relatively young age, Dr. Amen wrote out the script to his own funeral and has used it to guide his life ever since.
“I reverse-engineered my life,” Dr. Amen says, citing the pioneering work of psychiatrist Elisabeth Kübler-Ross as an inspiration. “She said it is the denial of death that is responsible for people living empty, purposeless lives because when you think you are going to live forever you don’t take care of the things you must do today.”
By contrast, people who live as though they could die imminently tend to live in the moment, he says.
Those who address their midlife crises—and their mortality—head-on can launch themselves into a golden era of renewed passion and transformation. The period of reassessment during that fabled midpoint can produce change that is both surprising and welcome.
Long is the list of artists and innovators whose most fertile periods began later in life. The famed chef Julia Child made her television debut at age 51 after publishing her first cookbook at age 49. Bram Stoker published his masterwork “Dracula” at age 50.
HOW TO OVERCOME A MIDLIFE CRISIS
To reassess at the midpoint of life consider taking some of the following actions:
- Write your own eulogy. Knowing how you want people to remember you can help guide you to a stronger sense of purpose in your life.
- Start therapy to help uncover and discard blocks to happiness
- Learn something new, such as a language, a skill like dancing, or a sport like pickleball.
- Spend more time outdoors. Science has long identified the beneficial impact of nature on mental health.
- Invest in your love life. Recommit to a long-term partner to reinvigorate your connection, consider exiting an unhealthy relationship, or start dating again after a long hiatus.
- Find new horizons, whether near or far to explore.
- Add a new brain-healthy habit to your repertoire. This could include improving your sleep hygiene, drinking more water, eating more vegetables, or meditating.
- Find new ways to spend time with friends and families. Plan ahead with loved ones to go to the movies, share more meals, take more walks or hikes together, as well as trips, both long and short.
Above all, stick it out.
While several studies have described the despair that besets many people between the middle years of 40 to 60, other research has found that people over the age of 60 say they’ve never felt better.
Depression and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Do you feel like you could sleep all day? Does getting out of bed feel like a daunting task because your energy is so low? Does the thought of taking a shower, brushing your teeth, and seemingly minor tasks feel overwhelming or impossible? Have you noticed that you have headaches and stomachaches, and get sick more often? Are there days when you want to eat a whole pizza and others when you can’t imagine taking a bite of food? These could be some of the physical warning signs of depression.
DEPRESSION IMPACTS MORE THAN YOUR MOOD
Depression can significantly affect your physical health. The neurotransmitters serotonin and norepinephrine influence both pain and mood, which helps explain the connection, but it’s more than the physical pain that is linked to depressive symptoms. Gastrointestinal issues, lower libido, sleep problems, restlessness, and plenty of other physical symptoms can all be attributed to depression.
Affecting an estimated 4.7% of the adult population and 11.5% of the youth in the United States, depression is the number-one disability in the nation and has a huge social and economic impact from the loss of work to relationship dysfunction. Suffering from depression is not just a minor interference that only impacts the person with the condition—family, friends, and co-workers are all impacted by a person who lives with depression.
13 PHYSICAL SIGNS AND SYMPTOMS OF DEPRESSION
1. Change in sleep.
Data from a 2022 study show that nearly 75% of depressed patients suffer from insomnia. Keep in mind that disrupted sleep and depression have a bidirectional relationship and sleep should be part of the equation when diagnosing depression.
2. Chest pain.
While chest pain occurs for a variety of reasons other than depression that should be considered and diagnosed, those who are depressed are likely to report that they have chest pain. Research published in The American Journal of Cardiology suggests that these pains can occur in people without other cardiovascular issues and narrowed that list to those who suffer from depression.
3. Fatigue and exhaustion.
Coupled with a lack of sleep, those who suffer from depression might be wiped out all the time and feel like they need to sleep at various hours of the day. Being depressed can cause exhaustion first thing in the morning or throughout the day, and overall weariness and depleted energy are common. Fatigue is more of a temporary event after engaging in a tiring activity, and exhaustion is more chronic and lingers. Both can be experienced with depression.
4. Aching muscles and joints.
Research links chronic pain and depression beyond minor physical pain such as a tense neck or shoulders. Since depression and pain share biological pathways and neurotransmitters, people who suffer from chronic pain can experience depression, and depression can cause chronic pain. An overall feeling of physical discomfort is common in those who are depressed.
5. Digestive problems.
A number of pathways connect the gut and the brain, especially the immunoregulatory, neuroendocrine, and vagus nerve pathways. Keep in mind that sleep, mood, pain, stress, and hunger are all regulated by the vagus nerve. A 2021 study found that those with depression have an increase in gut inflammatory bacteria, reduced short-chain fatty acid production, and the functioning of important neurotransmitters that affect mood. Gut health is imperative in helping with mood disorders such as depression.
6. Headaches.
Headaches can occur for many reasons and are not solely because of depression, so finding the source is important to treat the issue properly. However, research conducted in 2016 shows a connection between tension headaches and people who have depression.
7. Changes in appetite or weight.
Some people with depression have an increased appetite and others can’t imagine eating anything at all. Research conducted in 2020, published in Brain, Behavior, and Immunity found that inflammation in certain areas of the brain can cause appetite changes in people who are depressed.
8. Back pain.
While back pain can be caused by myriad issues from herniated discs to arthritis and pinched nerves, there is evidence that people with chronic low back pain are 3-4 times more likely to be depressed. Coping with pain is difficult on its own but coupled with depression can be debilitating and severely interfere with daily functioning. Understanding the effect of chronic pain on brain functioning is important to help treat symptoms.
9. Agitation and restlessness.
There are various forms of depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-TR-5), one of which is Agitated Depression. However, even without that specific diagnosis, it is common for depressed people to experience agitation and restlessness that can occur simultaneously with an inability to perform basic tasks. A feeling of jitteriness, uneasiness, and difficulty relaxing can contribute to sleep problems as well, which impacts depressive symptoms.
10. Sexual problems.
Low libido is frequently experienced along with depression. A study published in the journal Clinical Depression noted that 40% of men who report depression have reduced sexual interest and have difficulties reaching orgasm. Women who are depressed have certain brain regions—including the middle occipital and temporal gyri, hypothalamus, anterior cingulate gyrus, thalamus, and amygdala—that are less activated when visualizing sexually stimulating imagery. Sexually intimate relationships can suffer as a result of depression, which is often a factor, but changes in the brain have a major impact on libido.
11. Inflammation.
According to a 2019 study, inflammation affects both the peripheral and central nervous systems, resulting in increased activity in the immune system. Inflammation can set off a domino effect of problems throughout the body. Knowing that depression is connected to inflammation in the brain is an important factor in determining how to best treat the condition.
12. Compromised immune system.
Are you getting the common cold or flu frequently? Do you often feel “under the weather” or like you’re on the verge of getting sick? Inflammation has a negative effect on the immune system as it works overtime in a person who is depressed. Someone who is depressed is also more at risk of illness due to changes in sleep patterns, appetite, and physical activity.
13. High blood pressure.
There is an increase in sympathetic nervous system responses (heart rate increase, vasoconstriction) as well as the secretion of adrenaline and cortisol in people with depression and hypertension. This close connection is important to consider when seeking medical support for depression. Research supports the link between the 2, and showed a 9 times greater occurrence of hypertension in depressed people than in those who are not depressed.
WHEN TO SEEK HELP FOR PHYSICAL SYMPTOMS OF DEPRESSION
If you’re experiencing any of these lingering physical symptoms, it’s a good idea to make an appointment with a healthcare provider. Ruling out certain causes may be helpful in determining if your symptoms are due to physical issues or depression.
Depression and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.