Silent Diseases and Mood Disorders

By Jurriaan Plesman, BA (PSYCH), Post Grad Dip Clin Nutr

For many people it is difficult to believe that nutrition has anything to do with "mental illness". Mood disorders may appear out of the blue, without any apparent cause. Often a stressful event may be a trigger, leaving a person with a lasting emotional turmoil, apparently quite unrelated to one's diet. Mood disorders may be of many forms, from anxiety attacks, depression, Obsessive Compulsive Disorder (OCD), Post Traumatic Disorder (PTSD), to addiction. But let us focus on depression as one example of the many mood disorders.

It is important that when we talk about depression, we must make a distinction between "environmental" depression and "endogenous" depression. From a client's point of view, he is usually aware of the causes of "environmental" depression (such as rejection in love, death in family, grieving or traumatic event). In environmental depression, the person may often benefit from counselling or “talk-therapy”. In clinical depression, on the other hand, the client is most often NOT AWARE of the causes and this may lead him to seek professional help. Nevertheless, both environmental and endogenous factors can operate in tandem, but in that case we need to treat the biological factors first, before considering “psychological” factors. We need a healthy body to be able to deal with stress.

The evidence is overwhelming that "endogenous" depression, sometimes called "clinical depression", is nearly always due to some inner biochemical abnormality, although it may have psychological elements. Talk therapy and/or drug therapy often fails to bring permanent relief for the majority of patients. See studies.

I have said that one of the major factors triggering a depression or anxiety or a mood disorder is insulin resistance, a silent disease, and in particular pre-diabetic insulin resistance or hypoglycemia. See References. This can cause brain energy starvation triggering the release of excess adrenaline, a hormone that functions to convert glycogen (sugar stores) back into glucose, so as to feed the brain again. (See image) Insulin resistance interferes with the production of biological energy (ATP), necessary in the production of feel good neurotransmitters such as serotonin. Of course, this is not the only factor, there are many others. This can easily be established by carrying out a 4-hour glucose tolerance test as explained at our web site. We have found that most clients responded positively to this test, supporting the notion that a mood disorder is primarily a biochemical disorder. Other scientists have found the same:

"Many books that I've read - in particular, Carlton Fredricks's "New Low Blood Sugar and You" - say that when there is any mental disorder present, hypoglycemia is going to be right there along with it. Gary Null Page 264

Silent Diseases at the root of mood disorders

One need to understand that many of the underlying metabolic disorders affecting our minds are silent diseases, meaning that the person is not aware of the existence of the illness. Apart from insulin resistance, a typical example is the "Syndrome X" or the "Metabolic Syndrome", which is a combination of abnormal medical conditions such as hypertension, high triglycerides, insulin resistance and obesity. Usually, a person becomes only aware of the existence of this disease when his doctor measures his blood pressure and "discovers" that he has "high blood pressure". The reason appears to be that hyperinsulinism can cause magnesium to be dumped in the urine, upsetting the delicate balance of intracellular magnesium and calcium ions that regulate blood pressure, thereby contributing to hypertension. RAS Hemat Page 38.

Several authors have reported a significant association between metabolic syndrome and depression, Scott D Mendelson et al, 49 G Medeiros-Net et als.,1017 Gaetano Crepaldi et als., 7, Richard A Bermudes, 32

Depression associated with Metabolic disorder is more at risk of heart disease as well as type 2 diabetes. Vnitr Lek. 2009 Jul-Aug;55(7-8):650-2

Anxiety, panic attack and depression may be associated with certain heart conditions such as mitral valve prolapse.

Medicine seems unable to predict and treat Syndrome X or the Metabolic Syndrome at its root. The test for hypoglycemia mentioned above, would help doctors to diagnose it. Both Syndrome X and hypoglycemia (or pre-diabetic insulin resistance) are difficult to treat without drugs, hence conventional medicine centers around the use of drugs - practically the only form of "treatment". Conventional medicine does not encourage to use non-drug treatments that are available. Allopathic medicine seldom solves the problem. In fact, orthodox medicine has been in denial about the existence of hypoglycemia for many years. The American AMA made a statement that hypoglycemia is rare and that hypoglycemics were simply neurotic. Marilyn Light Page 5. (See also:Hypoglycemia: A Forgotten Disease by Dr George Samra --> page 6)

While early diagnosis and treatment leads to improved outcomes, diabetes remains undiagnosed in up to 50% of patients. MJA 2007 186(10):500-503.

Marilyn Light claims 10 - 25% of population is afflicted with hypoglycemia Marilyn Light. Not only that, for insulin resistance to develop into full-blown diabetes may take up to 20-30 years. Derek LeRoith et als. page 1151.

This reinforces the notion that it is a "silent disease" with dire consequences to one's physical and mental health, such as Eating Disorders.

Thus a person may have been suffering for many years from a silent disease, which can be triggered into full-blown depression, by an environmental stress situation.

Another silent disease affecting the mind is a food sensitivity to α-gliadin which is a component of gluten that can cause celiac disease, Rosalinda T Lagua, 92. Undiagnosed celiac disease is a common factor in the development of Alzheimer's disease, Schizophrenia or Down's syndrome. Chris M Reading at al 204 This applies to many other allergies an food sensitivities. Linda Knittel et al, 61, EW Cutler, 8, Gary Null, 116, Allergies: The Food and Disease Paradigm by Dr George Samra.

Other examples of a silent diseases are related to various illnesses of the the digestive system, that can affect the mind. A good illustration is the Leaky Gut Syndrome. When the bowel is inflamed, the gut lining becomes permeable and toxins are absorbed into the blood stream. This gives rise to many immunological reactions, among these symptoms of mood disorders. Partially digested molecules act as antigens - recognized as foreign substances by the body - that provoke an immune reaction. . RAS Hemat ,394,

Hemat argues that:

"The lining mucosal cells of the digestive tract have a high turnover rate such that the whole layer of surface cells may be renewed in 3-4 days. An inability to manufacture adequate building blocks (in this case, glucosamine "amino-sugars") will cause the intestinal wall to "thin" and allow toxins and not fully digested proteins into the blood stream." Hemat 41-2

There is strong evidence to support that depression is linked to the Leaky Gut Syndrome. Matthew Hogg, Maes M et als. 2008, Diseases associated with the Leaky Gut Syndrome are: inflammatory bowel syndrome (IBS), acne, eczema, psoriasis, AIDS, cystic fibrosis, liver disease, rheumatoid arthritis, asthma, celiac disease, lupus, fibromyalgia, Chronic Fatigue Syndrome (CFS), autism, food and chemical sensitivities. Louise Tenney, 14 and Elizabeth Lipski, 25

See also Altered Immunity & The Leaky Gut Syndrome by Dr Zoltan P Rona HYPONL 2003 page 7.

Lack of friendly bacteria and/or probiotics possibly due to over-prescription of antibiotics or any of the digestive illnesses may be responsible for depression. 2 studies on probiotics.

"Absence of hydrochloric acid in the gastric juice is a common symptom in depressive neuroses. It is frequently associated with mental fatigue, persistent worry and strain especially in persons with a congenital unstable psyche. The symptoms are very vague, lack of appetite, fullness after eating, gaseous eructations and diarrhea is more common than constipation. Pain is absent." Source

For a list of drugs and medications that may be responsible for depression see here ---> Page 7

Adrenal exhaustion is one of the silent diseases affecting the blood glucose supply to the brain. “Insufficient glucose available to brain tissues contributes to many neurological symptoms of Adrenal Fatigue, including sleep disorder, brain fog, anxiety, and depression.” Drlam.com May, 2009

And let us not forget hypothyroidism as a silent disease affecting the mind. It is shown as a flat curve sugar reaction in a four hour Oral Glucose Tolerance Test (Type 4 Hypoglycemia). This will naturally affect the conversion of sugar to biological energy called ATP, essential in the production of normal neurotransmitters. Hence this silent disease is associated with depression BJ Cohen , 92. It is possible to test yourself at home for hypothyroidism with the Basal Temperature Test for Hypothyroidism.

Menopause, when the body ceases to produce estrogen and progesterone, may be responsible for depression and mood swings in a proportion of menopausal women. Schnatz, PF et als. (2005) PubMed

Andropause is a collection of symptoms, including fatigue, decrease in libido, lack of concentration, mood swings, anxiety that is experienced by some middle-aged men. It has been attributed to a gradual decline in testosterone. Andropause correlates directly with depression, irritability, mood disorders and memory loss in mid-life crises. Google Scholar

Megaloblastic Anemia, Pernicious Anemia or Iron Deficiency Anemia due to vitamin B12 and folate deficiency and/or iron deficiency affect red blood cells carrying hemoglobin (iron-containing pigment of red blood cells), that carry oxygen from the lungs to tissues. These can be responsible for “psychological” symptoms such as fatigue. Iron is needed to make optimal amounts of ATP. (WA Lishman,559) They are examples of other silent diseases that could be responsible for depression, dementia and epilepsy. For a list of nutrients, deficiency of which can cause depression see RAS Hemat 165. See John Fry et al 208 on anaemia and how it contributes to depression and S Cembrowicz et al, 143 on various routine blood tests used in treating depression.

Vitamin D deficiency: Among a groups of 282 residents it was found that there was a significant association between depression and deficiency of vitamin D (the sun shine vitamin), Witte J G Hoogendijk et als (2008)

People with rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis, although strictly not silent diseases, are more likely to suffer from neuropsychiatric disorders Sundquist et als. 2008

Most inflammatory bowel disorders such as IBS, Crohn’s Disease and Celiac disease are associated with psychiatric disorders. Roger Jones 5, ER Greig et al. 774, Cosimo Prantera et al 456 , TM Bayless et al 570

It is obvious that digestive disorders interfere with the absorption and metabolism of important and essential nutrients necessary in the production of the right hormones and neurotransmitters.

Depression, anxiety, and moodiness are also symptoms of candidiasis, an other "silent disease". Burton Goldberg et als., 621, Allen C Bowling, 66 Stephen E Langer, 240

Statin drugs can cause mood changes

"While the medical establishment continues to push the suppression of cholesterol levels to abnormally low levels, it is not widely known that there is a significant amount of evidence linking low cholesterol to aggressive behavior and depression." Source

There are countless other silent diseases, such as fibromyalgia (SR Pillemer et al, 48), hypercalcemia, or hypocholesterolemia due to statin drugs, leading to Coezyme Q10 deficiency, that may affect blood sugar levels and lead to mood disorders. There are a number of other diseases, that unwittingly may affect the mind. To explore these, please go to: Diseases associated with Emotional Disorders. See also: Medical tests of depression.

Many mind-altering silent diseases may be caused by between 50,000 - 100,000 chemicals released into the environment,(RE Hester et als.132) beginning with petrochemical fertilisers and pesticides used in soil by big pharma-dominated agriculture and food production. Heavy metals - by-products of he industrial society - can lead to a wide array of psychological problems. RAS Hemat 194. Most of these toxins find their way to rivers and the sea, where they contaminate fish we eat. This could easily be avoided if organic farming be universally adopted based on the science of soil biology that would render soils more productive. Dr Maarten Stapper. Videos by Dr Maarten Stapper about Biological Farming

Coming back to the problem of insulin resistance, the chicken-and-egg question is, which came first insulin resistance or obesity.

The Insulin Resistance and Obesity controversy.

A recent report May 2009 by the Australian Bureau of Statistics indicated that about 68 % of adult males and 55 % of adult females were classified as being overweight or obese. Most of the medical literature claims that obesity is the primary cause of insulin resistance (Marshall Stevens Runge p 524, Pamela et als p340, Bray GA et al. p.656), but I tend to question this. If obesity is the cause of insulin resistance, then what causes obesity, apart from the outdated theory of excess caloric intake versus caloric expenditure. Hales et als. 419. As Russell Faris et al. write:

"Research shows that only one person in twenty, and perhaps only one person in a hundred, ever loses weight and keeps it off while dieting. In the long run, diets makes us fat" Russell Farris et als. The Potbelly syndrome page 2. See also: 3 studies

The link between diabetes and obesity may be the presence of insulin resistance that is commonly found in these two disorders. Goran MI et al. p180

Recent findings indicate that impaired mitochondrial ATP production may predispose people to obesity, and we know that ATP is ultimately derived from glucose. Ultimately insulin resistance develops in obesity because alterations in partitioning of fat between adipocytes and the muscle and liver. Magnus D Johansen page 102. Intracellular starvation of biological energy can also lead to depression. Henry Osiecki --> page 6. ATP derived from glucose is needed in the formation of various neurotransmitters. RW Beck, 59

No one has demonstrated that obesity causes insulin resistance. All we really know is that insulin resistance is simply more prevalent among people who are heavier. In fact, we just may have the whole causal relationship backward - rather than obesity causing insulin resistance, it might be that insulin resistance is causing obesity. JE Oliver p.118 & R Farris et als.p.2

The reality is that a low carbohydrate and high protein diet such as the Hypoglycemic diet, Atkins diet, South Beach diet and Zone diet have been shown to lose more weight at 6 months on the diet. In addition, there tended to be fewer dropouts in the low-carbohydrate groups with increased high density lipoprotein (HDL ) and markedly decreased triglycerides concentrations. Fiebach p.1429

This all seem to point into the direction of a much simpler explanation that insulin resistance is the primary cause of obesity and not the other way around. It seems to me that obesity can be explained simply because insulin resistance blocks the absorption of glucose and other nutrients, which are then accumulated in the body first as glycogen. When glycogen stores reach its limits it is then converted to fat cells. P Atluri et als. p 251

This all goes to show that mood disorders are often associated with obesity, which can lead some people to eating disorders. For a 1 ½ hour lecture on the influence of sugar and especially cheap High Fructose Corn Syrup (HFCS) by Dr Robert H Lustig listen to lecture“Sugar: The Bitter Truth” below under videos.

Delusions

The person who is suddenly struck with a mood disorder would not be aware that what he believes triggered his "mental illness" is not so much an environmental stress situation, but rather an undiagnosed underlying biochemical disorder, reaching a breaking point. Mood disorders are often accompanied by delusions, just as in the more serious mental illnesses. A phobic reaction to a lift deludes the sufferer into thinking, that the elevator causes the anxiety reaction. It is often a delusion to think that a low self-esteem is the cause of depression, whereas in fact it may be simply one of the symptoms.

An environmental stimulus, that can be either mild of severe, may have been festering for many years, can become the trigger for a full-blown "mental illness" as one of the symptoms of the underlying biochemical abnormality. It is often a delusion to think that the environmental event is the real cause of the abnormal mood reaction. It is even more unlikely that a person will associate his illness with a nutritional disorder, because his diet has not noticeably changed and he has been deluded into believing he has been on a "healthy diet" all his life. Most diabetic people tend to believe they were on a "healthy diet", until the day they are diagnosed diabetic. Most people with "Syndrome X" seem to believe that they are on a "healthy diet". Most people with a mood disorder find it difficult to associate their illness with nutrition and most will deny that it has anything to do with nutrition. Here the delusion could well be a denial!

This also explains, why the illness does not necessarily mean that all hypoglycemics are depressed as is often assumed, just as "not all animals are dogs". You can be hypoglycemic without being depressed, but you could have anger control problems instead.

When the underlying biochemical disorder is triggered into action by a severe stressful event - usually called a trauma, as in a car accident or following war experiences - and the reaction lingers on over time it can be labelled a "Post Traumatic Stress Disorder (PTSD)". The sad irony is that both client and his/her therapist usually believe that the illness is caused by the traumatic event - real or imagined - and most of the useless therapy is now spent on drugs and analyzing the "psychological" causes of PTSD, called "Recovered Memory Therapy (RMT)". See Post Traumatic Stress Disorder and Nutrition here for an alternative approach.

Thus if we want to be serious about treating "mental illness", clients and therapists have to realize that most mood disorders are endogenous. If you have any philosophical doubts or objections about this, then at least a therapist should be obliged to eliminate any physical or medical causes of mood disorders, before he can claim it is "psychological". Unfortunately, most psychotherapists are not trained to do this.

In short, if you want to treat people for "mood disorders";

1) you must distinguish between "environmental" and "endogenous" depression, and

2) then eliminate physiologial/biochemical factors in endogenous depression by any nutritional means, if possible, and

3) then treat any psychological factors (damage) that may have resulted from a long period of having suffered from one of the silent diseases.

4) If self-help therapy fails, consult a Nutritional Doctor, Clinical Nutritionist or Nutritional Psychologist for proper diagnosis and treatment.

One of the problems of nutritional therapy is that unlike drug therapy, the body needs time to adjust. People expect nutrients to work like drugs. Nutrients need to be taken over a long time. The length of time depends on the disorder being treated. Most illnesses respond to nutritional treatment within three months, but if drugs have been used it may take up to a year for receptors of neurotransmitters to repair themselves with a high protein diet. Nora Volkow

One dilemma is that modern scientific treatment of "mental illness" is dominated by what I believe to be a fairly ignorant medical profession, when it comes to “mental illness”. Like The Spanish Inquisition of the 15th century, the medical profession and their pharmaceutical masters, are using the legal power of the state to enforce a monopoly of a drug-oriented medicine and psychotherapy. Confidence in conventional medicine appears to have reached a level of a self-evident faith in a folk religion by the community. This is not an attack on pharmaceutical drug therapy, that has saved so many lives. Without drugs, doctors would not have been able to treat so many illnesses throughout history. Drug therapy will always be an essential part of medicine. But it is corrupt to exclude any non-drug treatment or to monopolize by political means the healing profession with the use of drugs ONLY.

The consequence is that people with mood disorders are unable to consult government supported 'alternative and complementary' therapists who are trained and equipped to deal with "mental illness" in other than drug ways. Victims of the illness are left with the alternative to take more control over their own life by educating themselves about the nutritional aspects of mood disorders. Nutrients cannot be monopolized. It requires clients to become acquainted and read educational material about nutritional remedies, now widely available on the Internet. Happily, the Internet allows people to become educated. We will have to wait for the time when departments of psychology at universities around the world start training a new breed of psychotherapists with a knowledge and skills in psychology as well as human biochemistry. It is recommended that when treating yourself to discuss your findings with a professional health practitioner.

For further reading see:

Metabolically Ill or Metabolically Disadvantaged By Dr Chris Reading (Orthomolecular Psychiatrist) ---> page 3

Alcohol and Drug Addiction discussed by Dr George Samra

Treatment of drug Addiction

Why Alcoholics drink?

Hypoglycemia and Alcoholism by Health Recovery Centre

Alcoholism (Addiction) is a Treatable Disease

The Serotonin Connection

Depression is a Nutritional Disorder

Depression is a Disease of Energy Production

Conquering Anxiety, Depression and Fatigue without Drugs by Professor Joel H Levitt

Sugar Cravings