Supplements & Medications (1-2)



       I have always been skeptical of the wild and ridiculous claims surrounding many supplements. However, over the years there have been many studies that show there are, in fact, a few supplements that can be beneficial for mental health. I have tried several of the ones that hold the most promise and have had success with all but one of them. My conditions have always been on the severe side of the spectrum, so I am not ashamed to say that I still take prescription medication (more on this next week). When I started using both prescription medication and a few of the supplements on the following list, I noticed a significant improvement in my mental health. The research behind this list is scientifically sound and backed by medical doctors. However, these studies cannot take into account anyone’s particular needs or current medications. It is imperative that anyone wanting to add any of these to his/her wellness plan talk to their doctor first.

       Supplements vary in quality and availability around the world. In the U.S., there are no regulations of any kind, which can lead to poorly manufactured products that contain very little of the ingredient that is listed on the label. That is why I always buy supplements that have been USP certified or have been independently tested by ConsumerLab.com. There is a small yearly fee to join ConsumerLab, but if I am going to take something to improve my mental health, I want to know what I am taking. The following list contains the supplements that have been shown over the years, in clinical research, to have a positive impact on mental health.

Vitamin B:

       The Mayo Clinic did an extensive review of the best studies done so far on vitamin B and came to the conclusion that a deficiency of vitamin B, vitamin B12 in particular, can lead to abnormal mental symptoms such as dementia, psychoses, and mood disturbances.

       Vitamin B8 (Inositol) has been shown in studies to have therapeutic effects on conditions such as depression, anxiety disorder and OCD. While it has been demonstrated to be safely used in conjunction with most medications, there have been some questions raised about using it for extended periods of time to treat depression. Because of that, I only use it when I am extremely anxious. It can cause a little stomach upset though, so be warned. 

       Vitamin B9 (Folate) has been shown in numerous studies to help alleviate depression and to work well in conjunction with medications. However, it has been shown in studies that it cannot be supplemented properly with a pill. The only shelf stable version is a synthetic compound that appears to be ineffective. I boost my folate levels with a green smoothie everyday. Click here for more on green smoothies.

       Vitamin B12 (Cobalamin) has been the most extensively studied of all the B vitamins. There is unanimous consensus that vitamin B12 deficiencies can cause mental health problems. For example, a recently published report from The Clinical Journal of Psychiatry stated, “a mild decrease in the B12 level is associated with neurologic and psychiatric problems such as ataxia or mood disturbances.”  
       
       I love vitamin B12 and can tell a difference when I take it. I make sure to use B12 in the Methylcobalamin (methyl group). It is the easiest for our bodies to absorb. The cyanocobalamin (cyanide) type is cheaper but can be toxic in higher doses, is not easily absorbed and I avoid it. 

St. John's Wort:

       St. John's Wort is an herbal supplement that is occasionally used in the U.S., but it is wildly popular in Europe. It has been shown in many studies to be highly effective in treating mild to moderate depression. 

       It can interfere with many medications such as birth control pills, blood-thinning drugs, chemotherapy, HIV/AIDS medications, antidepressants and drugs to prevent organ rejection after a transplant. I found out the hard way on this one. The doctor I was seeing at the time that I tried St. John’s Wort was dismissive of all supplements. He seemed to take great pleasure in telling me I was spending money on expensive urine. I didn’t feel like watching him roll his eyes when I asked him about it, so I just started taking it while still on my other medications. BIG mistake! 


       Unlike many of the supplements on this list St. John's Wort does not seem to work well in conjunction with other medications, and it isn’t strong enough for me to take by itself. Therefore, I can’t take it.  That doesn’t mean that there haven’t been many studies that show it does work well on its own for mild to moderate depression because there have been. I would use caution with this supplement by making sure my doctor was in on the decision and was closely monitoring my progress. It’s better to be safe than sorry.

SAMe (S-adenosylmethionine):

       SAMe is a naturally occurring compound found in nearly every tissue and fluid in our body. It is critical to many of our most important processes. It helps break down brain chemicals such as serotonin, melatonin, and dopamine.

       There have been many studies over the years on its use to treat depression. The American Journal of Psychiatry recently published a study that reported, “SAMe can be an effective, well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder.” 

       It is sold as an over the counter supplement in the U.S., but in many parts of the world, a prescription is required. SAMe has worked wonderfully well for me. This is a supplement that I have come to rely on.

Omega-3 fatty acids:

       These fats have been shown in hundreds of studies to help treat depression and for depressive symptoms in people with bipolar disorder. Dr. Andrew Weil summed up the research nicely when he wrote, “Dietary supplementation with these fats, usually in the form of fish oil, has proved to be an effective, natural and nontoxic therapy for bipolar disorder, attention deficit hyperactivity disorder, postpartum depression, seasonal affective disorder and other health concerns. It also helps prevent depression and improve overall emotional wellbeing.” 
       
       The trick with these lies in the EPA and DHA ratios. The studies that have shown the greatest benefits had a ratio of at least 2:1 EPA to DHA ratio. That is where the problem comes in with trying to get omega-3s from plant-based sources. While there are plant-based sources of omega-3s, such as chia and flax seeds, their fats only come in the ALA form. ALA must be converted, and much of it is lost in the process. For vegans and vegetarians, there are algae based omega-3s that have the proper ratio and can be easily absorbed. I found this form worked just as well as the cold-water fish versions, but they are expensive.

       When I started buying fish oil, I quickly learned not to be fooled by high fish oil milligram numbers that are on the front of some brands. It is the EPA and DHA numbers on the back that actually matter. Most successful studies used a minimum of 2 grams of total omega-3s with at least 60% coming from EPA. Some studies went as high as twenty grams and no adverse reactions were experienced. I love omega-3s. I started noticing an improvement in my mood and my anxiety levels after taking them for only a couple of weeks. 

Saffron:


       Saffron is a spice derived from the flower that grows throughout Eurasia. There have been many studies on the effects of saffron on major depressive disorder. The Journal of Integrative Medicine published a study that did a meta-analysis of the controlled double blind studies done so far. It states, “Findings from clinical trials conducted to date indicate that saffron supplementation can improve symptoms of depression in adults with MDD.” 

       I haven’t tried saffron because my current medications and supplements are working well, but I wouldn't be opposed to trying it if I needed to. It should be noted, however, that high doses have caused unpleasant side effects such as headache and upset stomach.


DHEA (Dehydroepiandrosterone):

       DHEA is a hormone that our bodies make naturally. DHEA levels have been shown to be lower, on average, in people with mental illnesses.  A link between low levels of DHEA and to depression has been established. Studies have shown improvement in depression symptoms when taking DHEA as a dietary supplement. It has also been shown to work well with most prescription medications. 

       The Mayo Clinic analyzed the best studies on DHEA done to date and concluded that, “Most studies on the use of DHEA for depression support its use for this purpose. Recent research reports that high DHEA levels may be associated with successful treatment of major depression.” 

       I love DHEA. Within a short period time, I could tell a noticeable difference in my symptoms and mood. It should be noted that DHEA made from soy or wild yam has been shown to be ineffective.

Vitamin D:

        Researchers from the Department of Psychiatry and Behavioral Neurosciences at St Joseph's Hospital, Hamilton, Ontario, published a systematic review of 14 studies that included a total of 31,424 participants. They revealed an association between vitamin D levels and depression. It was found that low levels of vitamin D not only corresponded to depression but that lower levels of vitamin D increased odds for depression. The British Journal of Psychiatry just published a study in which the researchers concluded, “Our analyses are consistent with the hypothesis that low vitamin D concentration is associated with depression.” 

       I have yet to find any instances of adverse reactions with other medications, and the fact is that in industrialized societies, vitamin D deficiencies are common. This supplement didn't take much thought. I make sure to take a vitamin D supplement every day. I also try and get as much sunlight as possible, without getting burned. I don't think there will ever be a pill that can take the place of being outdoors and soaking up the sun, even during the winter. Click here for more on exercising outdoors.

Magnesium:

       Psychology Today has published articles on the benefits of using magnesium supplements. They point to several studies that show its benefits. In one, the researchers reported, “…that magnesium deficiency could cause depression, behavioral disturbances, headaches, muscle cramps, seizures, ataxia, psychosis, and irritability - all reversible with magnesium repletion.” Barbara Bartlik, MD, and Vanessa Bijlani, MD, both psychiatrists, wrote a review of Magnesium for Psychiatry Advisor in which they state, “Treatment with magnesium supplements has been shown to induce rapid recovery from depression, improve symptoms of premenstrual syndrome, and reduce hyperactivity in children with ADHD.  Also, patients with schizophrenia have lower erythrocyte magnesium levels than controls.” Obviously, these results came from adding a magnesium supplement to people who were deficient, but many people today are.

       Because our modern diet is often magnesium deficient, I take a supplement every day. After only a few days I noticed an increase in energy and felt significantly better. I have taken it ever since.


Melatonin:

       Melatonin has been studied extensively and has been proved to improve sleep patterns. Regular sleep patterns have been shown to be crucial for mental health.That is why so many people with mental illnesses are instructed to take melatonin.  

       Primary Psychiatry published a study that stated, “Evidence that antidepressant treatment can promote favorable melatonin receptor expression has led to the suggestion that combination therapy using an antidepressant plus a melatonergic agent may be an effective strategy for treating sleep disorders in the context of depression.” I have found that it certainly helps me sleep, and sleep is vital to my mental health. I take it every night.

Probiotics: 

       I saved Probiotics for last, because the evidence that they help mental health is still coming in. However, I didn’t feel I should leave it off the list because the evidence is growing that probiotics help ease depressive symptoms and anxiety.


        One of the reasons that researchers are so interested in our intestinal health is because ninety percent of our serotonin is produced in our gut. It is easy to see why many feel that if our intestines aren’t working properly, then our brains can’t either. There is still a great deal of work to be done, but it is promising. For example, one of the most recent studies found that people who took probiotics experienced lower levels of anxiety and depression. They also had lower levels of cortisol when they woke up in the morning. 


       While more results on the mental benefits are coming in, it should be noted that many overall health benefits have already been established. There doesn’t appear to be a downside to these, so I added them to my daily regiment. I’m not sure how much of an effect taking these have had on my mental health, but they have certainly helped my overall physical health.

       I realize that there are many companies that claim their products have mental health benefits, and they very well may. That doesn’t mean I want to be a lab rat for their products. I prefer to take things that have been on the market for years, tried by thousands upon thousands of people and are backed up by strong scientific studies. I don’t want to try the latest and greatest thing until it has been on the market for years, and large studies have been conducted on it. One clinical trial doesn’t do it for me. I want to see many trials over a long period of time, on a large population of patients. Then, I will consider it. I don’t have the luxury of being careless with my brain chemistry.
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       As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click this link and you will be directed to the International Association for Suicide Prevention. It is a great resource and is staffed by wonderful people.
Feel free to send your questions or comments to:
questions@thementalrunner.org


       It is no secret that I am a health nut/naturalist. I know the science behind exercise and eating healthy foods to improve one’s mental health is irrefutable. I have experienced the amazing effects of both, first hand. That is one of the reasons why, in the past, I found it difficult to take medications. I wanted to achieve outstanding mental health through natural means. Because of that, I understand why many people define good mental health as not having to take medication.

       The problem is that some people, no matter what they do, are unable to achieve good mental health without medication. The reason is simple. There are different types of mental illnesses, different causations and varying degrees of severity. I had to accept that no matter how clean I ate, no matter how much I exercised, no matter how many of the right supplements I took, no matter how many wellness activities I participated in, my brain chemistry is too severely imbalanced to achieve the life I want to lead without medicinal help. Since I am a naturalist by nature, it was imperative that I find a way to make peace with that.

       In other words, I had to change how I defined good mental health. Because I do love natural remedies, I was one of those people who defined being mentally healthy as being free from all pharmaceuticals. The problem I found with that, as I began to examine it, is that I know many people with mental illnesses who refuse to take medication and are miserable. That is not my idea of good mental health, with or without medication. I also realized that I know many people with mental illnesses, who take medication, and they are vibrant, healthy and content. That is what I strive for every day. I decided that vibrant, healthy and content was going to be my new definition of good mental health, whether it meant having to take medications or not. 

       It occurred to me that I could still be a health food nut, an exercise junkie and participate in as many wellness activities as possible while taking medication. Realizing my journey didn’t have to rely solely on natural remedies or solely on medication was a huge step for me. I accepted that no matter how perfectly I executed natural remedy solutions, I was still going to fall short of my new definition for good mental health. That much had become painfully clear. I also knew I couldn’t be lazy, expecting medication to solve all my problems, because that had never worked for me in the past. 

       It was simple; I needed to exercise, eat healthy foods, engage in wellness activities AND take medication. I am in a fight for my life. It wasn’t wise for me to show up to battle with one arm tied behind my back. I decided that I was going use everything at my disposal to have a wonderful life. I’m sure it seems like that should have been a simple decision; it wasn’t!

       Rethinking and reworking my stance on medication took time and effort. The more I thought about what taking medication really meant, the more I understood that it was something that I should be proud of. Four realizations came to me that have forever changed my perception of medications. I hope they are helpful.


       1. Taking Medication Exemplifies Bravery

       Summoning the courage to ask for help, and then accepting it, is a sign of bravery, not weakness. Having the courage to say that my very best efforts, without the aid of medication, weren’t good enough to achieve the life I wanted was a huge accomplishment. I believe in being strong, self-reliant and brave. In this case, I realized that what I was actually doing was using those ideals as defense mechanisms to shield me from my fear of needing help. I was ashamed that I couldn’t conquer this on my own. I felt weak. In truth, I was terrified.

       The way I regained my strength, my self-reliance, and my courage was by admitting that I couldn’t achieve what I wanted without help. Setting an appointment with a doctor to discuss my problems, and asking for help, was horrifying. After I had done it, I realized it was one of the bravest things I’ve ever done. I am proud of my pill bottles. They are trophies from one of my most terrifying victories.


       2. Taking Medication Means I Am Being Proactive

       I want to have as much influence over the outcome of my life as possible. There are many things that are completely outside of my control, but my actions in response to those things are not. I can’t change the fact that I have mental illnesses, but I can change what I do about them. 

       Deciding that I am going to do everything in my power to achieve good mental health brings me a sense of control and achievement. Even if symptoms do creep up, at least, I know I did everything in my power to prevent them. My illnesses are too severe for me to say that I have done my best to live a wonderful life if I refuse to take medication. If however, I have done my best, then the pressure is off, because I know I can’t control outcomes. I can only control my actions. I can and will continue to be proactive by adding medication to my wellness plan. What a relief that is! Now, I can let the chips fall where they may because I know I’ve done everything I possibly can. 

       3. Taking Medication Demonstrates Moderation In A World of Extremes

       The world we live in today is characterized by extremes. Modern medicine is certainly not exempt from this reality. The naturalists, like myself, love to rail against big pharmaceutical companies by pointing out all their flaws. In turn, the pharmaceutical companies love to take every opportunity to condescendingly point out the absurdity of some of the naturalists’ claims. As is usually the case, both sides have valid points. The important thing for me was to learn to stand up to both sides’ extremes.

       Standing up to big pharmaceutical companies and doctors who try and get me to take one more pill or a little higher dose is hard. Some doctors have become heavy handed with their prescription pads. It is much easier and faster to add another pill or to up a medication dose than it is to search for underlying causes or better alternatives. I had to find a doctor that would work with me to get to the lowest possible doses that would effectively treat my illnesses. That was an enormous help. I also decided to make a conscious effort to block out all advertisements for medications. Pharmaceutical companies spend billions every year trying to get people to take another one of their pills. I have to guard against that. 

       Standing up to naturalists who claim magical cures from mother earth is also hard. I want to believe that there is a secret herb or root that some obscure, indigenous people have known about for thousands of years and somehow kept it secret. Wouldn’t that be grand? Unfortunately, many of these naturalists are often selling junk supplements, junk documentaries or junk eBooks. Just like many pharmaceutical companies, many of them are more motivated by profits than wellness. The scary thing is that there is no oversight or regulations on their products. As I covered last week, there are some fantastic natural treatments for many mental illnesses. That doesn’t mean I’m going to be a sucker for the next "all natural" miracle cure that comes on the market.

       Obviously, both sides have valid points. That is part of the problem. I had to learn to sift through all the rubbish to try and get as close to the truth as possible. That is not a simple task. It takes a great deal of effort to find the diamonds in the rough. However, all that effort has paid me back in ways I could have never imagined.


       4. Taking Medication Demonstrates Patience (not my greatest strength)

       Taking medication often requires an enormous amount of patience. Because no two people’s brain chemistry is the same there are many different types of medication, that help with many different types of mental illnesses. That is a beautiful thing. If we only had a few medications, then many of us would be out of luck. 

       There is one drawback to having so many medications to choose from. It can take quite some time to find the right medication(s) and the right dose(s). I work hard on being patient. It is not a natural talent of mine. I want to fix things immediately. Honestly, I would prefer to go back in time and fix things yesterday if I could. When I am depressed, anxious or manic, I have even less patience. I think that is typical, though. I don’t know anyone who wants to feel bad any longer than they have to.

       That is why being patient with the process of getting the correct medications, at the right doses, is something I pride myself on. It takes an enormous amount of effort not to give up on them altogether when they aren’t working as well as I think they should. Remembering that there is a light at the end of the tunnel and that I will eventually feel better, allows me to accept that I don’t have to feel better right away. I remind myself that some things that take T.I.M.E., which stands for Things I Must Earn. That has helped me enormously.

       Coming to the realization that taking medication is one of the bravest, most proactive, level headed and patient things I have ever done makes me proud to take them. I refuse to live a life less than I am capable of. So, I can’t be too prideful to ask for help, too lazy to be proactive, too caught up in the extremes of the world to take the appropriate amount of medication or too impatient to continue the treatment. There is hope in exercise, health foods, wellness activities AND medication. Put them all together, and I have found amazing things begin to happen.
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       As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click this link and you will be directed to the International Association for Suicide Prevention. It is a great resource and is staffed by wonderful people.
Feel free to send your questions or comments to:
questions@thementalrunner.org