Highlights from Jonathan Otto's interview with Dr. Daniel Binus, for the Depression & Anxiety Series.
First of all I will say that the most common mental disorders in the United States and North America in general are anxiety disorders. Then the second are the mood disorders.
[00:03:00] Even though depression and bipolar are slightly less common than anxiety disorders, the morbidity from those is a lot higher, meaning the impact on individual's lives and the negative effect on society is a lot more for mood disorders because they have such a negative impact on an individual's life.
[00:03:30] In other words, the amount of quality of life that's lost as far as the difficulty that people have as a result, both in their families, in their relationships, and in their ability to function at their jobs.
[00:04:00] [00:04:30] Bipolar is one of these disorders that a lot of people get mixed up with because they think that if somebody just has mood swings that equals bipolar, but actually bipolar is a lot more complex than that. Generally speaking, people with bipolar will have ... Well, let's just to help you see it, visualize it, if this is the normal mood state, someone with bipolar might have a normal mood for a while, but then sometimes out of the blue, sometimes triggered by stress or different things, they could go into what we call a manic episode. Typically, what we think about with mania or manic symptoms, those are symptoms that actually have to go on for at least three or four days before they really meet official criteria for a manic episode. A lot of people think that if someone's just moody within a day that that's bipolar, but it's actually not, it takes several days of an elevated mood state to really be criteria for a manic episode.
[00:05:00] And so, what those mood states actually look like when people are more on the upswing, is that they generally have more energy, they can be more talkative, they have more racing thoughts, worse sleep. Their mood will change to be either more euphoric, like they feel on top of the world, like they can do anything, superhuman almost, or very irritable, and sometimes a combination of both.
[00:05:30] Unfortunately during those upswings, the manic episodes, people can often make very poor decisions. For example, they can go and gamble all their money away. They can go on sexual escapades and be very promiscuous. They can move places that they normally would never move, or make really poor relational decisions.
[00:06:00] And so, it can have a very big impact on people's lives, not just then during the manic episode, but the fallout is often very negative as well. So later on, after they essentially crash and burn, and a manic episode can go on for anywhere from several days, to several months sometimes, and eventually they burn out and their brain basically runs out of fuel.
[00:06:30] Then they crash and burn, and they generally become very depressed after that because they feel very remorseful about a lot of the decisions they've made, but not only remorseful, their brain, their neurochemistry is changed and they've basically burned all their neurochemical fuels, all their dopamine, and their brain cells have actually been damaged through that process. And so, they have a really hard time even feeling joy or happiness or motivation.
[00:07:00] [00:07:30] [00:08:00] Bipolar is a disorder that is actually, can be easy to treat for some people, but notoriously difficult for others. Some people tend to actually have more rapid cycling bipolar that goes where you have more frequent episodes. That can often require more medications and doing things to help stabilize the mood, but there's also, the thing that people often forget, they think that, "Oh if someone has bipolar they just have to rely on meds and only meds," but the truth of the matter is that there's actually a lot of things that can help to change the course of bipolar. One of those is engaging in really a healthy lifestyle, things that will help bipolar. Two of the things that are most important with that are consistent sleep patterns and consistent times for eating. I know those things might seem a little bit strange, but with bipolar, changes in schedule can be one of the big things that really triggers, especially the sleep aspect. I've had patients that have gone on trips where they go across time zones for example, and because their sleep is disrupted that alone can sometimes trigger the manic episodes.
[00:08:30] You know, another thing that I've definitely recognized with bipolar is that it's not always the case, but for some people with bipolar they get triggered by certain stressors in their life. And so, it can be really helpful for people with bipolar to recognize what are the stressors that usually trigger me?
[00:09:00] One of the things that I've often seen is when people feel like they are not performing quite as well as they should, or they're feeling like they need to measure up more than where they're at, and that can drive almost this subconscious, it gives people the subconscious drive to be better and be stronger, and work harder.
[00:09:30] As they start going into that mode it can actually start triggering this manic type of thinking. So I think as far as addressing bipolar, there are several factors that when you think about number one, identifying which trigger is going to be a major issue for you so that you can maintain as much stability, and you're not stressing yourself out and that sort of thing.
[00:10:00] Number two, maintaining a really good sleep regimen and not deviating from that any more than you possibly can. Number three, having good structure during the day. Number four, being really careful with nutrition and getting regular exercise. Number five, really engaging in a healthy support system and with other people that also are dealing with mental health issues and have actually overcome that. That seems to help a lot of people that have struggled, too, with bipolar to have that sort of support.
[00:10:30] The difference between bipolar 1 and bipolar 2 is primarily the severity, in other words bipolar type 1 is considered more severe, and if somebody's been hospitalized for bipolar then automatically they're bipolar type 1.
[00:11:00] But bipolar type 2, you have smaller episodes, they're not as long and as extreme with the manic episodes, and in fact they're called hypomanic episodes because they're little manias. A lot of people with bipolar type 2 actually tend to almost function a little bit better during their manic episodes because they get more done, they're more energetic, they're more motivated.
And so, people with bipolar type 2 are often very hesitant to even seek treatment because they almost get addicted to that little high and that little boost, but the problem with that is that they usually end up spending a lot of time in depression as well, and that can be very debilitating, whereas that type 1 bipolar, both the depression and mania are quite debilitating.
[00:11:30] Can bipolar 1 progress into bipolar 2?
[00:12:00] Well actually, it's usually the other way around in my experience. In other words, bipolar 2 usually progresses into bipolar 1, because bipolar 1 is the one that's more severe. I think that there are people that have actually improved and become less extreme in their manic episodes. Certainly I've seen some of that in my own clinical practice, that through managing their lifestyle choices, and also help getting the right psychiatric adjustments and help, that that can help to decrease the intensity of their manic episodes and also the frequency as well. And so that can often lead people to a much more stable course.
[00:14:00] One of the big takeaways as far as avoiding bipolar is really being careful as far as even considering taking antidepressant medications. Antidepressant medications can have their place, but we have to be very careful because they're a powerful tool, and as such, if somebody takes it and they're vulnerable to bipolar, and they may not know that, it could trigger a manic episode. Then they may be struggling with bipolar for the rest of their lives.
Getting off Medication for Bipolar
If somebody has bipolar is it possible to turn that around or, let's say, reverse bipolar? Is it possible?
[00:14:30] You know, it's a good question. I'll say this, and let's say, 70 years ago people with bipolar were frequently treated for their episodes, but then in between the episodes they were able to go off medication, live good lives, and that wasn't everybody, but that was a lot of people.
[00:15:00] Nowadays, they recommend pretty much lifelong treatments if you've been diagnosed with bipolar, but I believe that we have actually the pendulum's swung too far the other direction, and what we need to do instead of just recommending, "Okay, lifelong treatment now that you've been diagnosed as bipolar," is evaluate every case individually, and say, "Okay, if you're willing to engage in these lifestyle practices and also be very careful of monitoring your symptoms, then for the most part you could probably live your life medication free."
[00:15:30] I think a lot of people with bipolar actually could live that way if they were educated correctly, and if they were willing to implement what we know now as far as managing the disorder. So I'm not sure that you can completely reverse it, and I never say, "Never," but I think that we can do a whole lot better at managing it without people taking psychiatric medication on an ongoing, consistent basis.
[00:16:00] You know, it depends on the person and it depends on the situation, because if I was to say, "Everybody can get off their meds forever," I think I would be lying, because I think that there are some people that probably need to be on medications for most of their life or maybe even the rest of their lives.
[00:16:30] However, I think the majority of people can get off their medications forever, and there are some people that might still need to take medication on occasion, but only for small pieces of their life and the rest of their time thinking live medication free.
So I think there is a spectrum, but I think that we use far too many medications and then the fallout is the side effects, and then that they can often create a more chronic course for the disease.
Nature’s Foods for Mental Illness
[00:19:00] So, resveratrol is a grape compound that we can find in foods that can really help mental health and physical health, too. And it's found in foods such as red grapes and cranberries, blueberries, and peanuts. So you can find these things in food. And resveratrol is wonderful because it actually is antioxidant, and it can help to decrease the likelihood of developing plaques in your brain. So it helps to clear out these plaques that can actually cause Alzheimer's and different neurodegenerative disorders. And resveratrol also tends to actually enhance longevity. So it can decrease the aging process, they've found in some studies.
[00:20:30] So curcumin is very amazing for the mind and the body. It is very anti-inflammatory and some people actually find it beneficial even for pain. But I use it specifically to help people with mental disorders. And one of the things that they found is people that have traumatic brain injury, for example, they take curcumin, then that can help them to recover from traumatic brain injury. They've also found that people that tend to eat more turmeric, which is the parent compound of curcumin in spices and curries and that sort of thing, will actually have less likelihood of developing Alzheimer's disease. And so there seems to be some ability for curcumin to help clear plaques from the brain and to prevent Alzheimer's disease.
[00:21:00] Curcumin can help people with depression as well. And one of the reasons for that is because it's very strongly anti-inflammatory. And many people that have depression, a big aspect of that is actually because they have inflammatory response going on in their body.
[00:23:30] [00:24:00] [00:24:30] So as far as finding Omega-3's in your food, flaxseed, ground flaxseed specifically, is one of the best ways that you can get it. And I usually suggest two heaping tablespoons to my patients because that gives people a good boost of ALA Omega-3. And then there are other wonderful foods that you can find Omega-3 in as well, including walnuts, avocado, and almonds. And so those are all good plant-based sources for Omega-3. A lot of people think that if I get ... If I need Omega-3, I need to get it from fish. But the truth is that there are a lot of great ways from plant-based sources to get it. And there's a big concern in my mind about eating Omega-3's from fish, and that is that more and more, our fish supply is being toxified through heavy metals, especially things like mercury and other elements in our ocean, and that can actually end up being toxic to people as they ingest high levels of Omega-3's from supplements that are from fish oil or even eating fish themselves.
[00:27:00] Well, I think walnuts are a great example because walnuts are so healthy for the brain. And they actually look kind of like a brain when you look at it and you open up a walnut. There are other plant foods as well. Tomatoes, for example, can be good for the prostate, and they kind of look like a prostate. And kidney beans are good for the kidneys. So it's pretty amazing how God created all these things to actually look like the different organs, and they're actually beneficial for those particular organs.
[00:29:30] Another plant product that is very helpful for mental health are catechins. And catechins are found naturally in teas. Like green tea, for example. And it is anti-oxidant and anti-inflammatory. It actually helps to promote the amyloid processing through the non-toxic pathway. Meaning that it decreases the likelihood of developing Alzheimer's and other neurodegenerative diseases.
[00:31:00] [00:31:30] [00:32:00] Well, schizophrenia is one of those diseases that can be very, very sad because it can completely change somebody's life and it can make them not be able to function normally within society at all. What happens with schizophrenia is that the brain essentially changes to process information from the outside world and also internally in the wrong way. And so people can start having symptoms like delusions and hallucinations. And what we mean by that is the ... A delusion is a false, fixed belief. So they can start thinking, for example, that somebody's out to get them, or they're being stalked by the CIA, or someone's spying on them and watching them through video cameras, or maybe that someone can hear their thoughts, or that somebody is poisoning them. So those are examples of delusions. And it can make people very fearful. And it can make them act in very defensive ways. Sometimes they will go so far as to maybe even kill somebody because they are afraid that that person is out to kill them. And so if I don't kill them first, then they're going to come and kill me. And so it can be a very, very scary disorder. And it can be a dangerous disorder as well.
[00:32:30] And then as far as the hallucinations, a lot of people that have schizophrenia will actually hear voices of people talking to them. And sometimes those voices sound like they're coming from the outside of their head, or sometimes they're ... Sounds like they're just inside their head. But that can be very disruptive because they can barely even hear themselves think and they can't concentrate well. And then sometimes those voices are even telling them that you have to do this and we call that command auditory hallucinations. So the voices might be telling somebody go and kill your family, or go and hang yourself, or go and drive your car off the bridge, or something like that. And obviously, these are not only very disruptive, but if people start paying attention to those voices, then it can be very destructive as well.
[00:34:00] I think that what's actually happening is that the nerve cells are not properly firing and they're not aligned correctly. And there's certain imbalances with the chemical ... The neurotransmitters. And that in turn can lead to the brain registering sound and registering these voices. But it's not actually real voices. Now of course, I also believe in the spiritual realm as well. And so I do think that there are spiritual forces that will try to take advantage of any weakness that someone's brain actually has. And as such, if somebody has these holes in the wall, so to speak. In other words, the brain has these weaknesses, then spiritual forces could potentially take advantage of that and maybe wreak havoc and trigger some of these strange voices or sounds. Frankly, I'm not 100% sure how it all works. But I do know that these people suffer immensely as a result of these voices.
Solutions to Schizophrenia
[00:35:30] [00:36:00] [00:36:30] [00:37:00] There's no easy solution to any of these disorders. But the good news is with schizophrenia, we're learning more and more that there are things that can be done. Not just from medication side, but actually from other interventions. For example, they have a program in Finland where they are actually addressing schizophrenia very early on. And so what they'll do is they'll intervene and they'll not only engage with the patient, but they also engage with the family. And they do these interventions to help support the person going through these symptoms. And a lot of people within several months, their symptoms completely resolve as a result of intervening and actually helping them to learn to cope with these symptoms as soon as possible and in a healthy way. And then having the support from their family to do that. So a lot of people with schizophrenia will actually benefit from certain supplements. But it depends a lot on the results of their epigenetic tests. And there's certain tests that we can do to see whether they need, for example, more niacin or niacinamide. Or if they actually need less folate, or more folate, or vitamin B12, or things like this. And so what we're finding is that by approaching schizophrenia in a multi-modal sort of direction, then we're going to get the best results. And a lot of people with schizophrenia really do well even spending time outdoors and engaging with the natural beauty around them. Working in environments that is in a more natural setting. And even just going hiking and that sort of thing.
[00:38:00] A lot of people really are into detoxing from heavy metals nowadays. But you have to be careful because if you start detoxing too quickly, it can actually do more damage than good as the metals leave the body, it can start damaging organs like the kidneys and the liver.
[00:38:30] And it doesn't always do a lot of good. Once the metal's already been in your system, it's already done damage to your brain. Getting it to leave doesn't necessarily change a lot of the outcome. But if we're talking about trying to cleanse the body more naturally through introducing whole foods and plant based foods, then the body will start to slowly detox naturally. Because you ... The best way to detox generally speaking is to actually introduce natural things and not to allow any new toxins to come in. And then the body will actually start to detox on its own. And it will do it at a rate that's healthier versus if we try to detox and push the detox too fast. That can actually do damage to people.
[00:39:30] Even if people don't have, for example, a gluten allergy. If they have irritable bowel syndrome, going off gluten for a while can actually help to diminish their IBS symptoms because the gluten tends to trigger some of the symptoms for people. So there's certain foods that a lot of people have sensitivities to, that may not be inherently bad or they might even not have a full allergy to, but it doesn't hurt to minimize some of these for a while or even go off them for a while to really allow the body to bounce back.
[00:42:30] Yeah, well, niacin for some people can be extremely helpful. And it depends on their nutritional status. It depends on also their epigenetics as well. But it can help many disorders. One of the most profound effects that some people have seen is in certain sub-types of schizophrenia. One of the things that you always want to watch with niacin, though, is that it causes a lot of people to have skin flushing. So there's a form of niacin called niacinamide that generally doesn't cause skin flushing for people. So if you take that and you take the right dose for you, then that can help them that have that deficiency.
[00:44:00] [00:44:30] So with ADD, there's two major sub-types. One is where you have attention deficits without hyperactivity, and the other one is where you have the combination of both having attention deficit plus hyperactivity. And so, what it is, it's an extreme difficulty with paying attention, with concentration, with organization, staying on task, staying focused. And it really is a problem with the frontal lobe of the brain where the frontal lobe is not able to work properly to stay focused and concentrate and do the working memory tasks that are needed. And of course, that can lead to all sorts of dysfunction. People with ADD have a really hard time completing the jobs that they're supposed to be completing. And they tend to jump from one job or one career to another. And they're often the life of the party because they enjoy that stimulation and that sort of thing, but they have a really hard time being consistent with things. Staying organized. And that can really cause significant problems for them throughout their life.
[00:45:30] Well, one of the best things to treat ADD is actually enhancing your frontal lobe. And there's wonderful things to do to enhance the frontal lobe because that's really where the root problem is. One of the most studied things that people can do is actually exercise. And exercise by itself can often significantly improve people's ADD. But when you combine exercise plus cognitive therapy—Cognitive Behavioral Therapy—that's ideal. Because then you're getting the frontal lobe stimulation from the exercise, but you're also getting more structure through the cognitive therapy. You're also learning how to actually apply organizational techniques and concentration techniques to help you to function well despite the ADD symptoms that you have.
[00:46:00] Exercise is fantastic for the brain because it actually increases blood flow to the brain, especially to the frontal lobe. It also increases brain-derived neurotrophic factor, which is kind of like brain fertilizer, and that allows nerve cells to make new connections. And it also increases things like VEGF. V-E-G-F, which helps the blood vessels to actually grow better in the brain so the nerve cells can be nourished.
[00:46:30] [00:47:00] Well, aerobic exercise is ideal where you're getting your heart rate up. You don't have to get it up to a certain target range, but you just want to get it up so you're short of breath while you're exercising. That's kind of a good rule of thumb if you have to kind of ... You can't complete a sentence without taking a breath, that's a good sign that you're probably exercising about where you should be. And about 150 minutes per week is ideal. But any amount of exercise is good. So don't allow this 150 minute bar to keep you from starting. Even if you can just start with 10 minutes twice a week, that's a good start, and that will show you some benefit. But ideal is getting about 150 minutes a week.
[00:48:00] [00:48:30] So as far as cognitive disorders are concerned, there are several major cognitive disorders. The one that we deal with the most is Alzheimer's disease. And Alzheimer's disease basically involves certain plaques that invade the brain in unhealthy ways, and then that produces inflammation. It actually causes nerve cells to start degenerating and dying off. And so, when that happens, people lose the capacity to learn new information and so they start forgetting things. They start having difficulty remembering what they're supposed to do, meal times. And then it progresses to forgetting close family members and even really not remembering who they are themselves. And so it can be a very devastating disease because people really lose the sense of anything in their life that's valuable to them.
[00:49:00] [00:49:30] Well, the really amazing thing now is that in recent years, there are certain approaches that are actually really starting to show promise and that are helping people to reverse cognitive disorders, including Alzheimer's and other problems. And Dr. Dale Bredesen has actually developed a protocol that is helping a lot of people. And he basically tries to help people understand what is at the root cause of their cognitive dysfunction. And there's three main causes that he's identified. And one is inflammatory, where there's too much inflammation. The second is toxic, where there are toxins that are actually causing damage. And the third is a decreased ability to have the right nutrients coming into the brain. And so once you identify which one of those three cognitive issues are present, then you try to address those underlying issues through a diet, through exercise, through cognitive stimulation, and through supplementation.