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In part one of this series, we discussed therapy and cognitive behavioral training and I shared a few of my favorite exercises. We also discussed some great workbooks for anxiety, depression & poor self esteem, how to perform deep breathing exercises, and how exercise helps to mitigate depression and anxiety. If you missed it, you can view it now:
Depression, Anxiety and Medications
All of these things discussed on part one help, but when you’re a spoonie with multiple complex illnesses that wreak havoc on your chemical mediators (hormones), then you probably can’t improve your overall anxiety and depression utilizing psychological techniques alone. Many of us need help getting our conditions regulated to achieve the most stability in our mental health.
If you’re a POTSie, whether taking medications or not, you should be supplementing your sodium and potassium, which are both electrolytes essential to heart health. People with spoonie conditions are notoriously vitamin and mineral deficient. I have to take a half teaspoon of salt 3-5 times per day to keep myself adequately hydrated and my thinking clear. We’re all individual, so you likely need a different amount, but don’t be afraid to supplement at the levels your body needs. You can tell whether or not you’re getting enough of these by your blood pressure levels and symptoms and you can always get levels tested by the doctor. I test all of the vitamins and minerals I can at least annually; more often if necessary.
You can get the equivalent of an IV in oral form by using Oral Rehydration Salts. They’re a good way to supplement potasium, salt and a little glucose and they come in easy to carry packets, so they work great for emergencies and sudden drops in BP. My only caveat is to watch that you don’t consume too much potassium. It’s just as dangerous as too little potassium. When my potassium is too high, I develop cardiac arterial spasms and they are no fun. The bill I’m trying to pay off from my angiogram isn’t any more pleasant.
If you have a spoonie condition, you may benefit from taking a mast cell mediator. I’m of the mind that we all have some level or form of mast cell activation disorder and this is part of what drives the development of these mental health issues. When mast cells degranulate, they dump a number of chemicals into the bloodstream erroneously, and this is likely the cause of the extreme anxiety we tend to experience during serious reactions and flares. Even if you aren’t being affected by mast cell degranulation, quercetin offers powerful anti-inflammatory properties and you can use it to treat any kind of allergic condition to get symptom relief.
The best mediator I’ve found yet is a simple over-the-counter mediator that is food derived called quercetin. Quercetin is found in many fruits and veggies to varying degrees, but with our absorption issues, we benefit from much higher doses than you can get from eating an apple. Quercetin and other mast cell mediators helps prevent mast cell degranulation and the arbitrary dumping of dozens of chemical mediators into our blood stream that causes symptoms like anxiety, depression, inflammation and strange allergic reactions. Quercetin in particular is also known to have mild MAO-I effects because of its ability to improve mental health outcomes.
Another thing that could easily be coming into play is other vitamin and mineral deficiencies due to poor absorption. Every vitamin I have ever asked my doctor to test for has come out low unless I’m supplementing heavily. I suspect part of this is caused by an MTHFR mutation for me, but I haven’t been tested for it, yet. Whether it’s due to poor absorption or a gene mutation, the solution is largely the same; to bypass the stomach and/or take your vitamins and minerals in more easily absorbed forms that take conversion out of the equation. Methylated vitamins offer both. You can use methylated vitamin D as a topical and there are a wide variety of methylated B vitamins available.
Adequate magnesium levels are also very important for positive mental health. Taking the right forms of magnesium could help to alleviate the symptoms of anxiety and depression, provide mental clarity and better concentration and allows the muscles to relax. There is a variety of magnesium types, so be sure you’re taking the right one(s) based on your health needs. I prefer to take one with several types to target many of my health symptoms. Whatever you choose, if you’re battling anxiety and depression, be sure it includes ample amounts of magnesium glycinate.
There are a variety of natural medications that are supposed to help balance our hormone levels for improvement of depression. These supplements include SAM-e, 5-HTP, L-tryptophan and St. John’s Wort. While I have never tried any of them personally, each of these substances has been shown in multiple human studies to affect serotonin imbalances and help treat depression.
If anxiety is your problem, GABA just might end up being your new best friend. It certainly is mine. GABA is instrumental in the battle against anxiety and it’s understood that either our glutamate levels become to high or our GABA levels too low when we experience anxiety. Benzodiazipines work so well for chronic anxiety issues because it helps to balance glutamate and GABA.
Studies have proven that GABA is usually depleted in persons with chronic anxiety and increasing GABA levels can have a big impact on anxiety levels. And while benzodiazapines can have some bad side effects, it’s actually possible to supplement GABA directly. Currently, I take 500mg 4 times a day, which not only helps to significantly decrease my anxiety, it’s also allowing me to sleep and enjoy overall better health of my central nervous system. I’m even finding my pelvic floor dysfunction has decreased and I’m not too shy to admit orgasm is much more easy to achieve. It’s even helping with my tremors and the severe restless leg symptoms I was getting when I began weaning off of Topomax. I seriously doubt I would have succeeded at weening off of Topomax without the GABA, which was definitely increasing my anxiety despite helping to relieve my intractable migraines.
Remember, as with all supplements, if you’re going to try any of the above to help with your depression or anxiety, it’s necessary to do your homework first and ensure it’s safe for you. Always clear everything with your care providers and check for contraindications for use. Just because these remedies work for me doesn’t mean they are safe for you. For more detailed tips on how to choose the right supplements and what you need to know before deciding to take one: Choosing Your Own Supplements
There is one other source of depression and anxiety for spoonies I have yet to cover; as a side effect to medication. Just as H1 antihistamines can cause brain fog, there are many medications that can trigger depression and anxiety, including those that are actually prescribed for these conditions. Many of the meds prescribed to us are included, such as lyrica, neurontin, cymbalta, topomax, amitriptiline as so many more. If you’re experiencing new mental health problems and recently started any medications, talk to your doctor about an alternative that’s less likely to cause this problem. Personally, I’ve gotten away from most of these drugs by finding natural alternatives and I find I’m much more satisfied with my life and person when I’m not dealing with the debilitating side effects of pharmaceuticals.
Do be careful when weaning yourself from such drugs, as well. Coming off can also cause wild changes in your mood and ability to cope with anxiety and stress. They typically need to be tapered, but your doctor should be able to provide you with good instructions on how to go about it based on the specific drug. Tapering is a method of gradual reduction and helps the body to adjust more easily. I’ve had to taper off of so many of these drugs, accepting and taking them before I got smart and started doing my own research.
Since I’ve accomplished these changes in my life, I haven’t had a single nightmare or had to struggle with depression at all. I’m no longer plagued with memories that seem more like nightmares on repeat. I do still occasionally struggle with losing my temper when I get frustrated and the occasional flare up of anxiety in certain situations, but now I have techniques that help me to put them into perspective and process them. Now that I understand all the underlying mechanisms for my behavior, I have been able to come to a place of self-acceptance and forgiveness also comes much easier. If I’m not always angry with myself for my flaws, then I have room to make mistakes and backslide without beating myself up about it and beginning those bad cycles all over again. Not every CBT technique is for everyone, but there a wide variety out there. If these don’t work for you, keep trying until you find what works for you. It’s worth the work and so are you!
References and Further Reading:
- University Health News – Supplements to Treat Anxiety and Depression Yourself
- Health Prep – How Daily Exercises Helps Mental Health
- Consumer Lab: Which Supplements Help with Depression and Anxiety
- Psychology Today – Cognitive Behavioral Techniques Work
- University of Michigan Health – Stress Management: Breathing Exercises for Relaxation
- PubMed – The Role of GABA in Anxiety Disorders
- The Dizzy Cook – Magnesium Supplements Explained: Which One is Best for Your Type of Migraine?
- The Sleep Doctor – Understanding GABA