The Hormone Connection

This chapter deals with hormone imbalances, the most common medical problem associated with antidepressant use. Imbalances often occur in the thyroid and adrenal glands, both of which are covered in this chapter. Imbalances in hormones related to appetite and blood sugar are described in the chapter that follows.

I have been astonished to find that at least 80 percent of my patients have abnormal functioning of the adrenal system and about 30 percent have disturbances in the thyroid system. The very fact that you're taking antidepressants places you in a high-risk category for some sort of hormone abnormality. Antidepressant use may be associated with an increased risk of thyroid dysfunction and impaired insulin or blood-sugar control - which in turn can affect your adrenal and thyroid glands.

Hormone imbalances can rob you of energy, sexual vitality, and feelings of well-being. They can also lead to weight gain and dull your thought processes. The bottom line is: hormonal problems can compound the side effects of antidepressants and can sabotage the effects of the Fundamentals. This is why I urge you to have your hormone systems tested. There's no reason why you should continue to suffer from antidepressant side effects when there are simple, noninvasive ways to treat hormone imbalances.

Consider Rhonda, who was a thirty-nine-year-old mother of two when she first came to see me three years ago. Rhonda had been taking Zoloft, which her psychiatrist had prescribed for her depression six months earlier. Although she began to sleep better and didn't feel the same crushing sense of disappointment after a minor mishap at work, she found that she still wasn't able to shake the blues. She would force a smile as she tickled her two-year-old daughter and felt only apathy when thinking about an upcoming night out at her favorite restaurant. She told me that she just didn't enjoy pleasurable things the way she did before she got depressed. Rhonda had considered going off antidepressants when her doctor urged her to come to me. "Not only am I not being helped by the medications," she said, "but I'm actually feeling more tired than ever. I have trouble carrying a bag of groceries, and I feel like I'm moving in slow motion."

Based on her symptoms and my physical examination, I guessed that Rhonda's tiredness and lingering depression could be the results of an underactive thyroid. So I took blood tests to measure her levels of thyroid hormones. My assumption proved correct, and I treated Rhonda with thyroid hormone pills and told her to continue taking the Zoloft. Within a few weeks she noticed a dramatic difference in her moods. She was once again able to anticipate and enjoy the time she spent with her family and friends.

HORMONE IMBALANCES

Hormones are major links in the mind-body connection. They are the chemical messengers that can turn on and off a variety of genes in every cell in your body. We also know that all hormone imbalances may manifest as psychiatric disorders, such as depression, mania, anxiety, attention deficit, memory disturbances, dementia, and even psychosis. Hormone imbalances also mimic the side effects of antidepressants by causing weight gain, brain fog, and depleted energy levels. Hormonal problems go hand in hand with depression, and sorting out "hormone-triggered" depression from clinical depression is not always easy. I usually find that my patients have a mixture of the two. For this reason, I strongly believe that a detailed assessment of the hormone systems should be a routine part of every psychiatric evaluation.

I often explain to my patients that neurotransmitters (for example, serotonin and norepinephrine) and hormones act as the body's shock absorber system. We all drive down the road of life, and we hit potholes. If our shock absorbers are in good functioning order, it's like we're driving a Cadillac. We feel the pothole, but only for a brief time, then we make a quick recovery. If we have poor shock absorbers, we feel like we're driving an old pickup truck. We hit the pothole, are stunned by it, and may veer off the road.

What determines how our shock absorbers work? Some of it is genetic, and some of it is set by the stress or trauma of very early life. In addition to nutritional and chemical factors, social environments play a significant role, as do our attitudes and interpretations of events.

Your body's glands take their cues from your brain, which determines the exact timing and amount of hormones that should be released into your blood. By the same token, your brain gets a message from your glands (via your blood) providing a status update on hormone production and release. The relay of chemical signals between your brain and your glands keeps your organs functioning properly. But this system's equilibrium can be upset when your body takes a blow from, say, depression or chronic pain or stress. In fact, hormonal imbalances are a major reason why antidepressants don't provide complete relief from depression or other medical conditions. So if you're depressed, your brain relays this message to your glands, which alter their production of hormones. On the flip side, if you have a malfunction in one of your glands, your brain will get a message and may respond by causing a partial shutdown in some of your systems, which can make you feel depressed.

Before we move into the heart of this chapter, let me comment on some of the latest research on our chemical environment and hormone disrupters. As you will note in other parts of this book, I am a strong advocate of organically grown (free from pesticides, fungicides, herbicides, and hormones) foods. Aside from the evidence indicating organic foods' superior nutritional content, and definite health benefits in experimental animals, there is growing concern that the chemicals we accept in our environment are a significant cause of hormonal problems in the population at large, by mimicking or blocking the functions of our own hormone systems. I have often wondered if the frequency of hormonal problems in the people I work with is related to the chemical environment, and if that is not in some way also responsible for the steady rise in the incidence of depression over the last several decades. I do not know the answer for sure, but I for one prefer not to wait the ten or twenty years it may take to find out. That's why I strongly suggest that you eat organic foods whenever possible.

This chapter is divided into two parts: thyroid and adrenal system abnormalities. The chapter that follows will deal with blood-sugar abnormalities. At the beginning of each part, take the self-evaluation quiz to see if you are experiencing symptoms that need to be further evaluated by your doctor.