Dr Sarah LoBisco, ND

The Sad Mental State of Our Nation

The National Institute of Mental Health (NIMH)¹ reports that major depression is one of the most common mental disorders of Americans. It can result in significant interference in major life activities. Approximately 16.2 million U.S. adults, or 6.7%, has suffered from one or more major depressive episodes according to the 2016 National Survey on Drug Use and Health² (NSDUH).

The NSDUH based its findings¹ on criteria found³ in on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The authors stated in the survey their definition of major depressive episode (MDE) as follows:

Adults and adolescents were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth. NSDUH uses different age-adapted questions based on using the diagnostic criteria from DSM-IV to ask adults and adolescents about their experiences with MDE.30 Stated another way, some wordings of depression questions for adolescents were designed to make them more developmentally appropriate for youths.35 NSDUH also collects data on impairment in four major life activities or role domains because of an MDE in the past year.²

Interestingly, adults 18-25 had the highest prevalence of major depression (10.9%). 3.1 million youth have suffered from MDE in the past year with 70.5% of these experiencing severe impairment as defined by the study, as a result. This statistic is shocking and scary.

A Young, Medicated Nation

The CDC reports⁴ that “antidepressant use in the past month increased overall, from 7.7% in 1999–2002 to 12.7% in 2011–2014.” Keeping in mind that antidepressants are often prescribed for a multitude of reasons, by 2014 one in eight Americans⁵ reported recent use⁶ of antidepressants according to a survey of 14,000 people aged 12 and older.

The fact that so many young people are suffering, and the resulting allegations on the disintegration of our family unit⁷ in this culture, as well as the controversy of this topic of a medicated youth on the political sphere in connection to mass shootings, are beyond the topic of this blog.^8-12

Recently, there were two new studies on depression. Both were trying to find the perfect solution in a pill form to this issue.

With more people struggling with depression, and more young people being treated, one wonders why the medical community is blind to the importance of taking a broader perspective and dig deep into the causes. It may be time to embrace the personalized and naturopathic medicine approach to consider each unique individual with specific variations in their biochemical makeup and influencing factors.

In this post series, I will look at these studies and why they miss the underlying issues that may be contributing to our nation’s sad state. Then I will provide a more comprehensive look at what the implications of these studies are and how lifestyle medicine and essential oils can support the interplay of the infinite factors involved in brain health and emotional balance.

A Discovery on Depression and a Desire for a Quick Fix “Solution”

In the first study, researchers sought to better understand the underlying mechanisms involved in major depressive disorder (MDD). Their study provided information on how stress is one of the most powerful influencers of negative mood. Its prolonged effects can lead to maladaptive behavior through long-term neuroadaptations mechanisms that include dendritic remodeling, spine loss, and altered synaptic transmission.  The authors discovered that a receptor involved in stress-regulated genes in the brain (prefrontal cortex) was elevated in people with MDD.^13,14

According to Science Daily:

The researchers zeroed in on GPR158 as a player in depression after discovering that the protein is elevated in people with major depressive disorder. To better understand GPR158’s role, the scientists studied male and female mice with and without GPR158 receptors.

Behavioral tests revealed that both male and female mice with elevated GPR158 show signs of depression following chronic stress. On the flip side, suppression of GPR158 protects mice from developing depressive-like behaviors and make them resilient to stress.

Next, the researchers examined why GPR158 has these effects on depression. The team demonstrated that GPR158 affects key signaling pathways involved in mood regulation in the region of the brain called prefrontal cortex, though the researchers emphasized that the exact mechanisms remain to be established.

Martemyanov explains that GPR158 is a so-called “orphan receptor” (which gets its name because its binding partner/partners are unknown) with a poorly understood biology and mechanism of action. GPR158 appears to work downstream from other important brain systems, such as the GABA, a major player in the brain’s inhibitory control and adrenergic system involved in stress effects.¹³

The authors also found that there were several signaling proteins induced by the loss of this receptor in the brain. The key player seemed to be brain derived neurotrophic factor (BDNF) levels, not in the expected differences in neurotransmitter levels.¹⁴

The “Miracle Pill” Hunt Begins

The results from such a discovery usually leads down the road of a pill to manipulate the receptor that to achieve the intended symptom suppression.  In this instance, the idea would be to block the GPR158 receptor, or at least manipulate it.

Good intentions, but is manipulating one effect going to create a happier society?

In the next blog, I will review the second study and provide a more integrative viewpoint on assessing and addressing the many factors involved in brain health and emotions. I will also explain how lifestyle medicine and essential oils can help with brain support and mood balance.

References:

1. Major Depression. Updated November 2017. Available at: https://www.nimh.nih.gov/health/statistics/major-depression.shtml. Accessed March 6, 2018.
2. Ahrnsbrak R, Bose J, Hedden S, et al. Substance Abuse and Mental Health Services Administration (SAMHSA). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#mde
3. Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes: DSM-IV Criteria for Major Depressive Disorder (MDD). PDF Uploaded at: http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf. Accessed March 4, 2018.
4. Pratt LA, Brody DB, Gu Q. Center for Disease Control and Prevention (CDC). Antidepressant Use Among Persons Aged 12 and Over: United States, 2011–2014. National Health Statistics. NCHS Data Brief No. 283, August 2017. Available at: https://www.cdc.gov/nchs/products/databriefs/db283.htm
5. Mundell EJ. US antidepressant use jumps 65 percent in 15 years. Medical Xpress. August 15, 2017. Available at: https://medicalxpress.com/news/2017-08-antidepressant-percent-years.html
6. Pratt LA, Brody DB, Gu Q. Antidepressant Use Among Persons Aged 12 and Over: United States,2011-2014 (abstract). NCHS Data Brief. 2017 Aug;(283):1-8. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29155679
7. Brady, D. Guest Editorial: The Perfect Cultural Storm For A Tragedy by Dr. David M.Brady. The Psychology Times. Available at: http://thepsychologytimes.com/2013/01/06/guest-editorial-the-perfect-cultural-storm-for-a-tragedy-by-dr-david-m-brady/. Accessed March 6, 2018.
8. Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. Available at: https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml. Accessed March 6, 2018.
9. Karanges D, McGregor I. Antidepressants and Adolescent Brain Development [online}. Future Neurology. 2011;6(6):783-808. Available at: https://www.medscape.com/viewarticle/753055_3.
10. American Psychiatric Association. Efficacy Data Support Use of SSRIs in Youth, Expert Concludes. March 9, 2017. Available at: http://alert.psychnews.org/2017/03/efficacy-data-support-use-of-ssris-in.html. Accessed March 6, 2018.
11. Jane Garland E, Kutcher S, Virani A, Elbe D. Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2016;25(1):4-10.
12. Le Vere, A. Mass Shootings: The New Manifestation of an Ancient Phenomenon and their Link to Psychiatric Drugs. Green Med Info. October 5, 2017. Available at: http://www.greenmedinfo.com/blog/mass-shootings-new-manifestation-ancient-phenomenon-and-their-link-psychiatric-dr.
13. Scripps Research Institute. New research points to better way to treat depression. Science Daily. March 1, 2018. https://www.sciencedaily.com/releases/2018/03/180301125040.htm
14. Sutton LP, Orlandi C, Song C, et al. Orphan receptor GPR158 controls stress-induced depression. eLife, 2018; 7 DOI: 7554/eLife.33273

Photo by Andrew Ly on Unsplash

---

Sarah Lobisco, ND, is a graduate of the University of Bridgeport’s College of Naturopathic Medicine (UBCNM). She is licensed in Vermont as a naturopathic doctor and holds a Bachelor of Psychology from State University of New York at Geneseo.

Dr. LoBisco is a speaker on integrative health, has several publications, and has earned her certification in functional medicine. Dr. LoBisco currently incorporates her training as a naturopathic doctor and functional medicine practitioner through writing, researching, private practice, and through her independent contracting work for companies regarding supplements, nutraceuticals, essential oils, and medical foods.

Dr. LoBisco also enjoys continuing to educate and empower her readers through her blogs and social media. Her recent blog can be found at www.dr-lobisco.com.