Managing Depression and Anxiety With Nutrition

I'm a research junkie. I admit it. I own it. I'm okay with it.

I'm okay with it because it is the reason why I have found wonderful answers to my personal health issues. As I've taken the facts I've gleaned from various sources and put them all together into one whole just for me, I've found a great deal of relief from the maladies that biology has left me to face.

One such issue is my struggle with anxiety and depression combined. It seems to run in our family because as I've compared notes with relatives, we all manifest our issues in similar ways, and our genetic predecessors did as well for at least two generations back. The genetic cards I've been dealt haven't been an easy hand to play during life. But the bottomline seems to be a lack of seratonin in my system.

What is Seratonin?
Seratonin is the wonderful chemical that the brain uses to make electrical connections between brain cells so they can talk to one another. The seratonin serves like "wires"or "electrical conduits" for the electrical impulses to travel on. Called a neurotransmitter, seratonin is used to regulate lots of stuff in the body. It helps your brain to tell your heart to beat, to remind you to breathe, to tell your stomach and intestines to digest food. It's also used to regulate your mood.

The Limbic Center
About the size of a walnut, the limbic center of the brain is right in the core of the brain and is where all the "warm-fuzzies" get processed. It's where emotional attachments are processed. Women have a slightly bigger limbic than men which accounts for their ability to bond and for that in-born "mothering instinct". The limbic is where mood is handled and processed. Brain scans (pioneered by Dr. Daniel Amen) have shown that someone in a sad or depressed mood has a limbic that looks bright and "lit up" on a brain-activity scan, while someone that is in a fairly good mood has a limbic that doesn't light up nearly as much. The "hotter" the limbic runs the worse the person's mood usually is at the time of the scan. Just like a car radiator, the limbic can't run hot all the time without having adverse effects on every other function around it and connected to it. Just as a car radiator that overheats for too long eventually will result in a warped engine head, so too a limbic that overheats too long and too often will result in a "warped head".

Shortage of Seratonin
My body has a shortage of seratonin on a regular basis. For whatever reason, my body doesn't produce enough. Because my brain has a shortage of it, it uses the seratonin it does have for the critical functions first (i.e., keeping my heart beating). It then parses out the rest to other functions putting mood-regulation lowest on the priority list. So my brain has a tendency to run "hot" all the time because there's a lack of the "coolant" seratonin.

Getting More Seratonin into My Brain
The body is just amazing! It can take a complex carbohydrate food like whole wheat bread and in only a few digestive steps convert it into seratonin! Amazing! So for me, if I'm having an issue with anxiety I can eat a piece of whole wheat bread, a few Triscuits, or a yummy plate of whole grain nachos (pictured at right--see recipe at bottom). In about 20-30 minutes my mood feels more calm. If I remember to consume complex carbs throughout my day at regular intervals, I am able to regulate my anxiety much better. Conversely, if I eat a low-carb diet, I'm a bear to live with!

Nutritional "Supplements"
The work of both Dr. Christiane Northrup and Dr. Daniel Amen have been key for me to manage my seratonin imbalance issues as well. I take a multi-vitamin daily as well as a the following additional "supplements":

• Vitamin C


• Magnesium


• Omega-3


• Folic Acid


• Vitamin D


• 30 min. daily of natural sunlight or light from a full-spectrum light bulb


• Consciously and frequently think about something that makes my insides say "ahhhh" like baby kittens


• Sing to myself and let myself dance


• Give myself permission to take a nap when I need to nap


• I don't consume foods that have anything "hydrogenated" in the ingredient list

I won't go into the reasons why all the above "supplements" are biologically necessary, but they all assist important functions in my body to help me feel better emotionally (and physically).

Medicinal Supplementation
I have a fairly severe issue with seratonin imbalance, so I also take a prescription medication that falls into the class of seratonin reuptake inhibitors (SSRIs). This class of meds works like a dam in a river. It prevents my body from reabsorbing the little seratonin that it does produce and creates a reservoir for my body to utilize for the lower priority functions that it would otherwise short-change if I didn't take the SSRI. There are number of SSRIs in this class of medications. I've been on 3 different ones over the past 12+ years. Each has it's benefits. Eventually, I found the right fit for my particular brain chemistry which allows me to take a small dose and still get all the benefits of the additional seratonin available to my brain.

Bottomline
For me, tackling anxiety and depression required a multi-faceted approach--counseling, medication, and nutrition. Nutrition is a major facet of the three. It is easy to slack off on nutrition, but if I do I feel it. I've found that if I "feed" my body and my brain with the right nutrition (including exposure to sunlight), my issues are very manageable and my life is much more fulfilling and rewarding.

Healthy Nachos (6 points)
15 whole grain tortilla chips from Trader Joe's (Salsa Fresca flavor is great!)
1/2 can of fat-free refried beans
1 oz. sharp cheddar cheese
optional carmelized white vidalia onions (I use leftovers from other dishes)

Lay out the tortilla chips in one layer with edges slightly overlapping onto a microwave-safe plate. Put spoonfuls of refried beans evenly spaced over layer of chips. Hand-grate cheddar cheese over top. To regulate the amount, I put the entire plate onto my kitchen scale before putting the cheese on, zero out the weight, and then grate the cheese on until the scale reads 1 oz. Place optional onions over the top. Microwave the plate of nachos for 60-90 seconds on high. Enjoy with a cool glass of water!

"Salad" Doesn't Always Mean "Healthy"

My husband and I went out for a movie earlier this week and decided to catch a late dinner afterward at Mimi's across the parking lot from the theatre. I always like their chicken caesar salad and figured it was a safe bet for me being on WeightWatchers.

It wasn't.

I didn't find out the painful truth until I got home from the restaurant with my tummy full of the "evil" salad and looked up the nutritional facts online. Here's the scary breakdown thanks to CalorieLab:

Mimi's Cafe Blackened Chicken Caesar Salad
1,524 calories
119g of fat
40.5 points

HUGE gulp... Panic, panic, panic... Lots of "I wish I had just come home" thoughts... Then the reality that I have to suck it up, record it, start over the next day, and MOVE ON!

The lesson learned in all of this? Well, there are a couple really:

1) Don't Assume - I'd eaten at Mimi's before and had the same menu item, but I had "guessimated" when I recorded my points in the past. I shouldn't have done that. I should have looked it up the first time, figured out that it was an unwise menu choice, and found a better option when I eat at that restaurant.

2) Get Over It - Once I'd made the unwise menu choice, I had to battle with my internal voices telling me all was lost for the week because I'd gone over for the day and for the week, and I might as well just go and eat everything else unwise in huge quantities too. That's probably a common response. But I realized I couldn't do that. Just because I consumed an unwise meal, doesn't mean I have to consume two or three or SIX! It just meant I consumed ONE! And I could start over again the next day with a clean slate and move on. The one unwise meal would probably affect my body's ability to handle the calories appropriately but tacking on a whole bunch more would make the situation even worse.

3) I Am Not a Failure - Just because I consumed the one unwise meal, doesn't discount the weight loss I've experienced over the past year nor does it cancel out all the good nutritious practices I've adhered to during that time and the health benefits I've had from it. Trust me, my mind still wanted to go to that place, but I've had to fight that tendency and force myself again and again to view it all with a broader and more healthy perspective.

Bottomline
Mimi's Cafe is not a bad restaurant by any means. But for someone like me, their Blackened Chicken Caesar Salad is not a good choice unless I have the calories/points to handle the consumption (and I'm not sure how I ever would). The calories and grams of fat in the serving given are awfully high for a salad.

A Harvest of Love

There is very little else that can give me as much satisfaction as picking a basket of tomatoes straight out of the garden and bringing it inside to surprise my husband like I did today.

He's the tomato lover in the family and can eat them and eat them and eat them. He's the chef in the family so he makes wonderful culinary creations with them. He's also the allergy-sufferer in the family so he isn't able to be outside in our garden nearly as much as he'd like. It also means that he isn't aware of how many tomatoes are actually growing out there--hence the ability for me to surprise him with a brimming basket left on the kitchen counter in his prep area. It's always fun to hear him from the other room, "Oh Honey! Look at these tomatoes!" I know that he'll usually be making up one of his tomato salads with homemade vinaigrette later that evening

This whole ritual of growing tomatoes for my husband started the first spring we lived at Rosehaven Cottage.

We were immersed in remodeling and restoration--drowning in it actually. Our goal was to simply have access to all the square footage in our home, have a decent bathroom and kitchen, and not freeze from the drafts coming in from the spaces in the subfloor.

Early spring rolled around, and I had this overwhelming need to put in a vegetable garden. I was told by many that I was nuts and should just focus on the interior of the house. "Let the garden go this spring," they'd say helpfully, "Don't try to do everything at once."

But the persistent nagging to put in a garden kept coming into my psyche. I know not to ignor these persistent nagging thoughts. So I moved the installation of a vegetable garden up on the priority list (much to the disbelief of family and friends) and put in the first vegetable plants (including tomatoes) as soon as it was safe.

Summer came quickly and the tomatoes were thriving. I had put in Sweet 100's and the vines were burgeoning with the little round red gems of tomato sweetness.
At the same time that the tomatoes were ripening, my husband was struggling with health issues that led him to the doctor's office. On a hunch, the intuitive physician tested my husband's blood sugar right there in the office. It was through the roof. My husband walked out of the doctor's office that day with the diagnosis of being a Type 2 diabetic weighing on him. It would change his life. It explained a great deal of the health struggles he had experienced over the previous 2 years but wasn't any easier to take.

His mother is also a Type 2 diabetic and, fortunately, he had educated himself when she was diagnosed. He knew his diet would have to change drastically. His sweet tooth would have to be satisfied in some other way than the chocolate he was so fond of. But there is one thing that my husband loves more than chocolate--tomatoes!


It was now so clear why I had felt so driven to plant the vegetable garden. That first crop of Sweet 100's was a ray of hope during a very difficult life transition for him. The sweet little "candies" that he could pop in his mouth without guilt or hesitation made the depressing prospect of having diabetes so much easier to cope with. I knew that I had grown them for a very special reason, and it was no fluke that I had known to plant them.

So every year since that first year at Rosehaven Cottage, the tomatoe plants always go in the garden as soon as it's safe. My husband anxiously awaits the first tomato that is ripe enough to harvest. He's very much like a child waiting for Christmas morning. It's wonderful to watch. And every time I harvest another basketful and leave them on the kitchen counter for him, I feel a deep sense of love for him, for the garden, and for the blessing that tomatoes represent to us.

What Is Endometriosis?

From the Endometriosis Research Center:

Over 5.5 million women in the United States alone suffer from a painful, chronic gynecological disease known as endometriosis. Affecting more women than breast cancer, endometriosis is a leading cause of female infertility and hysterectomy. The disease can have a debilitating impact on a woman's life and her relationships; in some cases rendering her unable to work, care for herself or her family, or go about her normal routine. Studies have even shown an elevated risk of certain cancers and autoimmune diseases in endometriosis patients. Currently, there is no definitive cure for endometriosis.

The Missed Disease

The average delay in diagnosis of the disease is a staggering 9 years. The disease is often confused for Pelvic Inflammatory Disease, bladder infections, Irritable Bowel Syndrome and a multitude of other conditions. It is important for patients and physicians to work closely together to detect, treat and effectively manage endometriosis at the onset of symptoms.

What is Endometriosis?

Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus which builds up and is shed each month during menstruation) is found outside the uterus, in other areas of the body. These implants still respond to hormonal commands each month, and break down and bleed. However, unlike the lining of the uterus, the tissue has no way of leaving the body. The result is internal bleeding, degeneration of blood and tissue shed from the growths, inflammation of the surrounding areas, and formation of scar tissue. Endometriosis lesions can present themselves in almost any color, shape, size and location. The lesions can be virtually any color including black, red, white, clear and more, and they can be microscopic in size. Endometriosis implants can be spread throughout the entire pelvis including the reproductive organs, bowels, bladder, diaphragm and other areas in the body, and may not be visible without proper magnifying equipment and thorough examination. While uncommon, endometriosis has even been found lodged in the skin and the brain.

Symptoms of Endometriosis

Symptoms include, but are not limited to:

• heavy bleeding and pain before, during or after menstruation (pain is not normal!)
• nausea
• constipation
• diarrhea
• pain with intercourse
• ectopic pregnancies
• miscarriages
• infertility
• backache
• bladder pain
• premenstrual spotting
  

How is it Diagnosed?

Endometriosis may be suspected based on your symptoms. However, the disease can only be definitively diagnosed via surgery; either a "keyhole surgery" known as laparoscopy ("lap") or the more invasive laparotomy.

How is it Treated?

Studies have shown the most effective treatment for the disease is thorough eradication of all endometriosis. Unfortunately, if all the disease is not removed, there is an extremely high rate of recurrence.

Who Gets Endometriosis?

The outdated, misinformed theory that "white career women who delay childbearing" are the prime candidates for endometriosis could not be further from the truth. The disease knows no racial or socioeconomic barriers. It can affect any woman of reproductive age, from as early as a girl's first menstrual period. Endometriosis is also commonly found in women who have undergone hysterectomies and post-menopausal women [studies have shown that endometriosis implants produce their own estrogen and thrive even if all other hormone-producing organs are removed or non-functional] .

My story... in a very large nutshell

I don't care... I'm going to talk about it

I know there's a lot of people that don't like to talk about "women's issues". It makes them squirm as they frantically search for an opportunity to change the subject. That's probably the reason why I'd never heard of endometriosis before I was diagnosed in 2005. That's why so many women suffer from this disease in silence and/or ignorance. Well, guess what... I don't care. I'm going to talk about it!

What is endometriosis?
Click here to find out

A not-so-brief history of my life once I became "a woman"

I started menstruating at 14 1/2 years old and almost immediately suffered severe cramps. But since the other women in my family did too, I was told it was "normal".

As I aged into my 20's, my cycles got shorter and my flow got heavier. The pain was excruciating (often at a 9 or 10 on a scale of 1 to 10). I learned large doses of ibuprofen would dull the pain enough that I could rock myself into a fitful sleep and just sleep the pain away. Needless to say, I did a lot of sleeping every month.

By my late 20's, I was beginning to have odd pain in my right shin bone that would radiate through my leg. I went to see my general practitioner about that. Lots of tests were run, but no conclusive diagnosis could be reached. On the advice of my GP, I went to see an OB/GYN who diagnosed me with severe PMS and put me on birth control pills.

I got married in my early 30's. We immediately started trying to get pregnant so I went off the birth control pills. Year after year went by with no success. In the meantime, I was having increasing pressure in my lower abdomen and pelvic region in addition to the intense pain with my periods. There were days I couldn't stand up straight.

During the rest of the month, I felt like my uterus was blowing up like a slowly inflating balloon. My former OB/GYN had left her practice, so I went to another one who told me I couldn't possibly be feeling the sensations I was describing. She inferred that I was imagining things and wanted to put me on birth control again. Not helpful. That was the first and last time I saw her.

I persevered on knowing I wasn't imagining things but was at a loss for answers.

In 2003 (just before our 5th wedding anniversary) we got our fondest wish--a positive pregnancy test. All the blood tests and doctor's appointments were scheduled. I was excited because I was going to finally get the OB/GYN who had a stellar reputation in our community--such a reputation, in fact, that she only took patients with a positive pregnancy test.

My first blood tests showed my progesterone levels as extremely low so I was immediately prescribed progesterone cream to prevent losing the pregnancy and was classified as a "high risk pregnancy".

When it came time for the first ultrasound (something we had envisioned as being a wonderful bonding experience with us getting to see the heartbeat for the first time), my doctor was out of the office so it had to be performed by one of her colleagues. He noted that my uterus had a weird shadow on it, and he couldn't find a heartbeat this early. He mumbled that I must have miscalculated how far along I was. *sigh*

A second ultrasound with my own doctor went even worse than the first with her using insensitive language right off the bat. Just a note to anyone who cares, phrases like, "Well, this may not be a viable pregnancy..." aren't very good bedside manners when dealing with a high-risk pregnancy and a couple that has only been able to get pregnant once in 5 years.

I made an appointment with another doctor for a second opinion.

Before even seeing me, the second doctor ordered another ultrasound (this one performed by an ultrasound tech at an imaging facility). I wasn't going to get the results until I met with my doctor at our first visit. The day before my scheduled appointment at 13 weeks along, I started showing signs that I was having a miscarriage. A phone call to the doctor's office resulted in the advice, "Since she has an appointment tomorrow, just have her keep that appointment and we'll see her then." I miscarried at home--painfully and traumatically. The next day I went to my appointment. No one had noted on my file that we'd called to say I was miscarrying. So in the midst of hormonal chaos I had to explain repeatedly that I'd lost the pregnancy the day before to every disinterested member of the office staff.

The doctor saw me. She said I was fine. She didn't like the progesterone cream I'd been put on because it was a brand from Europe and a name she didn't know. She thought that may have contributed to the loss of the pregnancy. She ended our appointment with, "You can start trying again in 6 weeks."

I never had another positive pregnancy test again.

I don't care... I'm going to talk about diarrhea too

In the spring of 2005, I began to have digestive problems (that's code for "diarrhea"). The issues got progressively worse. I went to my OB/GYN with my concerns, because my Grammy (maternal grandmother) died from ovarian cancer. I wasn't going to mess around anymore. This was too serious to be dismissed again. I forced the issue by telling her that my symptoms were too much like my Grammy's were prior to her ovarian cancer diagnosis. My doctor ordered a full ultrasound.

The first ultrasound revealed that I had an ovarian cyst. Finally! Something someone else could see that didn't belong there! Hallelujah! I wasn't crazy!

My doc put me on a month of hormone therapy (birth control pills) to see if the cyst would shrink. After a month, another ultrasound was ordered. The second ultrasound revealed that the cyst hadn't shrunk... it had grown! It was now the size of a racquetball. The ultrasound also found a second odd-shaped oblong cyst (cysts are usually round). That one was the size of a Snickers bar and completely baffled my doctor.


The Halloween that changed my life

By October (a month after my 39th birthday), it became clear that I would have to have surgery to have the cysts removed. Laparoscopic out-patient surgery was scheduled for the morning of Halloween 2005. I was going to spend Halloween "under the knife"--kind of ghoulishly appropriate, I thought.

Three days before my surgery, I met with my doc for my last pre-op appointment. I asked her how likely it would be that the cysts would came back. She said it was highly likely. Out of the blue I asked, "Wouldn't it be best to remove my ovaries completely because of the history of ovarian cancer in my family?" She was stunned, took a second to regroup, and then advised me that if I chose that route, I should have a full hysterectomy so I wouldn't be at risk for uterine cancer (apparently, risk increases when the progesterone levels drop after ovary removal). I felt strongly that a full hysterectomy was the right way to go. She was still a bit stunned (so was my husband who was also at the appointment). My doc made some phone calls and scheduled the operating room necessary for the more involved surgical procedure. Instead of an out-patient surgery, I would be in the hospital for 5 days. But the surgery was still planned for Halloween.

Interestingly, when the surgery happened only a couple of days later it was very fortuitous that the operating room had been set up for a full hysterectomy. Here's why...

Once inside me, my doctor discovered that my reproductive organs were encased in adhesions (scar tissue). She immediately suspected endometriosis. Since endometriosis cannot be detected via ultrasound this was quite the "surprise". My uterus, fallopian tubes, and ovaries had become one mass encased in gnarled scar tissue. And the whole mass had adhered to the outside of my colon (hence, my digestive problems I'd been having). Scar tissue also encased my ureters (the small tubes leading from the kidneys to the bladder). The ovarian cysts that were detected via ultrasound were also due to endometriosis. My doc determined that I had at least 20+ years worth of damage from the disease that had gone undiagnosed all these years despite my pleas to at least 3 other doctors that I felt something was wrong.

Needless to say, surgery went twice as long it should have in order for my doc to remove as much as possible in the limited time she had. Blood transfusions in my blood type were unavailable so she had to do as much work as she could before I was in danger of bleeding out. She spent most of her time carefully removing the mass that was adhered to my colon without jeopardizing my colon. Although she had planned on a total hysterectomy (removal of uterus, ovaries, fallopian tubes and cervix), she chose to leave my cervix because the surrounding scar tissue was so bad she didn't want to run the risk of cutting my ureters.

I came out of surgery anemic and pale from loss of blood. My husband tried not to react when he saw me in post-op. He mentioned I was very pale. In my groggy state I said, "I decided to dress up as a ghost for Halloween." That's me... always trying to find something funny in every situation.

When I was told about what my doctor found and that biopsies had been sent to the lab to confirm it was endometriosis, my silent response was, "What's endometriosis?" In the days I spent in the hospital, my husband and I looked up everything we could find on the internet about endometriosis.

My surgical recovery went very well. In fact, I felt better 5 days after the surgery than I had felt just a week prior to surgery--that's how bad I felt before surgery.

After about 6 weeks of post-op recovery, I felt like I'd stepped into a whole new life that was finally free from the mysterious pain that had plagued me since I was 15 years old. I started to call my surgery my "Halloween Hysterectomy" and it became the milestone that I measured where my old life ended and my new life began.

My doctor told me I couldn't take any hormone replacement therapy (HRT) because if there were any rogue endometriosis cells left in my abdomen, they would continue to feed off any estrogen in my body and go through the monthly cycle that the tissue of the uterine lining does. The internal bleeding and subsequent scarring would come back along with the pain. They'd wreak havoc on my body again. She also strongly advised me to lose weight with the reasoning that because body fat produces estrogen it could also increase my risk of recurrence.

Over the next 6-8 months as my body healed from the surgery, I realized that I never wanted to go back to that place that I had been in for 20+ years--"Endometriosis Hell".

Because of my doctor's advice, I mistakenly thought I was the sole deciding factor as to whether or not my endometriosis would come back. I didn't understand that I had a disease that has no real remedy except removing all the endometriosis (something my doctor hadn't been able to do). I also didn't know that regardless of whether I had ovaries or body fat pushing any hormones through my veins, the insidious endometriosis implants (what the rogue cells are called) have their own "life support systems" that they can feed off of to grow and wreak havoc.

I found WeightWatchers and embarked on a journey of educating myself about nutrition and how to eat for wellness. Initially, I lost 45 pounds and kept it off until the end of 2007. Then slowly, my body started to revolt against my efforts. Despite the significant lifestyle changes I had made, my health started to deteriorate again. In spring 2010 (almost 5 years since my surgery), my digestive issues were back. I felt the same sensation of feeling like a slowly inflating balloon was in my lower abdomen. My reprieve hadn't seemed to last very long.

Except one thing was very different this time around... I knew what I was fighting, and I knew the enemy. It has a name. I could face all of it head on as long as I knew. That is where my story began again...

Follow the story of my second surgery chronologically by going to the links above in the sidebar at right -->