I write a lot about diet and nutrition, and there’s absolutely no doubt that the food we eat is one of the most important factors that determines our health.

But it’s a mistake to assume that food is the only consideration that matters when it comes to health, and that all health problems can be solved simply by making dietary changes. Unfortunately, this seems to be an increasingly common assumption in the Paleo/Primal nutrition world these days.

I see a lot of people in my practice that have their nutrition completely dialed in, but don’t take care of themselves in other ways. Maybe they don’t manage their stress, they don’t exercise, or they don’t sleep well.

Even if this person eats a perfect diet, are they really healthy?

And what about the person who doesn’t eat particularly well, but sleeps like a baby, gets a massage a couple times a month, has a lot of fun, spends lots of time outdoors, and doesn’t have any health problems?

What is health?

Moshe Feldenkrais, the creator of the Feldenkrais Method, defined health as “the ability to live your dreams“. I think that’s an interesting way to look at it. Using the examples above, it’s entirely possible that the person with the perfect diet but the rest of their life in shambles is less healthy than the person who doesn’t eat that well but takes care of himself or herself in other ways.

If you were to embrace Feldenkrais’ definition of health, how would you live your life differently? Would you put more time and energy into perfecting your diet, or would you spend a little more time focusing on the areas of your life that you tend to neglect? Which path would take you closer to being able to live your dreams?

In a previous article, I argued that the biggest obstacle to optimal health is our mind. The more patients I work with, the more convinced I am that this is true. From the article:

What I’ve observed in myself, in working with patients and in almost 20 years of meditation practice is that each of us has a significant blind spot or area in our lives where we lack awareness and insight. As a crude analogy, let’s call this a weak link in our chain and assume that the chain represents health.

Most of us invest the majority of our time and energy strengthening the parts of our chain that are already strong. These stronger links are where we feel comfortable and confident, where we can operate safely within the bounds of who we think we are.

And this is where the problem lies. No matter how much we strengthen the links in our chain that are already strong, if there’s still a weak link the chain as a whole isn’t stronger. It can break just as easily.

A better approach, of course, would be to focus our efforts on the strengthening the weak link. But that is much, much harder to do. Why? Because it usually requires us to step out of our concept of self and challenge our very identity. It asks us to grow and evolve and shine the light of awareness into the dark corners of our psyche. This isn’t something that happens overnight. It’s not as simple as popping a pill or eliminating nightshades from our diet. It’s a life’s work.

Yes, it’s important to pay attention to how much omega-6 fat you eat. Yes, it’s best to minimize phytic acid consumption by soaking nuts. Yes, it’s wise to avoid excess fructose, especially if you have digestive problems. These finer points of nutrition do make a difference.

But optimizing nutrition is only one variable in the equation of health. And if all of our attention goes there, at the expense of other variables that are also important (like sleep, exercise, stress management, pleasure, etc.), our health will suffer. That’s why only 4 out of my 9 Steps to Perfect Health are explicitly related to food and nutrition.

There’s more to life than health

In the same way that there’s more to health than food, there’s more to life than health.

I’m sure some of you have a friend or acquaintance that eats well and takes great care of themselves, but they’re a wreck in their personal or professional lives. Maybe they’re in a toxic relationship, they have a job that they hate, they can’t get along with co-workers or friends, or they feel lost, empty and unfulfilled.

And maybe you know someone that has struggled with a chronic illness for years, but has deep, rewarding relationships, meaningful work, a sense of purpose, and a rich, vibrant life.

Of course we all want to be as physically healthy as possible. There’s nothing wrong with that pursuit. But the cold, hard truth is that not all health problems are solvable. As much as we’d like to believe otherwise, we don’t have full control over all of the conditions of our lives.

What we do have control over is how we relate to ourselves and these conditions. In my opinion, this – more than anything else – is what determines our happiness and sense of well-being.

It’s possible to be physically healthy, but live in a constant state of struggle and dissatisfaction. Likewise, it’s possible to be ill, in pain, or physically disabled and be happy and at peace. I wrote about this in more detail in a previous article, Living with Chronic Illness: The Power of Acceptance.

I’d like to end this article by asking you two questions:

1. What aspects of health do you tend to ignore? And how does that keep you from living your dreams?
2. What areas of your life – beyond your health – could use more attention? How would addressing those areas bring you more happiness and peace?

Please leave your answers in the comments section!

I’m excited to announce that Dr. Paul Jaminet from perfecthealthdiet.com will be joining us on the next episode of the podcast. Paul is one of the smartest people I know, and I’m very excited to have him on the show. A while back I reviewed his excellent book, The Perfect Health Diet, which is still the book I recommend to patients, family and friends who are interested in learning about the approach to nutrition I advocate.

I’m sure you’ll have a lot of questions for Paul; please leave them in the comments section and we’ll get to as many as we can. We’re recording on Friday the 19th, so make sure to ask your question by Thursday the 18th.

I think Paul will be a regular guest on the show, so if we don’t get to your question this time, don’t worry – you’ll have another chance!

Dr. Emily Deans’ Evolutionary Psychiatry blog has quickly become one of my favorites over the past year. It’s rare to find a psychiatrist that acknowledges the role of nutrition in mental and behavioral health at all, much less one that approaches these topics from an evolutionary perspective.

This week Dr. Deans joins us on the podcast to discuss the role of Paleo nutrition in mental health. Topics covered include:

• The link between diet and Alzheimer’s
• Can nutritional changes effect depression?
• Does gastric bypass surgery lead to mental health issues?
• Can gluten intolerance induce mental disorders?
• What role does the “modern lifestyle” play in the increasing prevalence of mental health problems?
• How does an individual’s mental state influence his/her biology?
• Does iron deficiency anemia contribute to mental health problems?

Dr. Emily Deans’ Evolutionary Psychiatry blog has quickly become one of my favorites over the past year. It’s rare to find a psychiatrist that acknowledges the role of nutrition in mental and behavioral health at all, much less one that approaches these topics from an evolutionary perspective.

I’m excited to announce that Dr. Deans will be joining us on the podcast to discuss nutrition and mental health and answer your questions. We’ll be recording the episode on Friday, June 24th so make sure to leave your questions here by Thursday afternoon PST.

In April, The Healthy Skeptic blog will turn three years old. During that time I’ve written 157 blog posts and eight special reports on topics ranging from heart disease to depression to essential fatty acids and fish oil.

Those of you who’ve been following the blog for most of that time, or who’ve had the chance to go back and read a lot of those articles and special reports, probably have a pretty good idea of what my philosophy on health and nutrition is. But a lot of newer subscribers and visitors might benefit from a condensed summary of the ingredients I believe are essential to optimal health.

I often find myself wanting to refer to something like this – a quick primer that gives readers an overview of my approach – when I’m responding to comments or emails. Because let’s face it, not everyone has the time to go back and read 157 blog posts and 8 special reports to get a sense of what this blog is about.

I also want to create something that you all can easily share with friends and family who may be completely new to this stuff. In those cases I think it’s better to start with a broad, not-too-technical overview of the approach we discuss in more detail here.

With this in mind, I’m going to write a series called 9 Steps To Perfect Health. After I’m finished, I’m going to repurpose that series into an eBook and make it available for free. This way you and I will have something concise and easy to read to send to those loved ones who still think eating saturated fat causes heart disease, or that soy products are healthy alternatives to animal protein.

The conventional approach to healthcare has failed

There’s no better or more important time to get this information out there. Our health continues to deteriorate at an alarming pace, and the incidence of chronic, degenerative disease is skyrocketing each year. Consider the following:

• Diabesity (obesity + diabetes) affects more than one billion people worldwide, including 100 million Americans and 50% of Americans over 65.
• More than half of Americans are overweight, and a full one-third are clinically obese.
• Recent reports suggest that one-third of people born in 2010 will develop diabetes at some point in their lives.
• 9 out of 10 Americans will develop high blood pressure before they die.
• 4 out of 10 people who die each year in the U.S. die of heart disease, and rates of heart disease are projected to double in the next 50 years.
• Rates of infertility are expected to double in the next decade.
• According to the World Health Organization, depression is now the leading cause of disability, affecting more than 120 million people worldwide.

I could go on but I think you get the point. Our health is getting worse, not better.

Over the last 50 years the medical establishment has vigorously promoted a low-fat, high carbohydrate diet, claiming that it would protect us from heart disease and diabetes and make us healthier and happier. How has that worked out for us? The statistics above make it clear that the conventional approach has been a dismal failure that has not only failed to protect our health, but has directly contributed to the epidemic of modern disease.

All modern diseases share a similar cause

One of the most glaring mistakes conventional medicine makes is to assume that all of these modern diseases – diabetes, heart disease, depression, autoimmune disease, etc. – are unrelated conditions that don’t share a common cause. This is a convenient fiction created by the pharmaceutical industry (and perpetuated by the medical establishment) to sell more drugs.

The truth is that while these conditions do have unique features, they all share a common origin: the modern lifestyle. Poor diet, nutrient deficiencies, stress, lack of sleep, lack of or the wrong type of exercise, toxins and medications all directly contribute to the problems that are ruining our health.

The conventional approach is to treat each of these various problems with different drug, and ignore the fundamental factors that are at the root of all of them. That has been a stupendously unsuccessful approach. It’s time to replace it with a more holistic view of health, and to empower people to prevent and treat disease without unnecessary drugs or surgery.

Introducing the 9 steps

Here are the 9 steps we’ll be covering in the articles to follow:

1. Don’t eat toxins.
2. Nourish your body.
3. Eat real food.
4. Supplement wisely.
5. Heal your gut.
6. Manage stress.
7. Move like your ancestors.
8. Sleep more deeply.
9. Practice pleasure.

I’ll try to cover one each week, so we should be finished with the series by the end of March. If you know anyone you’d like to introduce to this material, please send them over to the blog and have them sign up for email updates.

And for those that were looking forward to the series on treating male and female hormones naturally, don’t worry! It’s coming up.

I had a great conversation with a colleague yesterday. We were talking about parasites, chronic infections and cancer. The conventional understanding is that pathogens cause disease and must be eliminated to restore health. This makes sense, on the surface, and it’s certainly true in the case of some virulent infections.

But what’s missing here is an understanding that the body is an ecological system. There are over 100 trillion microorganisms living in our gut alone. That’s 10x the number of human cells in our entire body. When you look at it from this perspective, we’re actually more bacteria, parasites and yeast than we are human.

In health, there’s a balance between the pathogenic organisms and the beneficial ones. It’s not that healthy people don’t have pathogens in their body; it’s that they have a lot more of the beneficial micro-organisms that keep the harmful ones in check. This is how it works in ecological systems. An invasive species is much more likely to proliferate in the absence of other species that normally inhibit its growth.

A perfect example of this is Clostridium difficile (a.k.a “c. diff”). C. diff is a virulent bacteria that can cause florid diarrhea and, if untreated, death. But consider the following facts about c. diff:

• C. diff infections are most likely to occur after a course of broad-spectrum antibiotics. Why? Because the antibiotics kill the beneficial gut flora that normally keep the c. diff in check.
• At least 20% of c. diff carriers are asymptomatic. Why? Probably because they have enough good gut flora and a strong enough immune system to inhibit its growth.
• By far the most effective treatment for c. diff known today is fecal bacteriotherapy, where the gut flora from a healthy human host is transplanted to the infected person via colonoscope. This suggests that creating a healthy internal environment that crowds out the pathogen is more effective than trying to kill it with antibiotics.

A lot of oncologists and cancer researchers now believe that all of us have cancer. But those of us that are healthy are able to keep it in check. When we say someone “has cancer”, what we’re really saying is that the growth of cancer cells in their body has gone out of control. Or, put another way, we could say that a person with cancer is someone who has lost the ability to fight the growth of cancer cells already in their body.

Likewise, we evolved in concert with parasites. There’s even evidence that certain parasites play a beneficial role in “tuning” our immune systems, and may be necessary for health. This theory is called the “hygiene hypothesis”. It’s based on the observation that autoimmune diseases are much more prevalent in developed parts of the world where standards of hygiene and sanitation are higher, and much lower in undeveloped parts of the world where sanitation and hygiene are poor.

In fact, there’s even a treatment for Crohn’s disease and ulcerative colitis that involves patients swallowing thousands of eggs of a particular parasitic worm. They use a pig whipworm that is capable of modulating the human immune system, but not colonizing the human host. This way there’s no danger of chronic infestation, but the patient still gets the “immune tuning” effect. This might be gross to think about, but considering it has a remission rate of higher than 70%, and is virtually free of side effects, it’s far better than almost any other option available for these conditions.

There’s also some intriguing evidence that H. pylori, the bug that causes peptic ulcers, paradoxically may protect against several other gastric diseases. Studies indicate that H. pylori was once more common, perhaps nearly universal in humans, than it is in our postmodern society. Even today, it’s estimated that 1 in 2 people around the world have H. pylori.

This brings the current strategy of completely eradicating pathogenic organisms like H. pylori into question. If we eliminate H. pylori completely, that might help the peptic ulcer to heal, but it could potentially cause other problems. The same dilemma may very well exist for other pathogens.

I think a better strategy for dealing with pathogens is to move away from the “shock and awe” antibiotic campaigns currently favored in conventional medicine, and toward a “nourish and support” protocol that involves boosting the body’s natural protection against the overgrowth of pathogens. Instead of focusing on eradicating the pathogen, we focus on supporting the body to keep it in check. Balance, rather than elimination, becomes the goal.

There are certain cases, of course, when the infection is so virulent and the host so weakened that it makes perfect sense to eradicate it completely – presuming that’s possible. But I believe this approach is far too common, and is too often employed in situations where supporting the body’s natural self-healing mechanisms would be safer and more effective.

As always, I’d love to hear your thoughts.

I’m excited to announce that I have officially launched my private practice. I specialize in working with people struggling with complex, chronic illness that haven’t been able to find help anywhere else. I see patients locally in my Berkeley, CA office, and I also offer long-distance consulting to people around the world via telephone and Skype.

If you or someone you know is in need of this kind of support, please watch the video below for an introduction to my approach, and visit my professional website for more information about how I may be able to help.

I read a lot about health and nutrition. I mean a lot. Sometimes several books a week, along with papers from the scientific literature. I’m a total research nerd. I admit it.

One complaint I’ve had for a long time is that there hasn’t been a single book I can recommend without reservation to friends and family that reflects my views on nutrition. There are certainly some great books out there, but there’s almost always something relatively significant I disagree with that keeps me from giving my full stamp of approval.

I had come to the conclusion that I’d have to write this book myself, but I simply don’t have the time and don’t anticipate that changing in the near future.

That’s why I was thrilled (and relieved) to discover the Perfect Health Diet by Paul Jaminet, Ph.D and Shou-Ching Shih, Ph.D. Paul was an astrophysicist at Harvard and Shou-Ching is a molecular biologist and cancer researcher at Harvard, and let me tell you, these folks are smart. Of course we know that being smart alone doesn’t cut it in the world of nutrition, but I’m happy to tell you that Paul & Shou-Ching combine broad and deep research, clear thinking and a direct, accessible writing style with a rock-solid grounding in evolutionary biology and nutrition.

Their book hasn’t been published yet, but it’s available as a PDF from their website. One of my readers linked to their blog, which I was unaware of. I read their series on healing gut problems, and it was so well done that I decided to check out their book.

I’m so glad I did. It’s broken into three sections: “optimizing macronutrition”, “eat paleo, not toxic” and “nutrition”. They cover everything from the ideal macronutrient ratio, to the finer points of fat metabolism, to the role of chronic infections in modern disease, to which foods are toxic and why, to the benefits of starch and the dangers of fructose.

It’s chock-full of well chosen studies to back up their arguments, but it’s written for the layperson so you don’t need a Ph.D from Harvard to understand it. I have not been this impressed by a book in this genre for a long time, and I’ve never found one that so closely reflects my views on nutrition.

They’ve got an A-list blog, too. Reading a few posts there will give you a good idea of the quality of their writing and research. The book costs about $25. Although it’s not yet in its final version, if you buy it now you’ll receive a hard copy when it’s finished.

Many of you have emailed me in the past asking me what book I would suggest as an introduction to the nutritional principles I write about. Well, this is it. Head over to their website and check it out.

For the last 50 years mainstream medical “authorities” have been hammering it into our heads that high cholesterol levels are dangerous and low cholesterol levels are desirable; that eating saturated fat is bad for us; and that a low-fat, high carbohydrate diet is healthy and helps people lose weight.

If you’re a new reader, you might be surprised to learn that there’s very little evidence to support these recommendations and plenty of evidence that contradicts them. Long ago I learned that if I wanted to live a long, healthy life it was in my best interest to ignore the dietary advice of the medical mainstream. And of course that’s why I started this blog – to share this information with all of you so you can make educated, and informed choices about your health.

Lately I’ve been encouraged by the number of studies being published that undermine the anti-fat, anti-cholesterol dogma we’ve been brainwashed with for so long. This is good news.

The bad news is that paradigm shifts do not happen overnight. It took half a century for researchers and doctors to convince people that eating toxic, highly processed, nasty-tasting vegetable oils was somehow better for them than eating traditional animal fats like butter and lard; that eating dry bagels, boneless-skinless chicken breast and salad with fat-free dressing was a path to good health; and that the best way to lose weight was to eat a highly unnatural diet high in processed, refined carbohydrates and low in fat.

So I don’t expect these ideas to disappear anytime soon, in spite of the solid evidence being published that contradicts them. It’s going to take time. But my sense is that it will take less time to convince people that eating traditional, nutrient-dense, whole foods that have been minimally processed is better for them than eating what the industrial food conglomerates have been selling us.

Here are the three studies.

The first is yet another study that associates low cholesterol with an increase in the risk of death (total mortality). It showed increased death rates in hospitalized patients with low cholesterol levels.

This shouldn’t be a surprise. There’s already plenty of evidence suggesting low cholesterol increases the risk of death – as well as contributing to other conditions such as cancer and depression. For more on this see my previous article Cholesterol Doesn’t Cause Heart Disease.

The second study shows (once again) that cutting carbs is the best way to lose weight and fight obesity.

No surprise here either. Countless studies, trials and reviews have demonstrated that low-carb diets are superior for weight loss, managing diabetes and preventing many of the other modern diseases which plague us. How long will it take until doctors and the media get the message? For more on one such recent review, see Low-carb Diet Best for Weight Loss.

The last study I want to share with you was performed by a Swedish PhD student. It demonstrates that children who eat saturated fat and full-cream dairy products are healthier than those who do not.

If you’re surprised by this, read my recent post Have Some Butter with Your Veggies as well as Whole Fat Milk: Benefits for Moms and Kids.

“A theory that is wrong is considered preferable to admitting our ignorance.” – Elliot Vallenstein, Ph.D.

The idea that depression and other mental health conditions are caused by an imbalance of chemicals in the brain is so deeply ingrained in our psyche that it seems almost sacrilegious to question it.

Direct-to-consumer-advertising (DCTA) campaigns, which have expanded the size of the antidepressant market (Donohue et al., 2004), revolve around the claim that SSRIs (the most popular class of antidepressants) alleviate depression by correcting a deficiency of serotonin in the brain.

For example, Pfizer’s television advertisement for Zoloft states that “depression is a serious medical condition that may be due to a chemical imbalance”, and that “Zoloft works to correct this imbalance.”

Other SSRI advertising campaigns make similar claims. The Effexor website even has a slick video explaining that “research suggests an important link between depression and an imbalance in some of the brain’s chemical messengers. Two neurotransmitters believed to be involved in depression are serotonin and norepinephrine.” The video goes on to explain that Effexor works by increasing serotonin levels in the synapse, which is “believed to relieve symptoms of depression over time.”

These days serotonin is widely promoted as the way to achieve just about every personality trait that is desirable, including self-confidence, creativity, emotional resilience, success, achievement, sociability and high energy. And the converse is also true. Low serotonin levels have been implicated in almost every undesirable mental state and behavioral pattern, such as depression, aggressiveness, suicide, stress, lack of self-confidence, failure, low impulse control, binge eating and other forms of substance abuse.

In fact, the idea that low levels of serotonin cause depression has become so widespread that it’s not uncommon to hear people speak of the need to “boost their serotonin levels” through exercise, herbal supplements or even sexual activity. The “chemical imbalance” theory is so well established that it is now part of the popular lexicon.

It is, after all, a neat theory. It takes a complex and heterogeneous condition (depression) and boils it down to a simple imbalance of two to three neurotransmitters (out of more than 100 that have been identified), which, as it happens, can be “corrected” by long-term drug treatment. This clear and easy-to-follow theory is the driving force behind the $12 billion worth of antidepressant drugs sold each year.

However, there is one (rather large) problem with this theory: there is absolutely no evidence to support it. Recent reviews of the research have demonstrated no link between depression, or any other mental disorder, and an imbalance of chemicals in the brain (Lacasse & Leo, 2005; (Valenstein, 1998).

The ineffectiveness of antidepressant drugs when compared to placebo cast even more doubt on the “chemical imbalance” theory. (See my recent articles Placebos as effective as antidepressants and A closer look at the evidence for more on this.)

Folks, at this point you might want to grab a cup of tea. It’s going to take a while to explain the history of this theory, why it is flawed, and how continues to persist in light of the complete lack of evidence to support it. I will try to be as concise as possible, but there’s a lot of material to cover and a lot of propaganda I need to disabuse you of.

Ready? Let’s start with a bit of history.

The history of the “chemical imbalance” theory

The first antidepressant, iproniazid, was discovered by accident in 1952 after it was observed that some tubercular patients became euphoric when treated with this drug. A bacteriologist named Albert Zeller found that iproniazid was effective in inhibiting the enzyme monoamine oxydase. As its name implies, monoamine oxydase plays an essential role in inactivating monoamines such as epinephrine and norepinephrine. Thus, iproniazid raised levels of epinephrine and norepinephrine which in turn led to stimulation of the sympathetic nervous system – an effect thought to be responsible for the antidepressant action of the drug.

At around the same time, an extract from the plant Rauwolfia serpentina was introduced into western psychiatry. This extract had been used medicinally in India for more than a thousand years and was thought to have a calming effect useful to quite babies, treat insomnia, high blood pressure, insanity and much more. In 1953 chemists at Ciba, a pharmaceutical company, isolated the active compound from this herb and called it reserpine.

In 1955 researchers at the National Institutes of Health reported that reserpine reduces the levels of serotonin in the brains of animals. It was later established that all three of the major biogenic amines in the brain, norepinephrine, serotonin, and dopamine, were all decreased by reserpine (again, in animals).

In animal studies conducted at around the same time, it was found that animals administered reserpine showed a short period of increased excitement and motor activity, followed by a prolonged period of inactivity. The animals often had a hunched posture and an immobility that was thought to resemble catatonia (Valenstein, 1998). Since reserpine lowered levels of serotonin, norepinephrine and dopamine, and caused the effects observed in animals, it was concluded that depression was a result of low levels of biogenic amines. Hence, the “chemical imbalance” theory is born.

However, it was later found that reserpine only rarely produces a true clinical depression. Despite high doses and many months of treatment with reserpine, only 6 percent of the patients developed symptoms even suggestive of depression. In addition, an examination of these 6 percent of patients revealed that all of them had a previous history of depression. (Mendels & Frazer, 1974) There were even reports from a few studies that reserpine could have an antidepressant effect (in spite of reducing levels of serotonin, norepinephrine and dopanmine).

As it turns out, that is only the tip of the iceberg when it comes to revealing the inadequacies of the “chemical imbalance” theory.

The fatal flaws of “chemical imbalance” theory

As Elliot Valenstein Ph.D., Professor Emeritus of psychology and neuroscience at Michigan University, points out in his seminal book Blaming the Brain, “Contrary to what is often claimed, no biochemical, anatomical or functional signs have been found that reliably distinguish the brains of mental patients.” (p. 125)

In his book, Valenstein clearly and systematically dismantles the chemical imbalance theory:

1. Reducing levels of norepinephrine, serotonin and dopamine does not actually produce depression in humans, even though it appeared to do so in animals.
2. The theory cannot explain why there are drugs that alleviate depression despite the fact that they have little or no effect on either serotonin or norepinephrine.
3. Drugs that raise serotonin and norepinephrine levels, such as amphetamine and cocaine, do not alleviate depression.
4. No one has explained why it takes a relatively long time before antidepressant drugs produce any elevation of mood. Antidepressants produce their maximum elevation of serotonin and norepinephrine in only a day or two, but it often takes several weeks before any improvement in mood occurs.
5. Although some depressed patients have low levels of serotonin and norepinephrine, the majority do not. Estimates vary, but a reasonable average from several studies indicates that only about 25 percent of depressed patients actually have low levels of these metabolites.
6. Some depressed patients actually have abnormally high levels of serotonin and norepinephrine, and some patients with no history of depression at all have low levels of these amines.
7. Although there have been claims that depression may be caused by excessive levels of monoamine oxydase (the enzyme that breaks down serotonin and norepinephrine), this is only true in some depressed patients and not in others.
8. Antidepressants produce a number of different effects other than increasing norepinephrine and serotonin activity that have not been accounted for when considering their activity on depression.

Another problem is that it is not now possible to measure serotonin and norepinephrine in the brains of patients. Estimates of brain neurotransmitters can only be inferred by measuring the biogenic amine breakdown products (metabolites) in the urine and cerebrospinal fluid. The assumption underlying this measurement is that the level of biogenic amine metabolites in the urine and cerebrospinal fluid reflects the amount of neurotransmitters in the brain. However, less than one-half of the serotonin and norepinephrine metabolites in the urine or cerebrospinal fluid come from the brain. The other half come from various organs in the body. Thus, there are serious problems with what is actually being measured.

Finally, there is not a single peer-reviewed article that can be accurately cited to support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not list serotonin as the cause of any mental disorder. The American Psychiatric Press Textbook of Clinical Psychiatry addresses serotonin deficiency as an unconfirmed hypothesis, stating “Additional experience has not confirmed the monoamine depletion hypothesis” (Lacasse & Leo, 2005).

When all of this evidence is taken in full, it should be abundantly clear that depression is not caused by a chemical imbalance.

But, as Valenstein shrewdly observes, “there are few rewards waiting for the person who claims that “the emperor is really nude” or who claims that we really do not know what causes depression or why an antidepressant sometimes helps to relieve this condition.”

How have we been fooled?

There are several reasons the idea that mental disorders are caused by a chemical imbalance has become so widespread (and none of them have anything to do with the actual scientific evidence, as we have seen).

It is known that people suffering from mental disorders and especially their families prefer a diagnosis of “physical disease” because it does not convey the stigma and blame commonly associated with “psychological problems”. A “physical disease” may suggest a more optimistic prognosis, and mental patients are often more amenable to drug treatment when they are told they have a physical disease.

Patients are highly susceptible to Direct-to-Consumer-Advertising (DCTA). It has been reported that patients are now presenting to their doctors with a self-described “chemical imbalance” (Kramer, 2002). This is important because studies show that patients who are convinced they are suffering from a neurotransmitter defect are likely to request a prescription for antidepressants, and may be skeptical of physicians who suggest other interventions such as cognitive behavioral therapy (DeRubeis et al., 2005). It has also been shown that anxious and depressed patients “are probably more susceptible to the controlling influence of advertisements (Hollon MF, 2004).

The benefit of the chemical imbalance theory for insurance companies and the pharmaceutical industry is primarily economic. Medical insurers are primarily concerned with cost, and they want to discourage treatments (such as psychotherapy) that may involve many contact hours and considerable expense. Their control over payment schedules enables insurance companies to shift treatment toward drugs and away from psychotherapy.

The motivation of the pharmaceutical companies should be fairly obvious. As mentioned previously, the market for antidepressant drugs is now $12 billion. All publicly traded for-profit companies are required by law to increase the value of their investor’s stock. Perhaps it goes without saying, but it is a simple fact that pharmaceutical companies will do anything they legally (and sometimes illegally) can to maximize revenues.

Studies have shown that the advertisements placed by drug companies in professional journals or distributed directly to physicians are often exaggerated or misleading and do not accurately reflect scientific evidence (Lacasse & Leo, 2005). While physicians deny they are being influenced, it has been shown repeatedly that their prescription preferences are heavily affected by promotional material from drug companies (Moynihan, 2003). Research also suggests that doctors exposed to company reps are more likely to favor drugs over non-drug therapy, and more likely to prescribe expensive medications when equally effective but less costly ones are available (Lexchin, 1989). Some studies have even shown an association between the dose and response: in other words, the more contact between doctors and sales reps the more doctors latch on to the “commercial” messages as opposed to the “scientific” view of a product’s value (Wazana, 2000).

The motivation of psychiatrists to accept the chemical imbalance theory is somewhat more subtle. Starting around 1930, psychiatrists became increasingly aware of growing competition from nonmedical therapists such as psychologists, social workers and counselors. Because of this, psychiatrists have been attracted to physical treatments like drugs and electroshock therapy that differentiate them from nonmedical practitioners. Psychiatry may be the least respected medical specialty (U.S. General Accounting Office report). Many Americans rejected Fruedian talk therapy as quackery, and the whole field of psychiatry lacks the quality of research (randomized, placebo-controlled, double-blind experiments) that serves as the gold-standard in other branches of medicine.

Dr. Colin Ross, a psychiatrist, describes it this way:

Of course there are also many “benefits” to going along with the conventional “chemical imbalance” theory, such as free dinners, symphony tickets, and trips to the Caribbean; consultancy fees, honoraria and stock options from the pharmaceutical companies; and a much larger, growing private practice as the $20 billion spent by drug companies on advertising brings patients to the office. Psychiatrists are just human, like the rest of us, and not many of them can resist all of these benefits.

In sum, the idea that depression is caused by a chemical imbalance is a myth. Pharmaceutical ads for antidepressants assert that depression is a physical diseases because that serves as a natural and easy segue to promoting drug treatment. There may well be biological factors which predispose some individuals toward depression, but predisposition is not a cause. The theory that mental disorders are physical diseases ignores the relevance of psychosocial factors and implies by omission that such factors are of little importance.

Stay tuned for future articles on the psychosocial factors of depression, the loss of sadness as a normal response to life, and the branding of new psychological conditions as a means of increasing drug sales.

Recommended resources

• Blaming the Brain, by Elliot Valenstein Ph.D.
• Rethinking Psychiatric Drugs, by Grace Jackson M.D.
• America Fooled: The truth about antidepressants, antipsychotics and how we’ve been deceived, by Timothy Scott Ph.D.
• The Loss of Sadness, by Alan Horwitz and Jerome Wakefield
• The Myth of the Chemical Cure, by Joanna Moncrieff

New research has just been published in the Journal of the American Society of Nephrology that questions the long-held popular belief that drinking eight glasses of water a day benefits our health.

According to Dr. Stanley Goldfarb and Dr. Dan Negoianu of the University of Pennsylvania in Philadelphia, there are four prevalent myths about water intake:

1. Leads to more toxin excretion
2. Improves skin tone
3. Makes one less hungry
4. Reduces headache frequency

Dr. Goldfarb and Dr. Negoianu reviewed all of the published studies which examined the health benefits of water consumption. They concluded that people in hot, dry climates, athletes or people with certain diseases might do better with increased fluid intake, but for average healthy people, more water did not mean better health.

“There is no clear evidence of benefit from drinking increased amounts of water,” Dr. Goldfarb wrote, but he also added, “There is also no clear evidence of lack of benefit.” In other words, the scientific research doesn’t tell us one way or the other whether there’s a benefit or not.

Fortunately, nature has endowed us with a mechanism that can in fact help us determine how much water we need to be drinking per day. It’s called thirst. If we simply pay attention to our thirst and respond appropriately, it’s likely that we will take in as much water as we need. Four to six glasses per day is probably sufficient for most people; but then again, the evidence indicates there is no harm in drinking more, so if you enjoy drinking a lot of water then knock yourself out!

There is no evidence that increased water consumption helps to excrete toxins. The kidneys perform that function in the body, and as long as they are healthy they do it very well. Dr. Goldfarb: “The kidneys clear toxins. This is what the kidneys do. They do it very effectively. And they do it independently of how much water you take in. when you take in a lot of water, all you do is put out more urine but not more toxins in the urine.”

There is no evidence supporting the other three myths either; namely, that it improves skin tone, reduces hunger and alleviates headaches. But again, if your experience is different and you find that water does help with these conditions – then there is absolutely no reason not to continue what you’re doing now (other than perhaps more frequent trips to the bathroom!) Just don’t go crazy with the water intake, because extremely high levels of water consumption can affect the fluid balance in the body, causing “water intoxication” and even death.

Finally, I’d be remiss if I didn’t emphasize that the quality of the water we drink is much more important than the quantity. My recommendation is that you invest in a high-quality water filter and install it in your home. Avoid bottled water, which is often simply tap water packaged in a plastic bottle that can potentially leach toxins into the water – especially when left in the sun. (You know that “plasticky” smell when you drink water from a plastic bottle that has been around for a while? Not good. Not good at all.) Nalgene bottles should also be avoided as they can leach another unsafe chemical called BPA into your water. Instead, buy a stainless steel water bottle and fill it up with your filtered water at home before you go out.

Also, both tap water and filtered bottled water contain fluoride, a highly toxic bone poison that should be avoided at all costs. Many commercial water filters unfortunately do not remove fluoride, which is present in our water supply because of the gross misconception that it supports dental health. But more on that myth in another article.

In part I we reviewed the environmental and ethical benefits of pasture-raised animal products, along with some general information about why they are more nutritious. In this article, we’ll look more specifically at exactly why grass-fed animal products are superior to commercially-raised alternatives.

Meat

• Meat from grass-fed animals has two to four times more omega-3 fatty acids than meat from grain- fed animals.
• When chickens are housed indoors and deprived of greens, their meat and eggs also become artificially low in omega-3s.
• Eggs from pastured hens can contain as much as 19 times more omega-3s than eggs from factory hens.
• When ruminants are raised on fresh pasture alone, their products contain from three to five times more CLA than products from animals fed conventional diets. CLA is a fatty acid that has recently been studied as a potent cancer fighter.
• The meat from the pastured cattle is four times higher in vitamin E than the meat from the feedlot cattle and, interestingly, almost twice as high as the meat from the feedlot cattle given vitamin E supplements.

Milk

• Unfortunately, 85 to 95 percent of the cows in the United States are now being raised in confinement, not on pasture. The only grass they eat comes in the form of hay, and the ground that they stand on is a blend of dirt and manure.
• Milk from a pastured cow can have five times as much CLA as a grainfed animal.
• Milk from pastured cows also contains an ideal ratio of essential fatty acids or EFAs. Studies suggest that if your diet contains roughly equal amounts of these two fats, you will have a lower risk of cancer, cardiovascular disease, autoimmune disorders, allergies, obesity, diabetes, dementia, and various other mental disorders.
• When a cow is raised on pasture , her milk has an ideal ratio of omega-6 to omega-3 fatty acids. Replace two-thirds of the pasture with a grain-based diet and the milk will have more than five times the amount of omega-6 fatty acids than omega-3s, a ratio that has been linked with an increased risk of a wide variety of conditions, including obesity, diabetes, depression, and cancer.
• Grassfed milk is higher in beta-carotene, vitamin A, and vitamin E. This vitamin bonus comes, in part, from the fact that fresh pasture has more of these nutrients than grain or hay. These extra helpings of vitamins are then transferred to the cow’s milk.

Free-range (pastured) eggs

• When compared to commercially raised, supermarket eggs, free-range eggs have:
  2/3 more vitamin A
• 7 times more beta carotene
• Up to 19 times more omega-3 fatty acids
• Significantly more folic acid and vitamin B12

Raw dairy products – another step up

The information above should convince you that grass-fed dairy products are superior in every way to dairy products that come from grain-fed cows. Another important distinction to be made is the difference between raw and pasteurized dairy products.

I will be covering this in further detail in a future article, but in short raw dairy products have several significant advantages over pasteurized alternatives:

• Raw milk is an outstanding source of nutrients including beneficial bacteria such as lactobacillus acidolphilus, vitamins and enzymes, as well as the finest source of calcium available.
• Pasteurizing milk destroys enzymes, diminishes vitamin, denatures fragile milk proteins, destroys vitamin B12, and vitamin B6, kills beneficial bacteria and promotes pathogens.
• Raw milk is not associated with any the problems of pasteurized milk, and even people who have been allergic to pasteurized milk for many years can typically tolerate and even thrive on raw milk.

Contrary to popular belief, raw milk is safe to consume. There has never been a pathogen found in the milk of the two largest raw dairy producers in California, Organic Pastures and Claravale. In fact, the USDA has been unable to even find pathogens in the soil at Organic Pastures – which is highly unusual. This is due to the much more stringent standards for sanitation that raw dairies must comply with in order to be licensed to sell their products.

Again, I will cover this in more detail in a future article. Stay tuned!