Washington Center For Psychiatry

Even a minor shift in the flow of one brain fuel is dangerous because it may adversely affect the flow of other fuels, and you will suffer.

Some doctors and psychotherapists fail to understand that any untreated problem is an invitation to more problems.  When you fail to fix chronic tiredness, you may hurt your brain.  Shockingly, there is ample evidence that prolonged exposure to worry and depression can cause irreversible brain shrinkage in critical areas such as the hypothalamus.

As Influential as Your Brain Fuels

They remain highly valuable to medical disorders, stress, trauma, and old age.  Paradoxically, experts agree that a number of factors act as promoters of your fuels.  Today, a modern doctor’s therapeutic aim is to identify these friendly factors and use them for good health.  Thus far they are not viewed as curative, but experts are optimistic.  While your promoters do not guarantee perfect health, they do appear complimentary to several traditional treatments for psychiatric disorders, and that means better results in patient care.

Among the most important are sunlight, creativity, good sleep, exercise, vitamins and minerals, and a healthy diet.

Good Friends of Brain Fuels – Sunlight and Creativity

Ever since Dr. Norman Rosenthal and his colleagues at the National Institutes of Health proved the curative power of sunlight in some depressions, sunlight, as an important ally to your angels, has gained further support.  Having daily, regular exposure to sunlight and the benefits of outdoor activities is very beneficial.  Sun is not a cure-all by any means, but daily one-hour exposure can help us fight life’s more difficult moments.  It’s not so surprising.  Even if you don’t suffer from seasonal affective disorder – a subtype of depression where mood swings are closely linked to seasons – the chance of feeling good are better at times when our planet Earth gets closer to the sun.

The panoply of benefits that sunlight radiates and the exact factors behind them are of great scientific curiosity, yet they are beyond my limited focus.  I am convinced that sunlight helps our brain fuels and us.  Over the years and I have witnessed how it helped thousands of my depressed patients.

An unlikely friend of sunlight, creativity also helps.  Some people may be dismayed that I would just mention creativity as a tool for better health and then not explore it more thoroughly.  I apologize for this, but the truth is, creativity and its psychological benefits are light years beyond my more modest and manageable goals with this book.  I will say to anyone who swims in the ocean of creativity, whether it is writing, painting, sculpture, music, gardening, decorating, or anything else, that creativity helps our angels and ultimately helps us.  For anyone faced with an emotional headache, any creative activity would help.  I’ve had patients who have survived major losses by becoming immersed in creative writing or painting or sculpting.  I’ve had others discover their hidden talent in music when they were simply attempting to escape their emotional pain.  And I will never forget the young teacher with broken ankles and wheelchair bound after an automobile accident, who yet managed to enroll in art class and create beautiful pieces of colorful ceramics.  In the end, it wasn’t the quality of her creative work that was astonishing, but rather, how her creativity helped her.

Good Sleep is a Friend of Your Brain Fuels

A good night’s sleep really can be curative.  In the some what guilt-ridden workaholic environment that many Americans are used to (compared to the Europeans who take six week vacations, take naps in the middle of the day, believe a great meal with plenty of wine is essential to one’s well-being, and enjoy love-making with a passion devoid of many issues of control, guilt, and complication), many Americans think if they work really late they are more productive.  They feel better about themselves and sometimes boast about long office hours.

Not good!  We need our rest!  A worried and sleepless brain is in twice as much trouble as a brain that can sleep.  A restful sleep comforts and shields an angel (GABA) versus insomnia, which undresses and robs her.  The net result of a sleepless night is increased nervousness, irritability, worry, and agitation.  Further untreated insomnia prolongs and worsens anxiety.

It is perhaps necessary to highlight a recent scientific finding:  Not only sleep, but quality of sleep, is important too.  Of all the different stages of sleep (rapid eye movement – REM, and non-rapid eye movement – NREM), the third and fourth stages of non-rapid eye movement sleep, delta sleep is crucial for our mental health, primarily because of its impact on various chemical angels.  For whatever reason, when delta sleep is shortened, interrupted, or disturbed, your brain fuels lose some of their special powers.  And the net result is increased irritability, worry, and anxiety, and diminished alertness and pronounced fatigue.

It is beyond this chapter’s modest goal of addressing common problems with sleep to discuss all the ramifications of a disturbed sleep pattern.  There are some interesting points worth mentioning, however.  When we are depressed our delta sleep is significantly compromised.  As we age, the same thing happens.  And why is this important?  Because delta sleep is closely linked with the production of growth hormone secretion, energy conservation, and the drop in core body temperature and metabolic rate, highly important physiological signs of maintaining long-term good health.  In some ways, it is not surprising that 63% of patients with psychiatric disorders suffer from sleep disturbance.  And there is enough evidence to suggest that persistent insomnia may lead to psychiatric disorders by weakening chemical angels.

Regardless of the reason, one common goal is obvious.  For better health we must sleep well and we must have a good delta sleep.

So if you feel stressed or anxious, never accept insomnia as the necessary price to pay.  Ask your doctor to prescribe a short-acting hypnotic such as Ativan, Ambien, or Sonata.  If he won’t prescribe it, find a doctor who will.  In most cases you will discover that when stress and worry are gone you won’t need any sleep aid, but if you still experience insomnia in the absence of stress, insomnia alone is a good enough reason to contact a psychiatrist.

Vitamins and Food Supplements

Making sense of all the manifestos by health experts of picking what vitamin, mineral or food supplement to consume is stressful.  You may have more fun with the process if you let yourself recall all the fantastic, yet erroneous, medical declarations from our collective past.  “Trust us, it is good for you to drink milk and live on steak and eggs,” our big brother once said, and this was not such a long time ago.  So experts, whether they are government health officials or the gurus from prestigious universities, kept rediscovering and then changing the recipe for the healthiest diet.  So this is just common sense without scientific scrutiny.  For me selecting a healthy diet or food supplement would always come down to really one question:  What is the evidence that they really help our chemical angels?

It is true that at present the world’s top scientists and the leading pharmaceutical companies have been aggressively investigating all possible leads to come up with a list of compounds that may show promise as the ultimate cocktail for good health.  Despite all the research, however, the list of brain fuel friendly vitamins and minerals that are scientifically validated is short.

For instance, there is some good evidence that materials like zinc, copper and magnesium all play key roles in controlling the N-methyl-D-aspertate (NMDA) receptor for glutamate.  There is some solid evidence that decreased levels of zinc, copper, and magnesium in the synaptic ocean can lead to abnormalities of mood.

There is also highly convincing evidence that omega-3 fatty acids and omega-6 fatty acids have stabilizing effects for our brain and have particular usefulness in the treatment of bipolar disorders.  The topics of dementias including Alzheimer’s have drawn significant attention to the preventative role of various minerals and vitamins in offering help for our chemical angels.  Here the evidence points in favor of vitamin E, vitamin B12, vitamin B6, and vitamin C as solid friends and defenders of our brain fuels and play a critical role in decreasing the chances of developing Alzheimer/s.  Another interesting chemical, Silicon, has been found to be useful in reducing our susceptibility to develop Alzheimer’s.  But perhaps among all the chemicals there is no cocktail as powerful and scientifically convincing as the cocktail of EM Power.

And amazingly, in a double-blind study – the ultimate litmus test for any study – Dr. Judith Kaplan and her University of Calgary colleagues proved that a special cocktail of minerals and vitamins can effectively reduce the amount of psychotropics a bipolar patient may need, or even in a few cases effectively eliminate all medications and replace them.

The story of the scientific origin of Dr. Kaplan’s research is a triumph for common sense, intelligence, observation, and ability to think outside the box.  For some time, astute Canadian farmers had been feeding their overly aggressive and unruly pigs and chickens special foods enriched with a vitamin and mineral concoction.  The farmers believed that the attacking chickens or ear-and-tail biting pigs behave less aggressively when fed with this special concoction, without the need for veterinary intervention.

In 1996, two animal nutritionists, David L. Hardy and Anthony F. Stephan, used the same concoction to treat two of Stephen’s children, who suffered from treatment refractory bipolar disorder.  Both children had remarkable response to vitamin-mineral cocktail and have not needed any psychiatric medication for six years (Popper, Charles W., Journal of Clinical Psychiatry, 12/01).  Hardy and Stephan worked with over 2,500 psychiatric patients and then began to collaborate with Dr. Kaplan.  Dr. Kaplan’s scientific research and her conclusion that vitamins and minerals can actually provide significant and measurable relief for patients with bipolar disorder coined a new name for them:  Friends of Our Chemical Angels.

As promising as Dr. Kaplan’s and other studies are, there remain many questions for researchers to answer.  Among the most important:  Is the concoction safe?  Which patients are better candidates for it?

On the safety side, what we already know is reassuring.  With the exception of a few vitamins (A and D) our bodies are well prepared to rid excessive amounts of any mineral or vitamin and not expose us to unexpected health risks.  And even with vitamins, toxicity is only possible with consumption of massive amounts of Vitamin A and Vitamin D.

Like the EM Power study, another fascinating research did get much attention from the scientific community.  The lead researcher, Dr. Thomas Truelsen, a renowned epidemiologist from Denmark who has been studying diet and health, offered good evidence that moderate wine consumption would reduce dementia by 70%.  And because of the relatively large size – 1709 people – and study methods, this study is a significant statement that moderated wine consumption is good for your brain.

In summary, there is now some scientific evidence that several vitamins, minerals, and food supplements do play a key role in helping our brain fuels.  It is beyond the modest goals of this chapter to review all the relevant literature.  However, the reader may find further interesting scientific findings in the reference list and refer to the chart for a summary of mineral, diet, and vitamin-psychiatric disorder connections.

Diet and Crucial Benchmarks of Good Health

How about the question of what is the healthiest regular diet?  Once again, what makes sense to provide a healthy environment for our chemical angels and how to do it through diet is an ever-evolving recommendation.  Yet when we look at a number of different studies it is impossible to argue with the defining importance of biological markers I would call the “A team”.  They include healthy blood pressure, body weight, blood lipids, cholesterol, sugar, and homocysteine levels.  And once again the answer is simple.  Do not worry about how you would do it, but find a way to maintain a healthy A team.  And by doing this you will be extraordinarily nice to your brain and significantly contribute to good health.  About how to maintain a good and healthy A team, it is only reasonable to suggest that you consult with your physician and work out a medical and dietary approach that makes it possible.

Exercise

You don’t have to be an Olympic runner to know that exercise reduces stress and tension and improves health.

What has been traditionally accepted by the medical community is that regular exercise at least three or four times a week is extremely beneficial not only to the well being of your body, but also of your mind.  Anyone who can follow such a healthy schedule should continue to do that.  What is great news, however, is the recent scientific studies showing that even a moderate amount of exercise can be very healthy and helpful for our overall health.  Dr. JoAnn E. Manson, Chief of Preventative Medicine at Brigham and Women’s Hospital in Boston, and the lead author of a medical study which appeared in the New England Journal of Medicine, concluded that after tracking 74,000 women for six years, the results suggest that the benefits of exercise are within reach of virtually every American and do not require equipment, organized sports, or painful exertion.  In this particular study, brisk walking for about two and a half hours a week or an equivalent amount of more strenuous exercise cut the risk of heart disease and stroke by about a third.

It is true that our intellectual knowledge, our brainpower, is often not enough to overcome all the life, stress, or reality based obstacles that often sabotage our exercise routine.

There is also the guilt factor.  It is not uncommon for us to set certain goals for ourselves and then feel intensely guilty for not meeting them.  Guilt, associated with failure to meet personal goals, then becomes a formidable adversary for our future motivation to exercise.

Perhaps prompted by so many of my patients’ guilt triggered self sabotage, and also to accommodate people for whatever real, imaginary, or psychological reasons suffer from “I’ve no time for exercise” syndrome, I developed an easy way to exercise:  once weekly exercise.  For example, you might start walking briskly for 30 minutes every week.  Increase the time by 30 minutes every week, and in a month you will be walking two hours per week.  I personally practice my own method and, by running 13 miles once a week, discovered all the wonderful benefits of such an exercise.  My pulse rate is a healthy 64 (without weekly runs it jumps to 75), and I feel it.

In fact, my weekly running – the only exercise I do – was good enough for me to run and complete a marathon in March 2002.  The Washington DC Inaugural Marathon was my first ever.  To prepare for the race, I slowly increased my running until I reached 20 miles a week, but only once a week.  On race day I not only finished the course but I did in five hours fifteen minutes.  Not bad for a 54 year old sedentary shrink.

By far the greatest chore for me was the realization that it had not taken extraordinary steps to prepare for a marathon.  I discovered a method of exercise that is practical, guilt-free and effective.

Ideally, meeting the goal of exercise weekly will encourage other health habits, such as walking up the stairs rather than riding an elevator, or taking a midday break for a brisk, fifteen minute walk.  Exercise induces more exercise, just as living on the couch produces couch potatoes.  Every new activity spurs new energy, more confidence and well-being.

John, one of my patients, was a middle-aged attorney, the married father of two who could not keep his weight down.  He got so heavy that his teenage sons nicknamed his swelling belly “Johnny”.  This made John feel awful, and he vowed to do something about it.

His first attempt at getting in shape was an ambitious plan to swim three times a week and follow a low calorie diet.  After a burst of enthusiasm for the new regimen, John slipped.  He missed one morning’s swim and then another.  Watching football on television, he impulsively devoured three scoops of chocolate ice cream.  Then he experienced intense guilt and self-loathing, more ice cream and missed morning swims.  The outcome was classic:  Defeat, resignation, and more guilt.

As part of our work together, I had him take weekly, 30 minute walks near his home along the C&O Canal in Maryland, just north of Washington, DC.  A smooth trail shaded by thick, leafy trees runs between the still waters of the canal and the rushing Potomac River.  His first walk by the canal was a success as he walked for 45 minutes instead of the 30 I had suggested.  At the end of six weeks, he was walking 90 minutes per week.  He also made an unexpected discovery.  Walking was not a waste of time.  In fact he enjoyed the lush natural setting, he was able to focus on challenges he faced at work and in his life and solutions to them.

His last physical confirmed what I had expected.  He achieved his goal of getting into shape, and his pulse dropped from 79 to 64.  In addition, he managed to regain control over his eating habits and a adopt a sensible diet, and subsequently lost ten pounds in a period of eight weeks.