Serial Diagnosing: Depression and Anxiety
Updated: 7 days ago
The recent mass development and production of mood-altering pharmaceuticals has resulted in an increase in diagnosing and labeling our patients as depressed or anxious. Pharmaceuticals treat these conditions by targeting specific neurotransmitters (i.e. serotonin, dopamine, norepinephrine, etc.) with an end goal of fixing a neurological imbalance. But what if there is no neurological imbalance to begin with?
It’s apparent that we have started serial diagnosing, assuming that every person who shows signs of depression or anxiety has a neurological imbalance and requires pharmacological intervention via prescription drugs. It looks as though we have stopped allowing people to be human beings that naturally feel emotions as a result of environmental variables. Experiencing depressed or anxious feelings throughout life is completely normal and circumstantial! I absolutely do recognize that there are extreme situations when an individual may ultimately require prescription medications based on a very serious neurological imbalance; however, my goal is to address the greater population that western medicine is misdiagnosing.
I have decided to talk about depression and anxiety together because not only are they both very common mental states that often overlap, but they are both equally misunderstood and over diagnosed in western medicine. Additionally, physicians commonly use the same medications to treat both conditions.
Our society receives an inadequate amount of education on how to handle emotions and what tools can be used to naturally re-balance our mental health without the use of prescription drugs. It is too often that I am counseling a patient on a new antidepressant/anxiolytic and find out they don’t even know why the medication was prescribed! WHAT?! (These are serious medications with even more serious side effects!) Most often, we will deduce together that it was a result of them mentioning to the doctor that they are stressed/nervous about school, work, or family life. Blasphemy!! This is a normal part of life, not a neurological imbalance! It’s really a minority of people that truly require pharmaceutical intervention. The rest of us simply require some assistance in acquiring tools to shed these negative emotions.
Ever heard of self-fulfilling prophecy? Well, it applies to our health on a grand scale. A big mistake that doctors make in western medicine is putting a disease state label on our patients. The patient then starts to identify with and in turn acts as expected from someone with that disease. We label the patient depressed, anxious, a diabetic, etc. when in fact their body is simply in a STATE of dis-ease.
Just as water can change from solid to liquid state depending on environmental variables, our bodies respond to our habits, lifestyles, diets, and beliefs by falling in and out of dis-ease. This means that our condition is by no means permanent and we should work to put the body back in balance, a state of ease.
In 2018, I went through one of the hardest years of my life- My dad was passing away. During what we knew would be his last couple weeks of life, I had made an appointment to a new physician to discuss some possible concerns I had with my heart. Prior to the physician walking in, the nurse asked me a slew of questions, then proceeded to preface the required “depression screening”. I found it very peculiar that she would feel this was an appropriate time to screen me for depression, as I did just state my dad was in hospice. I voiced to the nurse that I will not be partaking in that screening today, as my results will label me full blown “suicidal” and that is not at all indicative of me as a person outside of these circumstances. I asked her, “Wouldn’t it be a greater concern if I DIDN’T show signs of depression during this awful time in my life?” I felt her discomfort to my push-back. She was obviously not prepared to have a non-textbook conversation and responded, “I’m sorry. This is the protocol.”
So here, my friends, is the problem. We have promoted a healthcare system in which our providers are unable to think outside of a teeny, little box. Where we ask each patient the same questions even if those questions do not pertain to them. I would even say that doctors in western medicine have very little idea on what questions they actually should be asking if truly striving to heal a patient. This is what promotes the occurrence of wrongful diagnoses.
At the end of the visit, the physician validated my concerns about a “one-size-fits-all” approach to diagnosing and prescribing. Prior to me taking off, she noted that a follow up in 3 months is warranted to evaluate whether I will be needing an antidepressant……. People! Did you hear me?! This “doctor” was giving me a puny 3 months to get over losing my dad! Pathetic. Shows how intolerant we are of allowing people to feel all the emotions and to take ample time recovering from traumatic events. At no point did she ask me about my typical mood when I am not losing my dad, nor did she show any interest in discussing helpful lifestyle modifications to aid in bringing back my typically optimistic self.
Little did she know, I was meditating daily, avoiding all alcohol and drugs to keep a clear mind, and kept inspirational books beside me at all times to learn how I can become an even stronger version of myself having gone through this event. Maybe if she would have asked about all that, she could have avoided misdiagnosing me as “neurologically imbalanced”. She would have seen that all I needed was time and some helpful non-pharmaceutical interventions.
In reality, it took me 15 months (5 times as long!!!) to feel like I was Sylvia again. I would like to remind you how active I was in nurturing my mental and physical health during this time because I would venture to guess that as a result, this was a quicker recovery than the average person might experience when not using such practices.
Fact of the matter is, life can be very difficult at times. That is simply a part of being on this planet. Whether you are in a job role with stressful demands or your loved one just passed, you will continue to encounter feelings of depression and anxiety that come and go (and yes, I do completely realize some people are more sensitive than others making them more prone to these fluctuations.) The goal is not to avoid them, as feelings are important and indicative of what matters to us. The goal is to have compassion for yourself and understand what tools are out there to help you heal. I say heal because pharmaceuticals temporarily suppress symptoms.
With serial diagnosing of depression and anxiety on the rise, there is a strong chance your doctor may have recommended you get started on a prescription medication as the first step just by having one conversation with you. Firstly, I wanted to apologize on behalf of our healthcare system that no alternatives were discussed prior to starting pharmaceuticals. Let’s get into these side effects a little bit and then I’ll provide a list of factors that contribute to balanced mental health. Why don’t we take a look at Lexapro (escitalopram), a common antidepressant/anxiolytic. The side effects I most often see my patients experiencing are:
Disturbed sleep (Interrupted sleep has been a proven contributor to imbalanced mood. Sounds counterproductive to the healing we are hoping to achieve)
Bouts of depression/mania (A medication used to treat depression can cause depression? Yes! Don’t forget that these drugs work by messing around with your neurochemicals that partake in all states of emotion. Relying on a pill to keep everything in balance is bound to backfire)
Dry mouth (Perfect opportunity for bacteria to breed causing bad breath and inflamed gums)
Erectile dysfunction (Stress alone can greatly contribute to erectile dysfunction; however, mood-altering drugs are causing men younger than 50 years of age more concern with performance than ever before.)
Furthermore, and most concerning of all, mood-altering medications come with a “Black Box Warning” that states the increased risk of suicidality in patients taking these medications. This is because giving one of these pharmaceuticals to a person with feelings of sadness, irritability, or restlessness is like putting a band-aid on an active infection. It might conceal what is going on to a certain degree, but unless we clear the infection by getting to the root-cause, it will keep progressing and cause greater issues.
Too often your physicians won’t know the first thing about the kind of lifestyle modifications that are available for mental health, as their education puts minimal focus on this. Below are some factors that you can start considering when working towards re-balancing yourself into a state of ease. My descriptions may be a little general in this blog but please continue following as my future blogs will be going into great depth on all of the topics listed below. Additionally, always feel free to reach out with specific questions you may have pertaining to your personal journey, as I always recommend you speak to a healthcare professional before adding or taking away any herbals, supplements and/or other medications.
Eat Foods That Nourish Your Body. After all, that is the main point of food :)
How many times have you heard this said?! It’s true! The food you put into your mouth is used as nutrients to promote optimal brain function, mood, energy, skin, weight, etc. A healthy gut is key to proper serotonin production (a key component in mood regulation).
1. Cut out sugar (Do not replace with sugar-free products as those are often a greater hazard than sugar itself!)
2. Avoid prepackaged foods. Our food shouldn’t come with a long list of 10+ ingredients. We are living people, not robots, which means we must consume food that was LIVING at one point. I always give my patients a good rule of thumb: If you are 3 ingredients in and you start not understanding what they are, this is FOR SURE something you should be avoiding.
3. Start a food journal! You must be careful because though there are “general health foods”, we cannot assume that all our bodies will respond the same. There are many diet fads that scream for our attention, but I really believe that listening to our bodies and what they are telling us after consuming a meal is the best practice for properly nourishing ourselves. Grab a journal and begin writing down what you eat every day and how you feel afterwards. Pretty soon you will see patterns and clear answers to what foods might not be working well for your body and mind.
Practice Mindful Living
The definition of mindfulness is the state of being conscious or aware of something. In this day and age, we often live in an “unconscious” state where we are running from one task to another while answering 3,000 texts and emails. Writing that made me feel anxious, let alone actually living that way daily. We must learn to slow down and live with intention. Pay attention to your surroundings, stay present when engaging with loved ones and YOU be the one who decides what you do with your time. We often spread ourselves too thin and then blame everyone but ourselves. Take a look at how your decision effect the kind of life you lead.
Meditation is a superpower that we’d be crazy to live without! It’s as simple as taking 10 minutes out of your day to close your eyes, breathe and reaping the benefits! Many of you may be thinking, " Meditation is not for me. There is no way I could sit still for 10 minutes.", You should know that you are actually the best candidate and could get some of the greatest rewards from incorporating this practice. Some of the many benefits include:
1. Decreased stress/feelings of anxiety
2. Decreased blood pressure
3. Improved sleep
4. Uplifted mood
5. Better response time when making decisions
6. Increased ability to control explosive emotions when triggered
7. Improved immune system
It is important to always have the desire to keep learning about new tools that can be added to your “health toolbox”. Re-balancing your mental state is a journey that requires a lot of dedication, introspection and ultimately, you need to be comfortable with allowing it to become part of your lifestyle. A great way to start your journey is by reading books/blogs or listening to podcasts. You will be surprised to see how many people you find that you can relate to and use the advice that has been proven effective for them. My favorite books to read are self-improvement books as there is nothing I love more than finding new ways of living my best life. I will be sharing these books with you all monthly so you can make them a part of your tool box!
Don’t Stop Moving
Exercise comes in MANY different forms. There is no best way to exercise. The key is to stay moving throughout your day. Fit in little opportunities wherever you can to get your energy moving. Often people make the mistake of thinking they must have an hour workout at least 5 days a week for any positive results. Sounds stressful and unrealistic for many!! Never underestimate the power of even a short walk outside! Starting your day with a nice stretch is always recommended to get all your energy flowing but after that, the world is your oyster! The key is to move in ways that aren’t a chore for you, rather your way of re-energizing your system.
Talk About It
I would love nothing more than a world where we all understand the need of having a therapist. It is important to have a non-bias individual to help us work through “emotional baggage”, for a lack of a better term. It is not fair to always unload it on our partners, family and friends. It is good to have someone to see regularly where you can spill your brains- often just the act of hearing yourself say your thoughts out loud can be super beneficial!
Explore Natural Supplements
1. Lemon Balm Tea- Also known as Melissa, this herbal tea is great at promoting restful sleep and easing feelings of anxiety throughout the day. Feel comfortable enjoying a cup of this tea before bedtime or during the day (Please do not drive after consumption). Xanax, a benzodiazepine used for anxiety, is associated with increased rates of dementia and symptoms of depression. Lemon balm is an excellent alternative that does not involve such long term side effects!
2. Ashwagandha- An ancient Ayurvedic herb, best known for its ability to relieve stress and increase energy without being a cardiac stimulant.
For those of you that are taking medications currently, I will NEVER recommend that you discontinue the use of your medications without the supervision of your physician. What I aim to do is empower you to show your physician the desire to take responsibility for your mental
health by committing to lifestyle modifications that will hopefully result in discontinuation of prescription medications. A good doctor will support this journey of yours and work with you to achieve success. If you encounter a doctor that may resist you or does not have a good understanding of the benefits of lifestyle modifications pertaining to mental health, then it may be time for you to find a new doctor.
Dr. Sylvia Kolbiarz