depression
PMS – A Naturopathic approach to this common (but not normal!) syndrome.
January 18, 2012 | 
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If you are like most women (80%) you recognize that your period is coming by the changes you feel, emotionally and physically. Premenstrual Syndrome (PMS) refers to more than 150 symptoms that occur in the 2nd half of your cycle, after ovulation. Most women report increasing symptoms in their 30′s and 40′s, which makes sense given that most women are estrogen dominant as they approach menopause. There are 4 categories of PMS:
PMS – A: Anxiety (65-75%of PMS sufferers)
- Anxiety, tension, feeling “on edge”
- Irritability, anger
- Mood swings, Insomnia, Depression
- Feeling overwhelmed
- Sensitive to Criticism
PMS – C: Cravings (30% of PMS sufferers)
- Cravings for sweets and carbohydrates
- Increased appetite
- Headaches
- Fatigue
- Heart Palpitations
PMS – D: Depression (25-35% of PMS sufferers)
- Depression
- Forgetfulness, confusion
- Lethargy
- Withdrawal and disinterest in usual activities
- Insomnia
PMS – H: Hyperhydration/Water Retention (50% of PMS sufferers)
- Breast swelling and tenderness
- Abdominal bloating
- Weight gain of over 3 lbs
- Swelling of the face, hands, fingers and ankles.
Other symptoms common to all types of PMS can include: bowel changes (constipation, diarrhea), cramping, changes in libido, backache, headache, acne and other skin changes, night sweats, insomnia and nausea.
Most women fall into one or more categories, but find that one of the above categories best matches their symptoms. This is useful as it helps us to identify underlying causes, as well as manage symptoms until we get to the root cause.
What is the root cause?
As I said earlier, most women know their period is on its way based on how they are feeling. That part is normal. What isn’t normal is for symptoms to begin more than 1-2 days before the period starts, begin immediately after ovulation, cause major disruptions in life, or cause enough discomfort to require pain medication.
Finding the root cause can be tricky, but most of the time estrogen dominance is to blame. Estrogen dominance is when estrogen is high relative to progesterone. This can be a “true” dominance (estrogen is high, progesterone is normal) or a relative dominance (estrogen is normal, progesterone is low). Women who have been on hormonal birth control for many years, or have known exposure to xenoestrogens (ie, plastics, pesticides) often have a “true” dominance picture. In that case, we support the liver’s detoxification of estrogens and use foods to influence the balance of estrogen and progesterone (ie phytoestrogens). In cases of “relative” dominance, which is most common in peri-menopause when progesterone levels start to decline, we use herbs like Vitex to support the production of progesterone. Treating estrogen dominance usually takes 3-6 months, but most women begin to feel better after just 4-6 weeks.
Treating the “branches”
While the “root” cause is often estrogen dominance, the “branches” aka symptoms, can also be treated while we wait for the root to heal. The most common symptoms I see related to PMS are:
- Anxiety/Irritability/Mood Changes
- Insomnia/Sleep changes (especially during peri-menopause)
- Fatigue
There are a number of therapies that can be used to successfully manage the “branches”, including melatonin, 5-HTP, l-theanine, inositol and/or herbs that support adrenal health such as licorice, eleuthrococcus and ashwaganda. Many patients feel very discouraged by the time they seek out naturopathic care, having suffered for many years. Many women are also concerned that their symptoms are becoming more severe as they get older. In most cases, my patients report a 75% improvement in symptoms by 3 months, with many reporting significant improvement in just 1 month!
Correcting the imbalance
- Include phytoestrogens in your diet: beans, lentils, flax (2 tbsp/day). Some women also benefit from including soy foods (soy milk, soy beans, soy nuts, tofu).
- Reduce red meat consumption to less than 2x/month
- Reduce caffeine, sugar and alcohol
- Manage stress levels. Cortisol and progesterone come from the same precursor – your body will make cortisol at the expense of progesterone when under stress (physical/mental/emotional), making estrogen dominance worse.
- Choose organic foods most often, especially the “Dirty Dozen“.
- Avoid using plastics.
- See an ND to ensure a proper diagnosis and treatment plan.
PMS may be common, but it isn’t normal! It’s just a symptom of an underlying hormone imbalance that can easily be corrected with the right kind of treatment.
Posted in PMS, Premenstrual Syndrome, Uncategorized, Wellness, anxiety, depression, hormone health | 
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Seasonal Affective Disorder – aka ‘Winter Blues’
As we get ready to move the clocks back next weekend, people who suffer from Seasonal Affective Disorder (SAD) begin to dread the coming months. Those who suffer from SAD begin to experience:
- fatigue
- depression
- crying spells
- irritability
- trouble concentrating
- body aches
- change in sleep patterns
- decreased activity level
- overeating, especially of carbohydrates.
What causes SAD?
- Your biological clock (circadian rhythm): The reduced level of sunlight in fall and winter may disrupt your body’s internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.
- Serotonin levels: A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can cause a drop in serotonin that may trigger depression.
- Melatonin levels: The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood.
- Vitamin D Defeciency: Because vitamin D is produced when our skin is exposed to sunlight, declining levels of Vitamin D may play a role in SAD.
- Living far from the equator. Seasonal affective disorder appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter, and longer days during the summer months.
Treating SAD
Light therapy
In high-intensity, full-spectrum light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you’re exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood.
Light therapy is a good place to start for seasonal affective disorder. It generally starts working in two to four days and causes few side effects.
Enjoy the sunshine!
Make sure you take advantage of sunny days, and try to get some early morning sunlight exposure. A brisk walk around the block, or walking to work is a great idea.
Exercise
As with any type of depression, exercise helps to relieve symptoms and has many other benefits.
Supplements
Work with your ND or MD to ensure that you have adequate stores of Vitamin D. This vitamin is measured using either a blood or saliva test. Some people need to take much more than the recommended 1000 IU/day to meet their needs.
Melatonin is another interesting supplmement, which many people find helpful during the winter months, especially when sleep disruptions are present. Most people can safely start taking melatonin, beginning with 1-3 mg before bed. As always, consult with your ND or MD before taking mealtonin if you are taking any prescription medications.
The Naturopathic Approach
As with any symptom or condition, we work with you to get to the root cause of illness. We asses diet, lifestyle and environment to help you achieve health and wellness. SAD is a condition which responds very well to naturopathic medicine, and has helped many people get through the winter with a little bit more sunshine.
If you have any questions, please don’t hesitate to contact us.
Posted in Naturopathic Medicine, Seasonal Affective Disorder, Vitamin D, depression | Comments Closed
The Naturopathic approach to treating anxiety and depression
Most of us have been affected by anxiety or depression (in some form) at some point in our lives. Stress, worry and sadness are all normal ranges of human emotion, but they sometimes take on greater importance when they start to interfere with our ability to cope with daily life. If you’ve been diagnosed with anxiety or depression, you may take medication, seek counseling, or both as part of your treatment plan. Many patients come to us seeking alternatives to medication, as they are concerned about side effects. As I always say, everything has its place, and some people need a combination of therapies to achieve wellness.
For many people, anxiety and depression is situational. In these cases, there is a distinct cause or event that has led to these feelings, and in these cases, the feelings are temporary. That’s not to say you don’t need help and support, but once the cause is removed (or situation is resolved), the anxiety and depression lift. Most cases of situational depression respond very well to naturopathic therapies. There are several herbs which can help with both anxiety and depression. When used properly, herbal medicines can be very effective alternatives to medication, with fewer side effects. Additionally, supplements such as vitamin D, the B vitamins and essential fatty acids can be used to help alleviate symptoms.
But, what about people who have suffered with anxiety and depression for many years, despite trying various therapies? In these cases, a more thorough assessment is needed to determine if there is an underlying cause. While the term “chemical imbalance” is often described as the cause of depression, it needs to be taken a step further. What has led to the imbalance? Are there nutrient deficiencies? Drug interactions? Chronic stress? Adrenal fatigue? Estrogen Dominance? These are all examples of conditions that need to be addressed.
So, at the end of the day, there are several alternatives that naturopathic medicine can provide in the treatment of anxiety and depression, including clinical nutrition, herbal medicine, acupuncture and lifestyle counseling. But, what is more important is that you find therapies that work for you. Talk to all of your health care providers, and trust that they are all working towards a common goal – your health.
Posted in Naturopathic Medicine, Wellness, anxiety, depression, womens health | 
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Chinese Medicine and Emotional Health
In this 5000 year old system, we practitioners believe that there are many causes of illness. Injury, poor dietary choices, lack of exercise and organ dysfunction can all contribute to physical problems. However, the Seven Emotions can cause a direct injury to the bodily processes. The Seven Emotions are: anger, fear, fright, grief, joy, worry and pensiveness. Let’s take a look at how these emotions interact with the energy of the body:
1. Anger moves upward. I’m sure we can all confirm this as many of us feel a rush to the head or get a headache when we are angered. Other symptoms that can occur are raised blood pressure, blurry vision, dizziness and/or even stroke.
2. Fear moves downward. We’ve seen in movies where someone gets scared and wets themselves. Fear can also affect other systems reflecting in anxiety and/or confusion.
3. Fright moves in all directions (scatters). This can be seen in depression, confusion, lack of courage and/or can lead to outbursts of anger.
4. Grief makes us weak. When we are sad, we feel weak and vulnerable. This can also cause shortness of breath, excessive crying, frequent colds and/or skin conditions.
5. Joy is not a problem per se. Excessive joy, or over-excitement/mania, surprisingly slows everything down. Symptoms include: palpitations, insomnia, unclear thinking and heart attack.
6. & 7. Worry and pensiveness tie us up in knots. Overthinking, brooding and rumination all lead to a weakening of digestive processes and what they represent. Poor digestion, prolapse of organs and poor sleep are some of the symptoms that can occur.
As we can see, Chinese Medicine closely relates emotions with health and wellbeing. When treating patients, I can’t help, by nature of the acupuncture points, but not treat a person on a physical and emotional level at the same time,