4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 1

44 Things to Check Before Taking an Antidepressant

hat if I told you that the vast majority of the time, taking an

antidepressant for depression is like taking a Tylenol for a shard of glass in your foot. Wouldn’t you rather just remove it? You might not even

know that removal is an option if you believe that depression is an inherited

disease you’re destined to struggle with for life.

Depression (and anxiety and OCD and ADHD…) is a symptom of mismatch,

often bodily in nature. Healing the body can be the first and most critical step to reversing the diagnosis and the experience of low moods, hopelessness,

irritability, sleep disturbance, brain fog, and fatigue.

Psychiatry, unlike other fields of medicine, is based on a highly subjective diagnostic system. Essentially you sit in the office with a physician and you

are labeled based on the doctor’s opinion of the symptoms you describe. There are no tests. You can’t pee in a cup or give a drop of blood to be

analyzed for a substance that definitively indicates that “you have

depression” much in the way a blood test can tell you that you have diabetes or are anemic.

This is why it’s all the more important to explore reversible causes of what we are calling depression.

Here are four critical considerations before you hand that prescription slip to

your friendly pharmacist.

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4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 2

Thyroid madnesshrough my own experience with Hashimoto’s thyroiditis, I have learned that this chronic autoimmune condition can look psychiatric, but that it

is also reversible. I’m living proof!

Thyroid imbalance can cause anxiety, depression, cloudiness, weight gain,

poor concentration in addition to cold and exercise intolerance, dry skin, and

hair loss. You’re wearing socks to bed, pooping once a week, and penciling in your eyebrows. In postpartum thyroiditis, this presentation is typically

preceded by a period of hyperthyroidism where women can feel over-energized, suffer from insomnia, diarrhea, anxiety, and precipitous weight-

loss – these are the women who “bounce back” quickly after the baby only to

be peeling themselves off the ground 9 months later. For those already diagnosed and on a synthetic T4 compound like Synthroid, adjustments to

combination hormones may be needed.

You wouldn’t want to take Zoloft for a treatable thyroid condition, would you?

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4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 3

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Just a spoonful of sugar?f you’re anything like the rodents who find sugar to be more addictive than cocaine, then you are living under the influence. You are “hangry” all

the time, irritable and anxious when you can’t eat immediately.

It’s in almost every packaged food. Seriously. Look for it and you will find it. It

may come with different labels — cane sugar, crystalline fructose, high

fructose corn syrup — but it’s all sugar. This inflammatory and supersensory stimulant is behind much of what we are calling “psychiatric” including panic

attacks, brain fog, fatigue, and depression. Blood sugar instability comes in the form of insulin resistance and diabetes as well as reactive hypoglycemia.

The good news is that it is diet reversible in a matter of weeks!

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4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 4

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Foods that freak your brain outwo of the most processed foods are wheat and dairy. They are also in just about every bite an American takes. Increasing evidence is pointing

a finger at these foods and their potential to cause mood and cognitive symptoms including depression. Gluten, soy, and corn have been identified

as allergenic foods and a leading speculation as to how these foods became

and are becoming more allergenic is the nature of their processing, hybridization, genetic modification, and pesticide spraying rendering them

unrecognizable and triggering to our immune systems. Gluten (and processed dairy), when digested, result in peptides that, once through the

gut barrier, can stimulate the brain and immune system in unpredictable

ways. We are now beginning to understand how and why they are so addictive and why it may be so worth it to detox!

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4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 5

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A simple vitamin deficiency?ne of the most remarkable papers I have read in the psychiatric literature was about a 57 year old woman who was treated with

months of both antipsychotic and antidepressant medications and given two rounds of electroconvulsive treatment before anyone bothered to check her

vitamin B12 level.

Her symptoms were years in the making including tearfulness, anxiety, movement abnormalities, constipation, lethargy, and eventually perceptual

disturbances (hearing her name called) and the ultimate in severe psychiatric pathology: catatonia. Despite her inpatient treatment, she remained suicidal,

depressed, and lethargic.

If this is not a wake up call to the average psychiatric prescriber, I’m not sure

what is. Much of what we attribute to serotonin and dopamine “deficiencies”

melts away under the investigative eye of a more personalized style of medicine that seeks to identify hormonal, nutritional, and immune

imbalances that can “look” psychiatric in nature.

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Within two months of identifying her deficiency, and subsequent B12 treatment,

she reverted to her baseline of 14 years previous, and remained stable with no

additional treatment.

4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 6

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Get to the rootefore you consider a psychiatric prescription, you may also want to look at your other prescriptions including birth control, statins, Tylenol,

and antibiotics.

Take the invitation that your symptoms are offering you – begin to

explore what could be driving your struggle and find a new kind of health

through a truce with your body.

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4 Things to Check Before Taking an Antidepressant

Copyright © 2018 – Kelly Brogan MD 7