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Nervous System 3 -Depression (DEPRESSION (CAUSES (Exposure to certain…

- - - - Disorders involving the hypothalamicpituitary-adrenal
        axis or thyroid are especially likely to produce
        changes in mood
        
        Addison disease
        
        Cushing disease
        
        hyperthyroidism
        
        hypothyroidism
        
        prolactinomas
        
        hyperparathyroidism
    - - personality disorder
      - SAD
  - - - reserpine
      - beta-blockers
      - cocaine
      - amphetamine, narcotics, and alcoho
  - - - IL-1
      - IL-6
      - TNF-alpha
  - - - High tyramine foods to be avoided with
        MAOI’s
        
        Oxo, marmite, bovril, vegemite
        – High yeast products
        – Fermented soy extracts
        – Red wine
        – Mature cheese
        – Broad bean pods
        – Pickled herring
        – Caffeine
        
        – Game meats
        – Beer
        – Processed, pickled, aged meat
        – Bananas
        – Avocado
        – Liver
        – Fish
        – Chocolat
        
        High amounts of tyramine may cause a dangerous rise in blood pressure, the first sign
        of which is a throbbing headach
    - - Antidepressant effects can still linger in the system 2 weeks after
        discontinuation, so care must be taken before introducing any new
        nutrients, drugs or dietary changes that may interact still with the
        medication
  - - - The "aggression-turned-inward" construct, which, although apparent in many clinical cases, has no
        substantial proof
      - The "loss model," which postulates that depression is a reaction to the loss of a person, thing, status, selfesteem,
        or even a habit pattern
      - The "interpersonal relationship" approach, which uses behavioural concepts (i.e., the person who is
        depressed uses depression as a way of controlling other people (including doctors). It can be an extension
        and outgrowth of such simple behaviour as pouting, silence, or ignoring something or someone. It fails to
        serve the need, and the problem worsens
      - The "learned helplessness" model, which theorizes that depression is the result of habitual feelings of
        pessimism and hopelessness
      - The "biogenic amine" hypothesis, which stresses biochemical derangement characterized by imbalances
        of biogenic amines
    - - The newer model is now that is a combination of HPA dysfunction, inflammation and insulin
        resistance in combination with environmental triggers
  - - - Nutrient deficiency or excess
        • Drugs (e.g., prescription, illicit, alcohol, caffeine, nicotine)
        • Hypoglycemia
        • Hormonal derangement- thyroid, adrenal, reproductive
        • Allergy or intolerances
        • Environmental factors
        • Microbial
  - - - Neurological implications:
        
        Reduced brain-derived neurotrophic
        factor (BDNF) and resultant
        hippocampalatrophy
        
        Brain insulin resistance
        
        Upregulation of N-methyl-Daspartate(NMDA)
        receptor excitoxicity
        
        Reduced serotonin activity
      - Clinical implications:
        
        Excessive release of free fatty acids
        
        Increased platelet aggregation
        
        Increased hepatic secretion of VLDL
        and decreased LDL uptake
        
        Insulin resistance
        
        Significantly higher risk of coronary
        events
  - - - an affinity
        to nervous tissue
    - - In one study patients were injected with bacterial lipopolysaccahride endotoxins
        (LPS)
        • Endotoxin administration caused a profound transient physiological response
        with dose-related elevations in body temperature and heart rate, increases in
        plasma interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α and IL-1 receptor
        antagonist (IL-1ra), salivary and plasma cortisol, and plasma norepinephrine
        • These changes were accompanied by dose-related decreased mood and
        increased anxiety levels
- - - - Unfortunately, BH4
        is not currently available commercially
        
        BH4
        synthesis is stimulated by
        folic acid, vitamin B12, and vitamin C, it is possible that increasing these vitamin levels in the brain may
        stimulate BH4
        formation and the synthesis of monoamines like serotonin
  - - - Women in the lowest tertile of red blood cell folate (RBC) were 1.7 times more likely to be
        depressed than those in the highest tertile