An Endocrinologist Can Often Reverse Depression By Correcting Hormone Deficiencies
Linda is a 46 year old woman who has always been full of energy and enthusiasm for life. She has a family, a career, a wonderful husband but yet she finds that in recent months she has become increasingly sad, depressed and irritable. She finds herself making excuses to not attend social functions and is becoming increasingly withdrawn. The world seems to be turning gray and her mind seems dull and foggy.
Charles is a 55-year man who has worked hard all his life and has finally gotten to the point in his career where he has "made it."
He has a wonderful family. Yet he finds that he sits in front of the television staring into space flipping channels. It somehow seems so hopeless and pointless. Charles drags himself to work everyday because he has all these responsibilities. He wishes he could just leave it all and be free. What both of these individuals have in common is depression. Depression affects millions of Americans.
If Linda or Charles goes to a doctor, the most typical outcome is that they will walk out with a prescription for Prozac, Zoloft or the latest "SSRI" type of antidepressants.
Without question, these medications play an important role in the management of serious depression. However, they are often prescribed too readily without the patient undergoing a complete medical evaluation.
Researchers at the University of Texas Medical Center in Houston studied 100 patients admitted to a psychiatric hospital. Each patient underwent a thorough medical evaluation and for nearly half of them including 13 of the 30 depressed patients, a medical illness was found to be responsible for their psychiatric condition. One-third of the 100 patients experienced dramatic and complete clearing of their psychiatric symptoms when medical treatment was initiated. The link between psychiatric symptoms and physical causes, especially endocrine disorders, has been confirmed by numerous researchers.
Is there some conspiracy on the part of doctors to put everyone on antidepressants? Of course not. Doctors are, on the whole, compassionate caring professionals who want to do the right thing for their patients. The issue, pure and simple, is time. In this era of managed care, physicians are forced into spending less and less time with their patients. They are often penalized for ordering expensive laboratory testing. When a busy doctor is rushed for time, it is much quicker to simply hand the patient a prescription and go on to the next patient. Furthermore, some endocrine or nutritional problems may be subclinical and require the expertise of an endocrinologist, a physician trained in hormone disorders that is more sophisticated at detecting early or borderline metabolic problems.
Deficiency of thyroid hormone is probably the most readily known endocrine cause of depression. Typically, the person has symptoms of fatigue, dry skin, excessive sleep requirements, and weight gain. Estrogen or progesterone deficiency in women during perimenopause or menopause is often associated with depression.
In younger perimenopausal women, the depression may worsen in the one or two weeks preceding the menstrual cycle. PMS or premenstrual syndrome is a very real medical illness that is very responsive to therapy. After menopause, if the woman is either not on hormone therapy or is not on appropriate hormone therapy, the symptoms of depression can become more constant. In addition to depression, the menopausal woman may suffer from insomnia, fatigue, poor memory and concentration, anxiety, increased weight gain at the waistline and Fibromyalgia.
While not widely recognized, men can go through a type of male menopause called andropause. It has been estimated that with the aging process, about 40% of men experience at least some decline in testosterone production. Testosterone deficiency is also associated with depression. Other symptoms include insomnia, poor memory and concentration, weight gain especially in the abdominal area, fatigue, and irritability. Most all of these symptoms respond to a regimen of physiologic testosterone replacement.
Most recently, growth hormone deficiency has been recognized as a factor, which can lead to depression. Heretofore, it was believed that growth hormone was only needed in children to regulate growth, hence the name. Growth hormone levels tend to decline with aging and this phenomenon may be related to the increased incidence of depression seen in older individuals. Other symptoms of growth hormone deficiency include fatigue, insomnia, muscle loss or weakness, sagging facial muscles, and a protuberant belly with increased abdominal fat.
Deficiency in cortical, while less common can be associated with depression. Individuals with low cortisol often appear weak and frail, tire easily and may have weight loss or digestive disorders.
While total cortisol deficiency is life threatening and easily diagnosed, partial cortisol deficiency can be difficult to diagnose if the physician is not skilled in recognizing the signs and symptoms.
The good news is that depression is very treatable. Therapy can include nutritional supplements, bioidentical hormone replacement, exercise, psychotherapy and/or prescription drugs. The key is making a proper diagnosis so that therapy can be customized to the needs of the patient. Depression is not just a "chemical imbalance". Rather, it is a multi-factorial disorder that requires careful evaluation before committing an individual to long-term antidepressants.