By Tracy B. Williams
It is finally spring in Boston, and Liza Lane Knowlton is taking advantage of the beautiful weather. She sat confidently on a bench overlooking the Public Garden—one of her favorite places in the city. Her bright, blonde hair glistened in the sun. She wore a big smile, her braces sparkling.
Knowlton is happy, but just a year ago she was in a bad place mentally. “I suffered from severe depression from the fall of 2011 to January of 2014,” she said. During those three years, she noticed the quality of her mental and physical health diminishing.
She went to multiple doctors and specialists. “I’ve been to gastroenterologists, endocrinologists, gynecologists, and multiple others.” None had an answer for her worsening conditions.
Knowlton finally decided to take her health into her own hands. She did some research, and looked for more holistic, natural ways to treat her depression. This led her to the Rothfeld Center for Integrative Medicine in Waltham, Mass. “They test you for everything there,” she said. At the center, doctors will test for everything your conventional medical doctor will, but they interpret the tests differently. Her results from the center showed problems with her adrenal gland and her hormones. They were depleted.
She finally had peace of mind. But now she had to get her body back on track. Knowlton returned home with all the information she needed to move forward with her health.
Visit the website for the Rothfeld Center for Integrative Medicine at http://www.rothfeldcenter.com/
Now, Knowlton is a fierce supporter of holistic means to treat symptoms. She calls it “thoughtful medicine.” Six months ago, she started a group through Meetup—an online platform where people can find others with similar interests.
The Peaceful Warriors group meets once a week, on Wednesday evenings. It is a support group for others struggling with depression and anxiety, and are looking to taper off of medications. Each week, Knowlton engages the group and leads a discussion on natural solutions for depression. She shares what worked for her, and gives suggestions for others to try.
Before trying self-care, Knowlton was on a cocktail of medications—up to three different drugs, each used to treat a symptom of depression. “I was taking one for sleep, one for anxiety, and one for the depression,” she said.
Knowlton said she felt much worse on the drugs than she did before. “I felt numb. My emotions were watered down,” she said. To get extra help, she made multiple trips to emergency rooms and even spent time in and out of psych wards. With depression, a depersonalization happens, when a person feels separate from their environment. Knowlton said she could no longer enjoy the things she used to love, including sitting in the Public Garden on a nice day. “I was so out of it, I thought I would die,” she said.
One of her prescribed medicines was Remeron, or the generic Mirtazapine. Remeron treats major depressive disorder by targeting unbalanced chemicals in the brain. But like most prescription medications, it comes with its own set of side effects. For Knowlton, it stimulated her appetite. She would often binge on ice cream and cookies— “chocolate chip cookies to be exact!” She said. “I think weight and obesity can be tied to depression or eating disorders. I gained a lot of weight while depressed.”
She thinks these foods give people a temporary source of comfort and safety. “The problem is, they make us feel more depressed later on, and of course they cause us to gain weight, which is not good,” she said.
During treatment, Knowlton experimented with her diet first, eliminating certain foods. Most of her depression symptoms dissipated almost immediately after cutting out processed foods, grains, and sugary drinks and foods—including her beloved chocolate. But, healthy fats, she said, are good for you. After all, our brains are 60 percent fat. “Fat doesn’t make you fat. Sugar makes you fat,” she said.
“There’s something in chocolate called PEA–phenylalanine,” Knowlton said. PEA is an amino acid found naturally in breast milk and is added to foods and drinks for its antidepressant effects. “So, it’s not surprising that we binge on chocolate and other foods containing this amino acid,” she said.
Some people even take a phenylalanine supplement, although she said it can interact with a lot of antidepressant medication and can have various adverse effects depending on a person’s metabolic profile.
In addition to the weight gain, Knowlton’s mood deteriorated during her time on the psych meds. “One day,” she said, “I destroyed our printer.” She threw her family’s HP printer down the stairs towards her husband after he criticized her lack housekeeping. Her two sons, witnessed the event. “I was at the end of my rope,” she said.
For those like her who want to kick their prescription medication habit, “I would like to emphasize again the importance of doing a slow taper,” Knowlton advised. “I know the frustration of having to stay on the drugs when you want to be off, but just think of it this way: every time you take that slightly smaller dose you are closer to the finish line. In the meantime, keep streamlining your diet, your exercise and your mental health solutions.”
Knowlton is in a good place now, but still hits some rough patches every now and again. “I have definitely experienced depression coming back and hitting me hard and at this point I feel that it is the residual effects of overmedication. It can take up to six months or longer to get it all out of our systems,” she said.
The Case for Drugs
For others, maintaining the holistic lifestyle is neither acceptable nor affordable. Regarding their physical and mental health, they would rather stick to more conventional methods.
Completely tapering off prescription medication will not work for everyone, however. Sarah Sassone has Bipolar I Disorder, also known as manic-depressive disorder. “I would never consider alternative methods for treating my mania,” she said.
Sassone began feeling different her junior year of college, around the age of 20. “I was diagnosed with depression in March after my grandpa died. I was depressed for a year. When my depression leveled out, I was just very very manic all the time,” said Sassone.
Bipolar I is classified by severe manic episodes with mild to moderate depression. The disease is determined by abnormal and dramatic shifts in mood and energy that can affect a person’s quality of life. Sassone is one of about five-to-seven million adult Americans living with the mental illness. Although Sassone has not felt depressed in a while, she still suffers from frequent manic episodes. “The thing about mania is, you do it in the moment, and then you black out. It’s like getting really really drunk, and then falling asleep and not remembering what happened,” she said. “You’re overly happy, but at the same time, it’s unhealthy to be that happy.”
A Physician’s Perspective
Dr. Kira Alatar, a practicing family physician, sees the normal ups and downs in her bipolar clients. Depression is the most common symptom of bipolar disorder in her patients, but manic episodes can also be troubling. “They [the patients] feel great, like they’re on top of the world, but they get themselves into lots of trouble,” Alatar said. For many with the disease, mania feels dangerously good. But manic episodes can be potentially dangerous as well.
Patients are so energized during mania that they can operate on little to no sleep. They will also have several erratic days comprised of daredevil behavior, spending sprees, and sexual sprees.
Insomnia, feelings of irritability, and having very little patience for anything are other effects of Sassone’s mania. “When I’m manic, I just don’t listen a lot,” Sassone said. She described some episodes as feeling like she has ADD. In her long, four-hour classes, she has to frequently get up and walk around because she’s feeling so energized.
This can all be controlled however, with the correct dosage and administration of medications. “I don’t know where I’d be,” said Sassone. “I’d probably be in a mental institution without my meds.”
She has never considered tapering off, and has a hard time understanding why anyone would. “I have to be on my meds,” said Sassone. “I don’t know what I would do.”
She has experienced certain problems with medications but feels comfortable enough to speak to her psychiatrist about other solutions. One medication she has had problems with is Trazodone, an antidepressant. The medication is known for making people very sleepy, and is often prescribed for those suffering with insomnia. “I was cloudy all day and wasn’t able to think,” Sassone said. Abilify and Lithium make you gain weight and said she experienced night terrors while taking Lexapro.
The combination of medication is different for every person. It takes time and patience to figure out what works, she said. “It’s a lot of trial and error.”
Alatar said that prescription drugs are completely safe for managing moods. The only other supplement she recommends is St. John’s Wort, which has the same properties of SSRIs (serotonin-specific re-uptake inhibitors—a class of compounds used in the treatment of depression and anxiety disorders) such as Paxil and Zoloft. This supplement does what other drugs do, which is to increase the level of serotonin in the brain. “I do not recommend combining the supplement with prescription medication,” she said. “It is better to stick to either one or the other.”
Knowlton still distrusts prescription medicine and especially the motives behind pharmaceutical companies. She will stick to her special diet and supplements. Companies will list ingredients on labels, “but there’s no list of ingredients on pill labels. It’s all chemicals. Why would that make you feel good?” she said.