down in the dumps: depression, inflammation and botanical ... · depression, inflammation and...

5/16/2016

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DEPRESSION, INFLAMMATION AND BOTANICAL INTERVENTION

(ALMOST DR.)

LYDIA ANNE M BARTHOLOW, PMHNP, CARN-AP

Down in the Dumps: depression, inflammation and

botanical intervention

Who the hell am I?

Agenda

Ancient news Monoamine hypothesis

Psychopharm minute: allopathic antidepressants

Inflammation and Depression 101

Vehicles Allostatic load: Stress & Trauma BDNF and Neurotrophins Epigenetics Food Lifestyle Thoughts

Interventions

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Agenda

Ancient newsMonoamine hypothesisPsychopharm minute: allopathic antidepressants

Inflammation and Depression 101 Vehicles

Allostatic load: Stress & Trauma BDND and neurotophins Epigenetics Food Lifestyle Thoughts

Interventions

Addressing the monoamine hypothesis

SSRIs SNRIs Other common ADs

Prozac Effexor Wellbutrin

Zoloft Cymbalta Mirtazapine

Celexa Pristiq AMT/NRT

Lexapro

Paxil

Luvox

Your psychopharm minute

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Agenda

Ancient news Monoamine hypotheiss Psychopharm minute: allopathic antidepressants


Allostatic load: Stress & TraumaBDNF and NeurotrophinsEpigeneticsFoodLifestyleThoughts

Interventions

Inflammation and depression: 101

Monoamine transporters (receptors) influenced by neuroinflammation

Impaired neuroplasticity

HPA axis dysregulation via inflammation

Agenda




Interventions

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Vehicle: Allostatic load

Stressor or Threat:(cop in rearview mirror)

Amygdala

attaches fear to stimuli

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AmygdalaHypothalamus



Direct stimulation of fight or flight neurons

Adrenal Glands




Adrenal Glands

cortisoladrenaline/

catecholamines

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Adrenal Glands

cortisol

adrenaline/

catecholamines

-- immune system suppression-- suppression of inflammation-- water retention-- hyperglycemia/insulin resistance-- muscle breakdown-- fat redistribution-- decreased gastric integrity-- removal of calcium from bones-- thyroid dysregulation

-- pupil dilation-- sweat-- muscle contractility-- increased HR-- increased BP-- blood flow away from stomach -- bloood flow away from brain (30 IQ points) -- blood flow to vital organs-- increased blood sugar

effects of long term cortisol…

-- immune system suppression/suppression of inflammation:

-- water retention:

-- hyperglycemia/insulin resistance:

-- muscle breakdown:

-- fat redistribution:

-- increased gastric juices:

-- decreased gastric integrity:

-- removal of calcium from bones:

-- thyroid dysregulation:



-- water retention:








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Th1

Th2

Systemic inflammation via imbalance

Neuronal Inflammation

Who is stressed out?

Not you, right?

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White folks

Cisgendered folks

Christian folks

Higher SES

Straight Folks

Folks of Color

Transgender folks

Non-Christian folks

Lower SES

LGBTQI Folks

Privilege Oppression

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Agenda




Interventions



-- water retention:








a quick note on

BDNF

BDNF is a cute little brain helper in the neutrophin family.

Cortisol = BDNF

BDNF = Hippocampalatrophy

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Adrenal Glands

cortisoladrenaline/

catecholamines

Hippocampusnegative feedback

Hypothalamus

Agenda




Interventions

Epigenetics

The study of heritable changes in gene expression that are caused by factors such as DNA methylation(primarily) rather than by a change in the sequence of base pairs in DNA itself.

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5-HTTLPR

Serotonin-transporter-linked polymorphic region

Two alleles: short (s) and long (l)

S + hypercortisolemia = downregulation of 5HT receptors = depression, “neurosis”, PTSD

D. A. Collier, G. Stober, T. Li, A. Heils, M. Catalano, D. Di Bella, M. J. Arranz, R. M. Murray, D. Bengel, C. R. Muller, G. W. Roberts, E. Smeraldi, G. Kirov, [P. Sham & K. P. Lesch (December 1996). "A novel functional polymorphism within the promoter of the serotonin transporter gene: possible role in susceptibility to affective disorders". Molecular Psychiatry 1 (6): 453–450.

Agenda




Interventions



-- water retention:








http://en.wikipedia.org/wiki/K._P._Lesch

http://en.wikipedia.org/wiki/Molecular_Psychiatry

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Gastric Permeability?

Microvilli

Intestinal Lumen

Tight Junctions

Blood Flow

Intestinal Mucosal Cells

Are foods inflammatory?

High Insulin levels = inflammation!Omega 6s (linoleic acids) Omega 3s (alpha-linolenic

acids)

EPA

DHA

Anti-inflammatory

With perfect liver function!

Arachidonic Acid

Pro-inflammatory

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Agenda




Interventions

Do you love Netflix as much as I do?

Screen time

Sleep debt

Prolonged sitting

Unhealthy relationships

And so many more!

Agenda




Interventions

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Agenda

Ancient news

Monoamine hypotheiss

Psychopharm minute: allopathic antidepressants

Inflammation and Depression

101

Vehicles

Allostatic load: Stress & Trauma

BDNF and Neurotrophins

Epigenetics

Food

Lifestyle

Thoughts

Interventions

Interventions: Behavioral

Cut down on screen time Esp. 1 hr prior to sleep

More Vitamin N

More fun

More sleep

But not over 10 hrs

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Interventions: behavioral

Mindfulness – the ultimate in anti-inflamatoryactivity Yoga

Meditation

Spiritual practice

Coloring books

Psychotherapy Increases neuroplasticity

Decreases (hopefully) inflammatory thoughts

Interventions: Nutritional

Low glycemic diet

High nutrient density

Increase healthy fats – yup, even saturated ones

Gluten inflammatory triad: psych, joints, GI

Dairy must go for some

Interventions: Nervines

Scutellaria Affects GABA in the CNS, aids in raising the threshold for

Fight or Flight response

Avena CNS nutritive tonic Hippocampal health?

Eschscholzia californica Gabanergic effects (see Scuttelaria) Core pain?

Pedicularis Alters the cyclical cycle of F/F response

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Adrenal Glands

cortisoladrenaline/

catecholamines

Anterior Pituitary

Nervines

Scutellaria Affects GABA in the CNS, aids in raising the threshold for

Fight or Flight response

Avena CNS nutritive tonic Awesome “adaptogen” for adrenal exhaustion Hippocampal health?

Eschscholzia californica Gabanergic effects (see Scutellaria) Core pain?

Pedicularis Alters the cyclical cycle of F/F response

Anti-inflammatories

Curcuma longa Cox 2 inhibitor

Stops inflammatory cascades w/o inhibiting healing

Studies show it increases BDNF – what do you know?!!!

Glycyrrhiza glabra and spp.?

Prolongs life of cortisol: why is this good? Why is it bad?

Leaky gut?

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Anti-inflammatories

Zinjiber officinale

Boswellia

Cinnamonum

Allium sativum

Salvia

Questions? Comments?

www.lydiabartholow.com

[email protected]

http://www.lydiabartholow.com

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