tag:blogger.com,1999:blog-3045634714760830992.post5824181711678460974..comments2023-06-05T11:51:38.383-04:00Comments on Evolutionary Psychiatry: Depression 3 - Not Quite What It Used to BeAnonymoushttp://www.blogger.com/profile/04429177284200775781noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-3045634714760830992.post-47405574244888486832012-08-23T01:56:47.784-04:002012-08-23T01:56:47.784-04:00Fwiw, Stephan seems to have taken down his linolei...Fwiw, Stephan seems to have taken down his linoleic acid/thyroid post.David Mosshttps://www.blogger.com/profile/08508780038542342811noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-78162874501408340832010-09-15T02:11:38.210-04:002010-09-15T02:11:38.210-04:00"The researchers explain that people may stil..."The researchers explain that people may still feel hungry after eating a large steak-their stomachs may be full but their brains may not be producing enough serotonin to shut off their appetites." In your experience, are you more likely to eat 5,000 calories worth of steak in one sitting, or 5,000 calories worth of potato chips or candy??"<br /><br />This makes sense to me because I experienced this! The first month I went paleo/low carb, I wasn't eating any starches or grains like I had been before. I'd eat a generous helping of meat (maybe half pound or 3/4 pound of steak/pot roast/hamburger). After around that amount, you couldn't pay me to eat more of it and the thought of eating more was sickening. HOWEVER, the interesting thing, is that then 5 minutes later my stomach would feel empty and growl-y... BUT my appetite for protein/fat had been satiated. In other words, I felt the physical sensation of stomach hunger but felt a strong compulsion not to eat.<br /><br />So I think they might be right, because in a month I got to the point where I'd feel full mentally and physically. I thought perhaps it was just my stomach getting used to not having the starches and grains expanding and filling my stomach, but perhaps it was the serotonin.<br /><br />I stuck with it because I had confidence in the scientific literature, but there might have been many more who would take the really ravenous feeling I experienced (but a lack of appetite at the same time) as a signal that their body needed carbs after all and would quit the diet.Unknownhttps://www.blogger.com/profile/16112734088391166769noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-2570111924301212342010-07-03T08:26:09.176-04:002010-07-03T08:26:09.176-04:00anne said:
Case report of a patient (37 y/o fema...anne said: <br /><br />Case report of a patient (37 y/o female) with hx of dysthymia and anxiety d/o NOS who began low carb/primal-style diet in mid May and lost approx 20 lbs c/o mild nausea and carbohydrate cravings that she associates with "too high" dose of sertraline. Reduced sertraline from 100 to 50 mg resolved nausea & carb cravings within 2 days. <br /><br />I wonder if this is due to relatively rapid weight loss, and/or better endogenous serotonin production associated with dietary changes? Any thoughts? <br /><br />(heh - btw this patient is ME and I had a couple of carbohydrate-laden beers tonight so this post is probably not as coherent as I'd like!)<br /><br />Emily said: SSRIs like sertraline often cause nausea and carbohydrate cravings. Paroxetine seems to cause the most weight gain, from clinical experience. No one is exactly sure why this happens - though it is thought the antihistamine effect has something to do with it. Psychiatrists prescribe a lot of medicines that cause weight gain - and the more antihistamine and anticholinergic effect there is in the drug (olanzapine and clozapine are extremes in this regard, but paroxetine is also pretty anticholinergic/antihistaminergic), the more the drug seems to cause the weight gain. Something about the antihistamines may affect our insulin (or even leptin?) regulatory system, leading to carbohydrate cravings and then the weight gain. <br /><br />It should be said that the weight gain response is highly variable. Some people (especially depressed emotional eaters) lose weight. A type one diabetic patient on an SSRI had to lower her insulin - her serum glucose dropped - likely because she was much more relaxed. <br /><br />The other thing that comes to mind - since eating "primal style" I am much more aware of tiny alterations in my state of being. I know exactly when my stomach is a touch more upset. I know if I ate something that makes me crave something else. A single glass of wine has a big effect. Maybe you are noticing a side effect that was already happening on the higher dose, but without the non-primal food messing with your system, the side effect becomes clear? Just a thought! Thanks for sharing your experience.Anonymoushttps://www.blogger.com/profile/04429177284200775781noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-56763523055532946832010-07-01T01:17:39.694-04:002010-07-01T01:17:39.694-04:00I took the paper out into the weak winter sunlight...I took the paper out into the weak winter sunlight for a read today and landed back here to say exactly what you said Emily!<br /><br />We are expected to take the authors word for the above as no raw data is provided to allow us to see for ourselves.<br /><br />It strikes me as odd that a study that sets out to see whether a particular diet composition has an effect on mood starts out with one cohort containing more medicated depressed people than the other. Why did they not either choose a cohort of people on depression meds before randomisation, or exclude anyone with diagnosed & medicated depression at selection? This really undermines their conclusions.<br /><br />The other thing that really stood out for me is that they are comparing the effect of low fat vs. low carb. But they add an additional confounding factor by going down to a relatively low energy intake (~1400-1600kcal). I would imagine that the combination of only eating 1500kcal (assuming compliance) and only 20g of carbohydrate per day (1 banana), that I'd get quite depressed too. 20g is very low carb indeed when you compare to the likes of Mark Sisson's Primal Blueprint where he offers 50-100g as the sweetspot for weightloss.<br /><br />Now assuming that everyone in the LC group remained compliant (or both groups for that matter), there is a possibility that persistent low carb at that ketogenic level, combined with low calorie, could lead to depression. And that if you are going to go low calorie (why would you?) a higher carb intake may be required or beneficial from a mental health perspective (or undertaking regular carb refeeding).<br /><br />I have doubts over compliance given that only 30% of energy was supplied to participants and after a time they only received $40AUD per month toward purchasing the appropriate foods. Is there a possibility that those in the LC group turned their diet into one that was closer to the LF group? Except they are now dosing with both carbs & fat and caught in a bit of a no man's land? Hard to tell.<br /><br />Raw weight measurements are also unhelpful in knowing what has occurred with body compositions. I have increased my weight 2kg since going primal - but I am a darn sight leaner now.<br /><br />Overall, too many holes in this one to make it a game changer for me. And the protocol used is quite distant from a low carb primal diet in application (at least the Primal Blueprint variety which is arguably the most user-friendly entry point version - I think Kurt Harris says the PB is the diet you give your vegetarian girlfriend to try!).Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-47465593053588518762010-06-30T21:42:06.667-04:002010-06-30T21:42:06.667-04:00Anne - I honestly think everyone should do a glute...Anne - I honestly think everyone should do a gluten-free diet trial along the way. Some people will be able to tolerate wheat, but many will find some surprising results!<br /><br />Thanks Jamie - I thought the Archives were for purchase only, and I'm working on getting my institutional access returned after a paperwork snafu left me in the land of free full text this week. Major thing that jumps out on the first read - just as Dr. Parker said - " Of the volunteers who began the intervention, 19 (LC group, 13 of 55 [24%]; LF group, 6 of 52 [12%]; P = .10) were taking antidepressant medication. Throughout the intervention, 1 participant in the LC group took more antidepressant medication, and 2 participants took less. The results of the analysis did not change when the participants who were taking antidepressant medication were excluded." Really? No change in the analysis excluding 12% of the study? And those who had such significant mood issues that they sought treatment with medication?Anonymoushttps://www.blogger.com/profile/04429177284200775781noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-30908480686997803912010-06-30T00:21:45.912-04:002010-06-30T00:21:45.912-04:00Full copy of the Brinkworth paper here:
http://ar...Full copy of the Brinkworth paper here:<br /><br />http://archinte.ama-assn.org/cgi/content/full/169/20/1873<br /><br />Will try to have a read in the coming days.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-55918391568012952162010-06-29T11:15:02.628-04:002010-06-29T11:15:02.628-04:00I did not know I was depressed until I stopped eat...I did not know I was depressed until I stopped eating gluten 7 yrs ago. When I gave up gluten I was amazed how wonderful I felt. My brain was clearer, no more depressive thoughts or dark moods. I was amazed in the change. I had not known of my depression as that is the way I always felt. <br /><br />About 2 years ago I discovered problems with blood sugar and went on a gluten free low carb no grain diet. I have not noticed any deterioration in mood. Depression did not return. The only time depression returns is if I get accidental gluten. The smallest amount will make me feel depressed, anxious and agitated. This reaction occurs about 12 hours after exposure and lasts a couple of days.Annehttps://www.blogger.com/profile/16655747133135789559noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-92053371111820416722010-06-28T18:51:22.551-04:002010-06-28T18:51:22.551-04:00Hi Jamie - thanks for sharing your experience. I&...Hi Jamie - thanks for sharing your experience. I've had nothing but positive results from my primal diet, and it has been easy to follow. I'm not extremely strict except at home. If I'm out at a party, I will have a cupcake, for example. I try to avoid too much milk protein, as it upsets my stomach. I promise I'll get to GI illness and anxiety soon! <br /><br />Hi Steve - thanks for the VLC feedback. I did worry after reading the news reports on Brinkworth's study last year if very low carb might cause depression. I haven't had a chance to look at his study in depth, but will do so sometime over the next week. Depakote, an anticonvulsant and mood stablizer, creates ketone bodies in the CNS. (ketogenic diets are a known treatment for epilepsy, and might not be a half bad idea for bipolar disorder, though I'm not aware of any studies.) Depakote is known to stabilize mood a bit on the low side. (Depakote also causes weight gain and PCOS - interesting that it causes the opposite effects as a ketogenic diet in the periphery!)Anonymoushttps://www.blogger.com/profile/04429177284200775781noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-60806354093615855462010-06-28T02:29:56.079-04:002010-06-28T02:29:56.079-04:00Since you asked...
I've been eating low-carb ...Since you asked...<br /><br />I've been eating low-carb for the last 10 months (30 g/day for first four months, then 50-70 g/day).<br /><br />Didn't notice any effect on my mood whatsoever. (Generally good mood, not depressed).<br /><br />A study published about a year ago did upset the low-carb community (forgive me if you already mentioned it above). The major media headline was "Low-Carb Diets Cause Depression."<br /><br />Brinkworth et al put overweight folks on either low-fat or low-carb diet. Mood improved over course of one year in the low-fat, but not low-carb group.<br /><br />If memory serves me well, there were more depressed people at baseline in the low-carb group.<br /><br />-SteveSteve Parker, M.D.https://www.blogger.com/profile/13127995984175635389noreply@blogger.comtag:blogger.com,1999:blog-3045634714760830992.post-21645109022181357432010-06-27T22:03:59.063-04:002010-06-27T22:03:59.063-04:00Emily,
My experience on a primal diet has been si...Emily,<br /><br />My experience on a primal diet has been similar to yours. Part of my pathway to eating primally was the dissolution of my marriage. Knowing I was falling into a black hole after that, I was determined to throw the kitchen sink at my health so that my wheels didn't come right off. I generally feel calm & relaxed on most days, am generally more motivated, and I have a different level of emotional reactivity. Previously I would have been the type to brood and sulk on an issue. However, increasingly, I deal with most things in the here & now. This might be related to an increased sense of self-confidence since changing my lifestyle too.<br /><br />Interestingly, I have gone from being someone on a long fuse (tending toward sulking & depression), to someone who is on a shorter fuse (tending toward being more level but dealing with issues as they come up).<br /><br />In terms of my nutrition patients, anxiety states tend to predominate - though I also tend to see a lot of people with gut issues, so perhaps I have a self-selecting population. I only deal currently with one patient who is on prescription meds for depression (fluoxetine) and she has a mixture of depression and anxiety. With her health history I suspected issues with folate metabolism and sure enough we picked up a MTHFR polymorphism in her. She is slowly adapting over to primal eating and has noticed improvements to the point where she is working with her GP to come off the fluoxetine.<br /><br />There is an expectation amongst many though, that changes in diet that might deal with depression will lead to them boucing off the walls as in being in a mild state of mania. I think your description is perfect - serenity.Anonymousnoreply@blogger.com