What is...NEUROTRANSMITTER IMBALANCE?

[Depression, anxiety, fatigue and sleeplessness aren't just in your mind. An imbalance of molecules in your brain could be the cause.]

Joe has been under tremendous pressure of late. His marriage of fourteen years is going through a rocky time. His work stress is about the same, but it seems so much more than usual. Fatigue in his body seems to sink deeper with each passing day, yet his nights are fitful, interrupted, and non-rejuvenating. Piercing through the bone deep fatigue is the heavy hand of an anxiety that just won't quit. He should be too tired to be anxious and his short temper is causing problems with his colleagues. In the past few weeks pants are fitting much too tight. Probably up about twenty pounds, but food is the only sense of comfort he has these days. Oh well, weight is the least of Joe's problems. Life seems very bland without any of the excitement of earlier years. It seems as if he's on a treadmill just barely keeping up. One misstep and he'll be flat on his face. Some life this turned out to be! The bitterness of this trap is stealing his spirit.

Joe's situation is not uncommon in this fast-paced world. We've all either been there or know someone who has. If left unchecked or uncontrolled, Joe's malady will lead to further problems. He'll probably see his blood pressure rise steadily until his doctor prescribes a blood-pressure pill to go along with the one he's taking for his high cholesterol. Down the road he's headed for sugar diabetes and heart disease. Then more prescriptions for anti-depressants and anxiety pills. In a few short years, the medicine cabinet has gone from empty to almost ten different pills a day! How did life get so complicated and unhealthy?

The process of events described above is a result of our body's normal reaction to an abnormal situation. This most wonderful machine, the human body, does its best to accommodate to changes and stresses, while trying to maintain an internal balance. Fortunately for us, the human machine has built-in "software" to help us stay balanced. When you are dehydrated, you feel thirsty. When your blood sugar is low, you feel hungry. When you need rest and renewal, you feel sleepy. These are all very powerful urges because they arise from the survival instinct. Survival is the most powerful motivator that the human body knows. If you've ever tried to go without food, water, or sleep for an extended period of time, you know what I mean! The drive to survive is a tough one to try to ignore.

So what exactly happened to the man in the introduction of this article? Most of his problems center on neurotransmitters. Neuro what? Neurotransmitters are molecules that regulate brain function.

These are the chemicals that can elicit or accentuate emotion, thought processes, joy, elation, and also fear, anxiety, insomnia, that terrible urge to overindulge in food, and much more. Initially, for Joe, the stress started to drain his serotonin levels (serotonin is one of the fifty or more neurotransmitters). Serotonin, in part, controls the sleep-wake cycle; it regulates mood and appetite and, in the bowel, exerts some control over regularity. For Joe, his lack of serotonin contributed to his blue moods (or depression), his insomnia, and his food cravings that led to being overweight.

Interestingly, lack of serotonin leads the body to crave or desire carbohydrate foods like bread, pasta, potatoes, cookies, cakes, doughnuts, etc. This craving appears to fall under the regulation of the survival instinct. Have you ever tried to ignore this craving with a plate of chocolate chip cookies sitting in front of you? Near impossible. It's the "Betcha can't eat just one" syndrome!

Serotonin is the "contentment hormone" because, in adequate amounts, it leaves you just that -- very content. When you're content, you're not looking for a piece of bread or a sweet dessert after a full meal. You're full; you're content, no other cravings. Wisely, the body craves these carbohydrate foods because they temporarily raise the serotonin levels, but at the price of too many empty calories. His body instinctively was trying to balance and regulate and, in the short term, it worked. But in the long term the weight gain was disastrous!

Much of Joe's anxiety and quick temper were from other neurotransmitter players, specifically norepinephrine (or more commonly known as noradrenaline). Joe's norepinephrine was skyrocketing out of control, in part due to lack of balance from serotonin. Elevated norepinephrine will leave you feeling jittery, much like drinking too much coffee. No wonder the poor guy had trouble sleeping! It contributes to anxiety or a restless feeling like "ants in your pants," and can also leave you feeling irritable and cranky. Sound like anyone you know? Along with too much norepinephrine goes insufficient epinephrine (previously known as adrenaline) which can rob your energy until fatigue has set in bone deep. If you have some element of fatigue, you have insufficient epinephrine.

The last of the major neurotransmitters is dopamine. Dopamine has to do with the sleep-wake cycles, mood, and the joy of life. If you have enough dopamine, you have a zest for living. This zest for living, taken to an extreme, is called hedonism or over-indulgence. The ancient Greeks used to be big on having parties and eating and drinking too much. Cocaine and speed abuse are two modern examples of hedonism, which greatly raise brain dopamine levels.

Other maladies that are under the control of neurotransmitters and may respond to balancing include: nicotine craving, fibromyalgia, PMS, irritable bowel, anorexia, caffeine craving, attention deficit disorder (ADD), bulimia, migraine headache, panic attacks, alcohol craving, leg cramps, constipation, obsessive/ compulsive disorder, aggression, and impulsivity. So you can see that a few small molecules in the brain were responsible for Joe's insomnia, anxiety, fatigue, depression, weight gain, irritability, lack of ambition, and carbohydrate craving. If we could only open up his head and pour in a little serotonin and dopamine, his troubles would be all over! Well, it's not quite so easy, but medical researchers have found ways to manipulate the body's stores of neurotransmitters.

The earliest medicines were called the tricyclic anti-depressants. They were fairly effective but still very crude in their actions. The newer class of mood modulators started with Prozac, a name that is very well known to us all. These newer medicines helped to raise serotonin, thereby helping to balance neurotransmitter levels. Of course, there were multiple side effects, which were often reported in the newspaper headlines (some true, but many were bogus accusations). All in all, they turned out to be fairly safe drugs but still had their flaws and shortcomings. The selective norepinephrine re-uptake inhibitors are the newest class of mood modulators and, as the name implies, regulate serotonin and norepinephrine.

Other therapies for Joe's malady might include counseling, exercise, stress reduction, and diet. They are all known to benefit the brain neurotransmitters in a positive way. It's just What the doctor ordered, right? Maybe so but...

They are quite worthy goals, but when you're in a slump like Joe's it's the farthest thing from your mind. Have you ever tried to go home and exercise after a very stressful day? You just want to jump right up and get into a big heavy workout! Only if the workout includes a bag of chocolate chip cookies and the TV remote! This type of reaction occurs because making the necessary changes also incurs stress. It just makes the plate too full. Stress has drained your body of any will to motivate! Unfortunately (or maybe fortunately), the body doesn't distinguish emotional stress from physical stress from intellectual stress. The same bodily reaction occurs to all three, with the same devastating final result.

So what else is there to do except to fall into a hopeless spiral of increasing stress and increasingly poor health? The answer is in precursors. Precursors are what the body uses to make neurotransmitters from substances that are readily available in the diet, mostly from protein sources. The dietary precursors to neurotransmitters are amino acids, vitamins, and minerals. These are readily combined into specific supplements that, when used properly, do a very nice job in neurotransmitter modulation. They can help to raise serotonin and dopamine levels, thereby balancing themselves, as well as nephrine and norepinephrine. The use of amino acids to balance neurotransmitters is not well known or widely accepted in the medical community. Nonetheless it is a fine program for giving people like Joe and others some excellent results and great relief. The amino acid supplements are quite safe (they are the building blocks of protein). In addition, they are very effective in providing relief from suffering due to neurotransmitter imbalance. To properly regulate these supplements requires some special training and experience. They can also be safely used in conjunction with most medicines.

So now Joe (and anyone else) has a safe and effective alternative to effect neurotransmitter balance. Stress, anxiety, depression, irritability, insomnia, overeating, weight gain, carbohydrate cravings, fatigue, and poor motivation now all have an appropriate therapy.

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By John B. DeCosmo, D.O.

John B. DeCosmo, D.O. is an osteopathic physician board certified in family practice. He is medical director of Millennium Medical, a holistic healthcare facility specializing in the integration of medical and alternative practices. St. Petersburg. (727) 541-2675.

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