“You’re just being hormonal!” We’ve all heard this in some context. On the one hand, it’s a dismissive phrase implying someone’s behaviour is irrational. On the other, there may actually be some truth behind it. Dr Sly Nedic explains why.
Are you feeling depressed and anxious? Are you experiencing a lack of motivation, mood swings or having trouble concentrating? What about ‘that time of the month’ when you become short-tempered and irritable, seeking instant relief through moreish chocolates or ice cream?
The answer to these questions often points in a single direction: hormonal imbalance.
Patients often assume that frequent anxiety and a constantly negative mood must be depression, usually walking out of their GP’s offices with a prescription for antidepressants.
Others presume that PMS (premenstrual syndrome), which sometimes severely affects mental states, is an inevitable event that accompanies every woman during her reproductive years and simply lives with it.
Imbalances bring you down
The majority of our hormones can directly or indirectly affect the neurotransmitters in our brain involved in mood, concentration, cognition, emotional stability, perception of environmental stimuli, and more. There is a considerable amount of clinical data that supports the biological probability of hormones’ effect on our mental state.
When hormone levels are out of balance, patients may experience symptoms associated with psychiatric disorders; but this does not mean they do suffer from a mental disorder. It is clear that oestrogen is closely linked with women’s emotional well-being. As many as 90% of women experience unpleasant emotional symptoms before their periods.
Depression and anxiety affect women in their reproductive, oestrogen-producing years, and oestrogen fluctuation is linked to mood disruptions – namely, PMS, premenstrual dysphoric disorder, and postpartum depression.
Research has indicated that changes in oestrogen levels that happen before the second phase of the menstrual cycle may be responsible for the onset of PMS symptoms. In addition, the interaction between oestrogen fluctuations and serotonin – a neurotransmitter heavily involved with depression – may affect mood.
Current research clearly indicates that the oestrogen hormone itself can increase serotonin and the number of serotonin receptors in the brain, stimulating the effects of our ‘feel-good’ chemicals, endorphins. The fluctuation of oestrogen is, indeed, the problem.
The massive presence of xenoestrogens in our environment that are interfering with our oestrogen receptor by mimicking its action is responsible for the alarming increase in PMS.
In integrative medicine, doctors are much more aware of this environmental effect, inadequate xenoestrogen detoxification, the oestrogen-progesterone balance, and oestrogen dominance – all of which may affect the mental state of female patients.
It must be understood that curing PMS requires finding the root cause rather than treating these patients with artificial hormones (e.g. birth control pill) and antidepressants. Birth control pills do not address the cause of the hormone imbalance; they simply attenuate the symptoms and mask the real problem.
Furthermore, it has been observed that the reduction of thyroid hormone (an underactive thyroid) is directly linked to low serotonin levels. It is not a surprise that most patients suffering from hypothyroidism (the autoimmune condition Hashimoto’s disease is most prevalent) experience a depressed mood, low energy levels and anxiety.
If treated with only antidepressants, these patients very rarely improve, as this condition can only be reversed with adequate thyroid treatment.
For a delicate balancing of the thyroid hormone, especially in the context of an autoimmune condition, it is often not enough to use T4 hormone monotherapy.
A medication containing T4 hormone, usually prescribed by conventional physicians, is given to hypothyroid patients indefinitely. The conversion of non-active T4 hormone into active T3 hormone is the most critical event that needs to happen in the body to diminish the symptoms of low thyroid hormone levels.
A clinical study concluded that a sufficient amount of T3 hormone is crucial for serotonin balancing in the brain and combatting depression. The integrative medical approach uses interventions that ensure the adequate conversion of T4 into T3 as well as identify and treat the cause of low thyroid.
The imperative here is to restore healthy thyroid function (subsequently curing depression) and not to keep the patient on thyroid medication, accompanied by antidepressants, indefinitely.
Another hormone imbalance that is linked to feeling depressed is high cortisol. High cortisol levels, which are usually measured at 23h, contribute to low moods. Ongoing stress, with a high adrenalin level, can lead to anxiety.
Patients who are suffering from stress-related anxiety and depression usually try to relieve it with alcohol or bingeing on foods high in carbohydrates. Both are detrimental to adequate detoxification (methylation), which only perpetuates the problem – leading to even greater anxiety.
Our capacity to clear adrenalin drops significantly with alcohol intake. Scientific data has shown that we have specific areas in our brain that are more sensitive to adrenal hormones in genetically predisposed individuals. These genes are now easy to identify, giving us the opportunity to prevent stress-related depression and anxiety with genetic cancelling.
Interestingly enough, some of the ‘anxiety genes’ are seen from the evolutionary biology point of view as beneficial, protecting us from possible danger by predicting and anticipating it. In fact, some of these genes are permanently ‘switched on’ in a modern stressful society – leading to high cortisol, ongoing anxiety and a vicious circle.
Progesterone plays an important role in women’s mental state, and is often called the ‘feel-good hormone’. It has mood-enhancing and antidepressant effects. Optimum levels of progesterone promote feelings of calmness and well-being, while low levels can cause anxiety, irritability and anger.
In modern times, however, it has not been easy to maintain an optimal level of progesterone. Frequent anovulatory cycles, which used to be exclusive to perimenopausal years and puberty, are now present in all generations. Every anovulatory cycle destabilises progesterone levels, leading to anxiety.
Integrative medical physicians are fully aware of environmental toxicity affecting ovulation; this requires medical detoxification, nutritional correction and comprehensive lifestyle changes, after the temporary prescription of bioidentical progesterone. Again, traditionally, many of these women will be treated for anxiety when, in essence, progesterone balance should be achieved.
Insulin resistance and PCOS (polycystic ovarian syndrome) can cause mental disturbances such as irritability, bursts of anger, and a bad temper, especially in women with very high testosterone. Depression is also a part of insulin resistance syndrome.
Patients with type 2 diabetes are two to three times more likely to suffer from depression than those without diabetes. The relationship between depression and diabetes emphasises the need for diabetes screening in people with depression and depression screening in those with diabetes.
Diagnosing for the possible co-occurrence of these two conditions is important, as many cases remain undiagnosed, leaving patients to suffer from the burden of both diseases without adequate clinical support. A common scenario is seeing PCOS patients being put on chronic therapy: antidepressants, birth control pills and type 2 diabetes medication without any improvement or the potential reversal of PCOS.
Finding the cause of insulin resistance and PCOS would be the first step towards reversal, which is precisely what an integrative medicine approach would achieve. Hormone imbalance is a frequent cause of mental instabilities in women of all ages, and balancing hormones should be the priority in restoring mental equilibrium.
Resources www.8thsense.co.za. References available on request.
Written by Dr Sly Nedic – MBChB (Bel)
- Founder of 8th Sense Medi-Spa, Sandton www.8thsense.co.za
- Board-certified doctor of WOSAAM (World Organisation of Society of Anti-Ageing Medicine)
- Member of IHS (International Hormone Society)
- Member of A4M (American Academy of Anti-Ageing Medicine)
- Faculty member of Preventive Genetics- Laboratories Reunis, Luxembourg
A2 Disclaimer: This article is published for information purposes only, nor should it be regarded as a replacement for sound medical advice.
This article was written by Dr Sly Nedic and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine Winter Edition (Jun-Sep 2021. Issue37).
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