Before You Medicate…. Investigate, by Stephanie Strozuk, MD
Blog written by:
Stephanie Strozuk, MD, is the Functional Medicine doctor at The Body Image Boutique in Saddle River, NJ. She is board Certified in Pediatrics and also in Adolescent and Young Adult Medicine, and has obtained additional training through The Institute for Functional Medicine. Dr. Strozuk is the founder of Evolved Adolescent and Young Adult Medicine.
Before You Medicate…. Investigate
Fatigue… low mood… insomnia…mood swings… inattention… agitation…rapid heartbeat…racing thoughts. Sound familiar? These symptoms often times result in a prescription for an antidepressant or antianxiety medication. But what if I were to tell you that these symptoms may be a message that something else may be awry besides a “chemical imbalance “in the brain?
In the six decades that psychotropic medications have been studied, the conclusions about their use and effectiveness have been confusing and conflicting. In October 2004, the FDA issued a “black box “warning about an increased risk of suicidal thoughts or behavior in children and adolescents treated with Selective Serotonin Reuptake Inhibitor (SSRI) medications. In 2006, the FDA extended this warning to young adults up to the age of 25. As an adolescent and young adult medicine physician, I have significant concern about these potential side effects as do many of my patients. But what do we do when we have symptoms that interfere with our functioning in everyday life? Perhaps we should be digging deep and looking at the root causes of the symptoms before making a psychiatric diagnosis and starting medication.
The symptomatology that we often associate with psychiatric diagnoses may be due to a multitude of medical issues. Burgeoning research is showing that the complex relationship between the gut, brain, immune and hormonal systems may drive symptomatology that may be labeled psychiatric. If you pick up just about any health book or magazine published in recent years, you will likely find information about how inflammation is the driving force behind many illnesses including heart disease, obesity, and diabetes to name a few. We now know that depression as well as other psychiatric illnesses may be driven by the inflammatory process as well. But what creates the inflammation? The answer to this is likely multifactorial and unique to each patient. It is possible that the foods we eat, the integrity of our gut, the diversity of our gut bacteria, the medications we take, food sensitivities and psychological stress in and of itself can be driving forces in inflammation. This can become a vicious cycle where inflammation is at the center. The inflammatory process can trigger depression and it can be perpetuated by depression or other stresses.
Other potential triggers of psychiatric symptomatology include autoimmune diseases such as Celiac Disease , Hashimotos’s thyroiditis , Grave’s disease and Lupus to name a few. Endocrine disorders such as hypothyroidism, hyperthyroidism, and adrenal fatigue or insufficiency may drive symptoms. Metabolic issues such as blood sugar imbalance (dysglycemia), Polycystic Ovarian Syndrome (PCOS) and insulin resistance may drive symptoms. Micronutrients such as B vitamins, folate, magnesium, vitamin D, and zinc are essential to the body’s functionality and production of neurotransmitters and deficiencies may affect mood. Fatty acid deficiencies should be investigated and addressed as deficiency may drive mood symptoms.
The potential causes of mood disorders are vast. While there may be a role for psychotropic medications in certain cases, untangling the web to discover your individual cause deserves a closer look in partnership with your doctor. So before you medicate… investigate. You may be surprised about what you find.