The Lies That Depression Tells Us

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In this short (6:42) video, psychiatrist Dr. Tracey Marks talks about 8 commonly-believed lies that depression often tells us. They are:

  • “I don’t measure up”
  • “No one cares about me”
  • “I’m better off alone”
  • “No one understands”
  • “It’s all my fault”
  • “I have no reason to be depressed”
  • “Nothing matters”
  • “I’ll never get better”

Some of these can be reinforced by people around us; it’s easy to believe that “no one understands” if for example the few people we interact with the most don’t understand, or that “I have no reason to be depressed” if people try to cheer you up by pointing out your many good fortunes.

The reality, of course, is that depression is a large, complex, and many-headed beast, with firm roots in neurobiology.

There are things we can do that may ameliorate it… But they also may not, and sometimes life is just going to suck for a while. That doesn’t mean we should give up (that, too, is depression lying to us, per “I’ll never get better”), but it does mean that we should not be so hard on ourselves for not having “walked it off” the way one might “just walk off” a broken leg.

Oh, you can’t “just walk off” a broken leg? Well then, perhaps it’s not surprising if we don’t “just think off” a broken brain, either. The brain can rebuild itself, but that’s a slow process, so buckle in:

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Want to know more?

You might like these previous articles of ours about depression (managing it, and overcoming it):

Take care!

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  • Lost Connections – by Johann Hari

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    Johann Hari had a long journey through (and out of!) depression, and shares his personal findings, including his disappointment with medical options, and a focus on the external factors that lead to depression.

    And that’s key to this book—while he acknowledges later in the book that there are physiological factors involved in depression, he wants to look past things we can’t change (like genes accounting for 37% of depression) or things that there may be unwanted side-effects to changing (as in the case of antidepressants, for many people), to things we genuinely can choose.

    And no, it’s not a “think yourself happy” book either; rather, it looks at nine key external factorsthat a) influence depression b) can mostly be changed.

    If the book has a downside, it’s that the author does tend to extrapolate his own experience a lot more than might be ideal. If SSRIs didn’t help him, they are useless, and also the only kind of antidepressant. If getting into a green space helped him, a Londoner, someone who lives in the countryside will not be depressed in the first place. And so forth. It can also be argued that he cherry-picked data to arrive at some of his pre-decided conclusions. He also misinterprets data sometimes; which is understandable; he is after all a journalist, not a scientist.

    Nevertheless, he offers a fresh perspective with a lot of ideas, and whether or not we agree with them all, new ideas tend to be worth reading. And if even one of his nine ideas helps you, that’s a win.

    Bottom line: if you’d like to explore the treatment of depression from a direction other than medicalization or psychotherapy, then this is will be a good book for you.

    Click here to check out Lost Connections, and reforge yours!

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  • The Connection Cure – by Julia Hotz

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    You may recognize some of the things in the subtitle as being notable elements of the Blue Zones supercentenarians’ lifestyles, but this book looks at numerous quite diverse countries, and people from many walks of life.

    What they have in common—and this is mostly a very person-centered book, relying a lot on case studies, with additional references coming from wider sociological data—is social prescribing.

    What is social prescribing? That’s what the author (a journalist by general profession) answers comprehensively here, and it’s about looking at the ways medical problems can often have nonmedical solutions. It doesn’t necessarily mean that walking will cure your cancer or art will cure your diabetes, but it does mean that very often a key part of an unhealthy lifestyle is fundamentally something that can be fixed by one or more of: movement, nature, art, service, and belonging.

    She looks at social prescribing in its birthplace (the UK, where cheap solutions that are nevertheless evidence-based are very much prioritized), in big countries like Canada and Australia, in aging countries like Singapore and South Korea, and yes, also in the #1 country of pill prescribing, the US.

    The structure of the book is interesting, we first have 5 person-centered chapters addressing each of the social prescribing aspects and how they helped in two example case studies for each one, then 5 country-by-country epidemiological chapters looking at the big picture, then 5 person-centered chapters again, this time looking at personalizing social prescribing for oneself (this section of the book being headed “Social Prescribing For You And Me”), looking at what is going on in one’s life and health, which of the 5 elements might be missing, and what tangible goal-oriented benefits can—according to the evidence—be obtained by tending to what one actually needs in terms of social prescribing.

    The style is narrative and journalistic, with very little hard science, but very little that’s wishy-washy either. It is, in short, a pleasant and informative read that helps the reader really understand social prescribing, the better to implement it in our own lives.

    Bottom line: if you like having extra nonmedical approaches to avoid or alleviate medical problems, then this book will really help you achieve that.

    Click here to check out The Connection Cure, and get social prescribing!

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  • The Collagen Cure – by Dr. James DiNicolantonio

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    Collagen is vital for, well, most of our bodies, really. Where me most tend to feel its deficiency is in our joints and skin, but it’s critical for bones and many other tissues too.

    You may be wondering: why a 572-page book to say what surely must amount to “take collagen, duh”?

    Dr. DiNicolantonio has a lot more of value to offer us than that. In this book, we learn about not just collagen synthesis and usage, different types of collagen, the metabolism of it in our diet (if we get it—vegans and vegetarians won’t). We also learn about the building blocks of collagen (vegans and vegetarians do get these, assuming a healthy balanced diet), with a special focus on glycine, the smallest amino acid which makes up about a third of the mass of collagen (a protein).

    Not stopping there, we also learn about the interplay of other nutrients with our metabolism of glycine and, if applicable, collagen. Vitamin C and copper are star features, but there’s a lot more going on with other nutrients too, down to the level of “So take this 75 minutes before this but after that and/but definitely not with the other”, etc.

    The style is incredibly clear and readable for something that’s also quite scientifically dense (over 1000 references and many diagrams).

    Bottom line: if you’re serious about maintaining your body as you get older, and you’d like a book about collagen that’s a lot more helpful than “take collagen, duh”, then this is the book for you.

    Click here to check out The Collagen Cure, and take care of yours!

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  • Rapamycin Can Slow Aging By 20% (But Watch Out)

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    Rapamycin’s Pros & Cons

    Rapamycin is generally heralded as a wonderdrug that (according to best evidence so far) can slow down aging, potentially adding decades to human lifespan—and yes, healthspan.

    It comes from a kind of soil bacteria, which in turn comes from the island of Rapa Nui (a Chilean territory best known for its monumental moai statues), hence the name rapamycin.

    Does it work?

    Yes! Probably! With catches!

    Like most drugs that are tested for longevity-inducing properties, research in humans is very slow. Of course for drugs in general, they must go through in vitro and in vivo animal testing first before they can progress to human randomized clinical trials, but for longevity-inducing drugs, it’s tricky to even test in humans, without waiting entire human lifetimes for the results.

    Nevertheless, mouse studies are promising:

    Rapamycin: An InhibiTOR of Aging Emerges From the Soil of Easter Island

    (“Easter Island” is another name given to the island of Rapa Nui)

    That’s not a keysmash in the middle there, it’s a reference to rapamycin’s inhibitory effect on the kinase mechanistic target of rapamycin, sometimes called the mammalian target of rapamycin, and either way generally abbreviated to “mTOR”—also known as “FK506-binding protein 12-rapamycin-associated protein 1” or “FRAP1“ to its friends, but we’re going to stick with “mTOR”.

    What’s relevant about this is that mTOR regulates cell growth, cell proliferation, cell motility, cell survival, protein synthesis, autophagy, and transcription.

    Don’t those words usually get associated with cancer?

    They do indeed! Rapamycin and its analogs have well-demonstrated anti-cancer potential:

    ❝Rapamycin, the naturally occurring inhibitor of mTOR, along with a number of recently developed rapamycin analogs (rapalogs) consisting of synthetically derived compounds containing minor chemical modifications to the parent structure, inhibit the growth of cell lines derived from multiple tumor types in vitro, and tumor models in vivo.

    Results from clinical trials indicate that the rapalogs may be useful for the treatment of subsets of certain types of cancer.❞

    ~ mTOR and cancer therapy

    …and as such, gets used sometimes as an anticancer drug—especially against renal cancer. See also:

    Research perspective: Cancer prevention with rapamycin

    What’s the catch?

    Aside from the fact that its longevity-inducing effects are not yet proven in humans, the mouse models find its longevity effects to be sex-specific, extending the life of male mice but not female ones:

    Rapamycin‐mediated mouse lifespan extension: Late‐life dosage regimes with sex‐specific effects

    One hypothesis about this is that it may have at least partially to do with rapamycin’s immunomodulatory effect, bearing in mind that estrogen is immune-enhancing and testosterone is immunosuppressant.

    And rapamycin? That’s another catch: it is an immunosuppressant.

    This goes in rapamycin’s favor for its use to avoiding rejection when it comes to some transplants (most notably including for kidneys), though the very same immunosuppressant effect is a reason it is contraindicated for certain other transplants (such as in liver or lung transplants), where it can lead to an unacceptable increase in risk of lymphoma and other malignancies:

    Prescribing Information: Rapamune, Sirolimus Solution / Sirolimus Tablet

    (Sirolimus is another name for rapamycin, and Rapamune is a brand name)

    What does this mean for the future?

    Researchers think that rapamycin may be able to extend human lifespan to a more comfortable 120–125 years, but acknowledge there’s quite a jump to get there from the current mouse studies, and given the current drawbacks of sex-specificity and immunosuppression:

    Advances in anti-aging: Rapamycin shows potential to extend lifespan and improve health

    Noteworthily, rapamycin has also shown promise in simultaneously staving off certain diseases associated most strongly with aging, including Alzheimer’s and cardiac disease—or even, starting earlier, to delay menopause, in turn kicking back everything else that has an uptick in risk peri- or post-menopause:

    Effect of Rapamycin in Ovarian Aging (Rapamycin)

    👆 an upcoming study whose results are thus not yet published, but this is to give an idea of where research is currently at. See also:

    Pilot Study Evaluates Weekly Pill to Slow Ovarian Aging, Delay Menopause

    Where can I try it?

    Not from Amazon, that’s for sure!

    It’s still tightly regulated, but you can speak with your physician, especially if you are at risk of cancer, especially if kidney cancer, about potentially being prescribed it as a preventative—they will be able to advise about safety and applicability in your personal case.

    Alternatively, you can try getting your name on the list for upcoming studies, like the one above. ClinicalTrials.gov is a great place to watch out for those.

    Meanwhile, take care!

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  • Your Brain On (And Off) Estrogen

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    This is Dr. Lisa Mosconi. She’s a professor of Neuroscience in Neurology and Radiology, and is one of the 1% most influential scientists of the 21st century. That’s not a random number or an exaggeration; it has to do with citation metrics collated over 20 years:

    A standardized citation metrics author database annotated for scientific field

    What does she want us to know?

    Women’s brains age differently from men’s

    This is largely, of course, due to menopause, and as such is a generalization, but it’s a statistically safe generalization, because:

    • Most women go through menopause—and most women who don’t, avoid it by dying pre-menopause, so the aging also does not occur in those cases
    • Menopause is very rarely treated immediately—not least of all because menopause is diagnosed officially when it has been one year since one’s last period, so there’s almost always a year of “probably” first, and often numerous years, in the case of periods slowing down before stopping
    • Menopausal HRT is great, but doesn’t completely negate that menopause occurred—because of the delay in starting HRT, some damage can be done already and can take years to reverse.

    Medicated and unmedicated menopause proceed very differently from each other, and this fact has historically caused obfuscation of a lot of research into age-related neurodegeneration.

    For example, it is well-established that women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.

    Superficially, one might conclude “estrogen is to blame” or maybe “the xx-chromosomal karyotype is to blame”.

    The opposite, however, is true with regard to estrogen—estrogen appears to be a protective factor in women’s neurological health, which is why increased neurodegeneration occurs when estrogen levels decline (for example, in menopause).

    For a full rundown on this, see:

    Alzheimer’s Sex Differences May Not Be What They Appear

    It’s not about the extra X

    Dr. Mosconi examines this in detail in her book “The XX Brain”. To summarize and oversimplify a little: the XX karyotype by itself makes no difference, or more accurately, the XY karyotype by itself makes no difference (because biologically speaking, female physiological attributes are more “default” than male ones; it is only 12,000ish* years of culture that has flipped the social script on this).

    *Why 12,000ish years? It’s because patriarchalism largely began with settled agriculture, for reasons that are fascinating but beyond the scope of this article, which is about health science, not archeology.

    The topic of “which is biologically default” is relevant, because the XY karyotype (usually) informs the body “ignore previous instructions about ovaries, and adjust slightly to make them into testes instead”, which in turn (usually) results in a testosterone-driven system instead of an estrogen-driven system. And that is what makes the difference to the brain.

    One way we can see that it’s about the hormones not the chromosomes, is in cases of androgen insensitivity syndrome, in which the natal “congratulations, it’s a girl” pronouncement may later be in conflict with the fact it turns out she had XY chromosomes all along, but the androgenic instructions never got delivered successfully, so she popped out with fairly typical female organs. And, relevantly for Dr. Mosconi, a typically female brain that will age in a typically female fashion, because it’s driven by estrogen, regardless of the Y-chromosome.

    The good news

    The good news from all of this is that while we can’t (with current science, anyway) do much about our chromosomes, we can do plenty about our hormones, and also, the results of changes in same.

    Remember, Dr. Mosconi is not an endocrinologist, nor a gynecologist, but a neurologist. As such, she makes the case for how a true interdisciplinary team for treating menopause should not confined to the narrow fields usually associated with “bikini medicine”, but should take into account that a lot of menopause-related changes are neurological in nature.

    We recently reviewed another book by Dr. Mosconi:

    The Menopause Brain – by Dr. Lisa Mosconi

    …and as we noted there, many sources will mention “brain fog” as a symptom of menopause, Dr. Mosconi can (and will) point to a shadowy patch on a brain scan and say “that’s the brain fog, there”.

    And so on, for other symptoms that are often dismissed as “all in your head”, as though that’s a perfectly acceptable place for problems to be.

    This is critical, because it’s treating real neurological things as the real things they are.

    Dr. Mosconi’s advice, beyond HRT

    Dr. Mosconi notes that brain health tends to dip during perimenopause but often recovers, showing the brain’s resilience to hormonal shifts. As such, all is not lost if for whatever reason, hormone replacement therapy isn’t a viable option for you.

    Estrogen plays a crucial role in brain energy, and women’s declining estrogen levels during menopause increase the need for antioxidants to protect brain health—something not often talked about.

    Specifically, Dr. Mosconi tells us, women need more antioxidants and have different metabolic responses to diets compared to men.*

    *Yes, even though men usually have negligible estrogen, because their body (and thus brain, being also part of their body) is running on testosterone instead, which is something that will only happen if either you are producing normal male amounts of testosterone (requires normal male testes) or you are taking normal male amounts of testosterone (requires big bottles of testosterone; this isn’t the kind of thing you can get from a low dose of testogel as sometimes prescribed as part of menopausal HRT to perk your metabolism up).

    Note: despite women being a slight majority on Earth, and despite an aging population in wealthy nations, meaning “a perimenopausal woman” is thus the statistically average person in, for example, the US, and despite the biological primacy of femaleness… Medicine still mostly looks to men as the “default person”, which in this case can result in seriously low-balled estimates of what antioxidants are needed.

    In terms of supplements, therefore, she recommends:

    • Antioxidants: key for brain health, especially in women. Rich sources include fruits (especially berries) and vegetables. Then there’s the world’s most-consumed antioxidant, which is…
    • Coffee: Italian-style espresso has the highest antioxidant power. Adding a bit of fat (e.g. oat milk) helps release caffeine more slowly, reducing jitters. Taking it alongside l-theanine also “flattens the curve” and thus improves its overall benefits.
    • Flavonoids: important for both men and women but particularly essential for women. Found in many fruits and vegetables.
    • Chocolate: dark chocolate is an excellent source of antioxidants and flavonoids!
    • Turmeric: a natural neuroprotectant with anti-inflammatory properties, best boosted by taking with black pepper, which improves absorption as well as having many great qualities of its own.
    • B Vitamins: B6, B9, and B12 are essential for anti-aging and brain health; deficiency in B6 is rare, while deficiency in B9 (folate) and especially B12 is very common later in life.
    • Vitamins C & E: important antioxidants, but caution is needed with fat-soluble vitamins to avoid toxicity.
    • Omega-3s: important for brain health; can be consumed in the diet, but supplements may be necessary.
    • Caution with zinc: zinc can support immunity and endocrine health (and thus, indirectly, brain health) but may be harmful in excess, particularly for brain health.
    • Probiotics & Prebiotics: beneficial for gut health, and in Dr. Mosconi’s opinion, hard to get sufficient amounts from diet alone.

    For more pointers, you might want to check out the MIND diet, that is to say, the “Mediterranean-DASH Intervention for Neurodegenerative Delay” upgrade to make the Mediterranean diet even brain-healthier than it is by default:

    Four Ways To Upgrade The Mediterranean Diet

    Want to know more from Dr. Mosconi?

    Here’s her TED talk:

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    Enjoy!

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  • Less Common Oral Hygiene Options

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    Less Common Alternatives For Oral Hygiene!

    You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.

    There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.

    Tooth soap

    The idea here is simplicity, and brushing with as few ingredients as possible. Soap cleans your teeth the same way it cleans your (sometimes compositionally quite similar—enamel and all) dishes, without damaging them.

    We’d love to link to some science here, but alas, it appears to have not yet been done—at least, we couldn’t find any!

    You can make your own tooth soap if you are feeling confident, or you might prefer to buy one ready-made (here’s an example product on Amazon, with various flavor options)

    Oil pulling

    We are getting gradually more scientific now; there is science for this one… But the (scientific) reviews are mixed:

    Wooley et al., 2020, conducted a review of extant studies, and concluded:

    ❝The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene❞

    Source: The effect of oil pulling with coconut oil to improve dental hygiene and oral health: A systematic review

    The “Science-Based Medicine” project was less positive in its assessment, and declared that all and any studies that found oil pulling to be effective were a matter of researcher/publication bias. We would note that SBM is a private project and is not without its own biases, but for balance, here is what they had to offer:

    SBM | Oil Pulling Your Leg

    A more rounded view seems to be that it is a good method for cleaning your teeth if you don’t have better options available (whereby, “better options” is “almost any other method”).

    One final consideration, which the above seemed not to consider, is:

    If you have sensitive teeth/gums, oil-pulling is the gentlest way of cleaning them, and getting them back into sufficient order that you can comfortably use other methods.

    Want to try it? You can use any food-grade oil (coconut oil or olive oil are common choices).

    Chewing stick

    Not just any stick—a twig of the Salvadora persica tree. This time, there’s lots of science for it, and it’s uncontroversially effective:

    ❝A number of scientific studies have demonstrated that the miswak (Salvadora persica) possesses antibacterial, anti-fungal, anti-viral, anti-cariogenic, and anti-plaque properties.

    Several studies have also claimed that miswak has anti-oxidant, analgesic, and anti-inflammatory effects. The use of a miswak has an immediate effect on the composition of saliva.

    Several clinical studies have confirmed that the mechanical and chemical cleansing efficacy of miswak chewing sticks are equal and at times greater than that of the toothbrush❞

    ~ Hague et al.

    Read in full: A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health

    And about the efficacy vs using a toothbrush, here’s an example:

    Comparative effect of chewing sticks and toothbrushing on plaque removal and gingival health

    Want to try the miswak stick? Here’s an example product on Amazon.

    Enjoy!

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    Learn to Age Gracefully

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