Hello. Welcome to
Health For A Lifetime.
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I'm Don Mackintosh, your host
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today. And today we're
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privileged to have
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Dr. Neil Nedley from
Ardmore, Oklahoma, with us.
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Welcome Dr. Nedley.
Thank you; good to be with you.
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Dr. Nedley is an internal...
a specialist, actually,
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in internal medicine.
He takes care of people
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every day in
acute care settings.
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And he also is the
author of a new book,
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and that book is
entitled Proof Positive.
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Excellent resource material.
Some of the things we're talking
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about today are going to
be touched on in that book.
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But I understand that you
also are working on a new book
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that will touch on
our subject for today.
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I don't know when that will be
out, but you're... even in your
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busy schedule you're
able to do some writing.
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We try to do as much as we can.
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That's why we can't predict
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when it will be out.
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Our subject for today is
something that is touching
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the lives of many people
who are watching right now.
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The subject is depression,
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and in America there
are over 17,000,000 people
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who have been
diagnosed with depression.
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But worldwide there's about
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from this right now. So
if you're watching today
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and you're feeling
depressed, stay tuned.
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If you have a friend or a
relative or someone that you
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know that is depressed,
maybe you would mention
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this program to them as well
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because what we learn today
I know will be helpful to you.
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It's been helpful to me just
beginning to talk about this
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with our guest this morning.
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Dr. Nedley, what
exactly is depression?
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Maybe that's
where we should begin.
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Maybe you can help us
in understanding what we're
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talking about when we actually
are talking about depression.
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Depression actually is more than
just a feeling of deep sadness.
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That's what most people
really think depression is.
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That's one of the symptoms
of depression and actually
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one of the diagnostic
indicators of depression.
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But really strictly
from a definition sake, it is
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good to go over this.
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So in other words, if you
have had the death of a spouse
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or if you have lost your job
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or if something very traumatic
has happened in your life
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and you're feeling
sad, that is natural.
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We don't classify
that as a major depression.
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But if you haven't had those
things and you're still feeling
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deep sadness and at least 5
of the following 9 symptoms,
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then indeed you do have
the definition of depression.
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And this is one disease
that doesn't really require
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a physician per se to diagnose.
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Actually you can
almost self diagnose
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if you know what
the definition is.
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And then from there it
really requires a physician
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to try to find the underlying
cause as well as the treatment.
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So the people watching
today that maybe say: "Hey, I...
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I feel very depressed. "
As they listen today, they can
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really have a good indication
about whether or not they
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are truly clinically depressed.
And then they need to get
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in touch with someone who
can help them if that's what...
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that's what it
seems to indicate.
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Exactly. What
are those 9 symptoms
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of which you need at least 5 of?
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Some people won't
have the deep sadness;
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they'll have agitation.
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Some people that are depressed
will not be able to sleep
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at night and
others will sleep too much
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and they'll be falling
asleep through the daytime
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and they'll usually
have some sleep disturbance.
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Some people when
they are depressed
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will eat more and gain weight.
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Others will eat less
and lose weight, and that is
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one of the characteristic
hallmarks as well.
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As an internal
medicine physician
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that's probably one of the
most common symptoms I find
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in depressed
patients is fatigue.
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In fact, when someone comes
to me complaining of fatigue,
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I will then try to find out
if they have any of these other
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eight symptoms. And if
they do have five of them,
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their actual cause of
fatigue may be depression.
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And then we have to find out why
in the world they're depressed.
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Well, for the viewer watching
today, what you're saying is
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if we have 2 to 4 of those
for more than a 2-week period
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we really need to be concerned
about what's happening.
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Is that what you're saying? Yes.
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Now at the bottom of the
last graphic it did mention
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2 to 4 is what we call
sub-syndromal depression.
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OK. That doesn't
classify as a major depression.
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Sub-syndromal depression means
that you may be on your way
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to a major depression, but
even if you have 2 of those
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9 symptoms you need to
take alert and this program
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is still for you.
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But in order to be
classified as major depression
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you need 5 out of those 9.
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It was interesting as we were
talking before the beginning
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of the program that you
said: "This is happening
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younger and younger to people.
People that are 25 years old
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now there's a lot more people
that have a major depression.
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even by that age. "
Yeah, we used to call this
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the mid-life crisis that
used to occur more commonly
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in people in their 40's.
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But major episodes of
depression in this country
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are now occurring at the
age of 25 in many individuals
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and a lot of individuals
even younger than that.
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It is a disease that is
on the increase in America,
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and we really need to
start addressing this disease
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much more fully like we
have addressed other important
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diseases in America such
as heart disease and cancer.
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And I don't think we've paid
enough attention to this disease
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personally. Is this
the type of thing...
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You know, often you hear people
that say: "Hey, well I'm not
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feeling very
good... I feel depressed. "
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You hear people say: "I'm just
depressed for some reason. "
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And then you'll hear someone
else talking with them and
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they'll say: "Hey, just,
you know, pick yourself up. "
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You know... "Grit your
teeth, bear it, get through it
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and you'll work through
this. " Is that good advice?
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Or are there some risks
that are involved in just
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following that type of
attitude toward depression?
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For someone who has depression
that is not good advice
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simply because they
cannot snap out of it.
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It takes - once we find
out the underlying cause
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and then undergo treatment
- it takes a week minimum
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before a depressed
patient starts feeling better
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and usually about 3-4
weeks until they get a maximum
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effect from whatever
therapy we are instituting.
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And so if you're truly depressed
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you're not going to be
able to snap out of it.
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Now some people might just
be feeling sad for some reason
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or another... they didn't
get enough sleep last night.
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They don't really
have depression per se.
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And those individuals can snap
out of it just by getting on
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a... going for a run
for 45 minutes and getting
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good sleep tonight...
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and then tomorrow
they'll feel great again.
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That's not what
we're talking about.
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People that have depression
cannot snap out of it,
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and to give them the
impression that they can
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is really setting
them up for discouragement.
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What kind of things are they
going to endanger themselves
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further? Are there
any physical conditions
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if they try and do that
that they may, you know,
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become involved in?
Well, I think it's important
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to understand that
anyone that is depressed
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does have an
increased risk of developing
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a number of problems,
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and this is why need to address
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it early.
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In addition, it does a number
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of other things as well
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in increasing the risk of really
a depressed immune system.
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For years we have known that
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depressed patients tend to have
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offspring that have this...
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this tendency as well.
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But we haven't realized that
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depressed patients actually
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produce offspring that have more
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medical conditions and so it can
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even affect the medical
conditions of your offspring
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in an adverse manner.
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The reason why many people
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decline in physical ability
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is actually due to depression
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and not necessarily to another
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disease process. And then
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it does those things that we
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mention there on the screen
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in regards to impairing the
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immune system and thus we see
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those complications of infection
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or cancer or other like diseases
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being more likely.
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I believe that I
heard recently in the news
00:10:07.83\00:10:09.73
that they did study
some people groups that
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because they had very close
family ties they did have that
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depressive trait so to
speak. I don't know if that's
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the way to term that.
That it was passed on.
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And so if you're in a family
that has history of depression
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you really need to
take this seriously.
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You really need to take it
seriously, and this is a disease
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that also can be prevented.
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Just like heart
disease can be presented,
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just like cancer
can be prevented,
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depression also
can be prevented.
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And if you know you have a
family history of heart disease
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like I do... I have a very
strong family history of heart
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disease... I've taken
measures to almost guarantee
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that I won't
develop heart disease.
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You can also take similar
measures to make sure you
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won't develop depression
even though you come from
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a genetic background. I
think one of the things with
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depression and having talked
to people who are suffering
00:11:00.61\00:11:03.48
clinical depression...
and maybe some of our viewers
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today are thinking: "You
know, I feel almost depressed
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about being depressed.
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I feel like it's something
I shouldn't talk about.
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Here I am a... " Maybe
they're a good Christian
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person. They think maybe
it's a sin to feel this way
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or I have no reason to do this.
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Are these normal effects?
00:11:20.74\00:11:22.97
They're normal feelings
when an individual is depressed.
00:11:23.27\00:11:27.70
The feelings of worthlessness,
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feelings of guilt
and even being depressed
00:11:29.58\00:11:31.94
that come about. But
that's where we really have to
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emphasize as far as finding
the underlying cause of the
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depression. Some people
are depressed simply because
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they haven't been
following the will of God.
00:11:42.54\00:11:44.38
And as a result of not
following the will of God
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they've had suppression to
the circulation of their frontal
00:11:47.95\00:11:50.52
lobe. And that in and of itself
can bring about depression.
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I think one example in scripture
00:11:53.96\00:11:56.51
that I can think of was Elijah.
00:11:56.71\00:11:59.18
Elijah - running away from
Jezebel, which he really wasn't
00:11:59.38\00:12:02.74
supposed to do - he ended
up in a pretty deep depression.
00:12:02.84\00:12:05.30
And the Lord said:
"What doest thou here? "
00:12:05.50\00:12:08.35
And so that may be one indicator
00:12:08.55\00:12:13.38
that if you are depressed
you may need to ask the question
00:12:13.59\00:12:16.06
"What doest thou here? "
00:12:16.26\00:12:17.33
Have you been doing
something in your life
00:12:17.53\00:12:19.19
that is contrary
to the will of God?
00:12:19.39\00:12:21.49
And if so, can you
change that around?
00:12:21.69\00:12:24.01
But that's only one of many
potential causes of depression.
00:12:24.21\00:12:27.43
And that's why we need
to really discuss this.
00:12:27.64\00:12:31.22
Are there any other
things, doctor, in your practice
00:12:31.52\00:12:34.76
that you have seen that result?
00:12:34.96\00:12:37.25
What are some of the other
effects that you see as a result
00:12:37.45\00:12:39.97
of depression? Well,
there are some other effects
00:12:40.07\00:12:42.61
that we really need to discuss.
00:12:42.82\00:12:44.82
First of all, there is
an effect of osteoporosis
00:12:45.12\00:12:49.77
that can come about as
a result of depression.
00:12:49.97\00:12:52.37
Other factors such as increasing
00:12:54.30\00:12:57.46
the risk of return
to addictive behavior.
00:12:57.56\00:13:00.24
is very common. In fact, those
00:13:00.38\00:13:02.29
that have been
addicted to a substance
00:13:02.39\00:13:04.67
they often relapse
because of depression.
00:13:04.88\00:13:07.90
And so it's very
important for those individuals
00:13:08.10\00:13:10.81
to really recognize the fact
00:13:11.01\00:13:14.10
that they need to
prevent depression
00:13:14.20\00:13:15.82
at all costs. And if
they get into depression
00:13:15.92\00:13:17.87
they need to have it
treated early because
00:13:18.07\00:13:19.76
it does
definitely increase the risk
00:13:19.87\00:13:21.84
that they're going to return
00:13:21.94\00:13:23.01
back to that addictive behavior.
00:13:23.12\00:13:25.02
It is one of the common causes
00:13:25.22\00:13:28.17
of a chronic headache.
00:13:28.27\00:13:29.28
And that's one of the
things I go through with
00:13:29.48\00:13:31.80
my headache patients is that
00:13:31.90\00:13:33.30
same list that we went through
00:13:33.40\00:13:34.90
to make sure that depression
00:13:35.01\00:13:36.16
is not the underlying cause.
00:13:36.26\00:13:37.63
We mentioned osteoporosis.
00:13:37.83\00:13:39.69
It's one of the causes
of thinning of the bones.
00:13:39.89\00:13:41.86
And when combined with stress
00:13:42.06\00:13:43.93
it increases the risk of HIV
00:13:44.13\00:13:45.96
progressing to AIDS.
00:13:46.06\00:13:47.27
Many people are
unaware of the fact
00:13:47.47\00:13:49.48
that even though
you may contract HIV
00:13:49.68\00:13:53.69
you do not have to develop AIDS.
00:13:53.90\00:13:56.17
There are many
individuals out there
00:13:56.37\00:13:58.78
that have had HIV for 15 years
00:13:58.98\00:14:01.01
and have never developed AIDS.
00:14:01.21\00:14:02.47
And really it's boosting
00:14:02.67\00:14:06.55
the immune system is the
important aspect of things.
00:14:06.65\00:14:08.94
And stress
combined with depression
00:14:09.14\00:14:10.89
is going to produce a big hit
00:14:11.09\00:14:13.10
and dramatically
increase the risk of a virus
00:14:13.30\00:14:16.20
manifesting itself such as HIV.
00:14:16.40\00:14:18.47
In that list the one thing that
kind of gripped my attention -
00:14:18.77\00:14:22.09
I understand most of those
- but talk a little bit about
00:14:22.29\00:14:25.65
osteoporosis and depression.
00:14:25.75\00:14:27.72
How does that?
How is that an effect?
00:14:27.92\00:14:30.02
Well, as far as the mechanism
of action it's one of those
00:14:30.32\00:14:33.19
unknowns at this point in time.
00:14:33.39\00:14:34.86
There are some speculation as
to how depression brings about
00:14:35.06\00:14:39.06
osteoporosis on a hormonal basis
00:14:39.16\00:14:42.81
decreased absorption of
calcium, etc. that can occur.
00:14:43.01\00:14:46.78
But exactly how
that occurs is unknown.
00:14:46.98\00:14:48.88
But it is a well-established
fact that thinning of the bones
00:14:49.08\00:14:52.11
does result from depression.
00:14:52.31\00:14:55.62
Hmmm. You know, in many
diseases that we hear about
00:14:55.82\00:15:00.32
I think since the time of
William Castelli being involved
00:15:00.52\00:15:05.54
in the Framingham Heart Study
00:15:05.74\00:15:07.36
they began to look at heart
disease and they came up with
00:15:07.56\00:15:09.71
this term "risk
factor" as you know.
00:15:09.74\00:15:11.74
That there are certain things
that are definite identifiable
00:15:11.94\00:15:15.26
risk factors. Is
there something like that
00:15:15.46\00:15:16.94
in terms of depression?
00:15:17.14\00:15:18.67
Are we identifying
things that lead to it?
00:15:18.87\00:15:21.21
Yes, we really need to do the
same thing with depression...
00:15:21.41\00:15:24.56
and that is let's take
a look at the risk factors
00:15:24.76\00:15:26.88
for depression.
00:15:26.98\00:15:28.07
Girls do not have to go
through an early puberty
00:15:38.02\00:15:41.33
if they're on a correct
diet that is lower in fat
00:15:41.53\00:15:44.56
and lower
particularly in animal protein.
00:15:44.76\00:15:47.03
And early puberty does have
an association with depression
00:15:47.23\00:15:51.42
later on in life.
00:15:51.52\00:15:52.56
Those that are working at
factories that change the time
00:15:54.78\00:15:57.80
that they have to be
at work every six weeks
00:15:57.90\00:15:59.70
and they have to go
midnight, afternoons, et cetera,
00:15:59.90\00:16:02.35
they have an increased
risk of developing depression.
00:16:02.55\00:16:04.74
Or those that choose to get
up at a different time every day
00:16:04.94\00:16:08.13
or really get out
of phase on the weekend
00:16:08.23\00:16:10.27
they increase
their risk as well.
00:16:10.47\00:16:11.94
Interestingly, grandparents
who raise their grandchildren
00:16:12.24\00:16:15.90
are at an increased risk
of developing depression.
00:16:16.10\00:16:18.97
And that is
occurring in much more frequent
00:16:19.27\00:16:22.73
occurrence today
than ever before.
00:16:22.93\00:16:26.75
With two
parents that are working
00:16:26.95\00:16:29.52
and the fear of some of the
things in daycare, et cetera,
00:16:29.72\00:16:34.19
grandparents are having to
get involved in the raising
00:16:34.39\00:16:36.65
of their grandchildren and with
the splitting of homes, etc.
00:16:36.75\00:16:39.44
And so we're seeing
grandparents come in
00:16:39.64\00:16:41.89
with this disease at
rather alarming rates.
00:16:42.09\00:16:44.81
In addition, there is smoking
00:16:45.11\00:16:48.86
is a risk factor not only
for developing heart disease
00:16:49.06\00:16:52.29
and cancer but also depression.
00:16:52.49\00:16:54.38
Interestingly, those that
smoke have an increased risk
00:16:54.58\00:16:57.44
of developing depression,
and those that are depressed
00:16:57.54\00:17:00.26
have an increased
risk of picking up smoking.
00:17:00.46\00:17:02.44
So it's one of those
positive feedback cycles.
00:17:02.64\00:17:04.60
And the same is
true with alcohol.
00:17:04.70\00:17:05.99
Those that drink alcohol
increase the risk of depression.
00:17:06.19\00:17:08.65
Those that are in adolescence
who are not living with
00:17:08.95\00:17:11.90
two biological parents
are at an increased risk
00:17:12.00\00:17:14.27
in developing
depression. So divorce.
00:17:14.37\00:17:16.41
That's right. Divorce and
remarriage put adolescents
00:17:16.61\00:17:21.50
at risk. And then severe
sexual abuse in childhood
00:17:21.70\00:17:26.27
increases the risk of
depression later on in life.
00:17:26.47\00:17:29.12
The milder forms of sexual
abuse have not been associated
00:17:29.32\00:17:32.49
with it but it's the much more
severe types of sexual abuse
00:17:32.59\00:17:35.18
that have been. So of course
many of these risk factors...
00:17:35.28\00:17:38.71
We can make choices to
avoid smoking and alcohol.
00:17:38.91\00:17:43.36
Some of the others
we're more or less victims.
00:17:43.56\00:17:46.17
We can't as children
say: "Well, you know,
00:17:46.37\00:17:49.66
my parents are divorced
and I was the cause of that. "
00:17:49.96\00:17:54.07
Although I think maybe that's
one of the reasons they get
00:17:54.27\00:17:56.52
depressed. They think
maybe they are the cause of it,
00:17:56.62\00:17:58.15
I don't know. But some of these
things we can actually avoid.
00:17:58.19\00:18:02.09
Yes. Some are
modifiable risk factors
00:18:02.30\00:18:04.13
and other ones are not.
00:18:04.33\00:18:05.48
Well in terms of risk
factors, the difference between
00:18:05.78\00:18:09.43
a risk factor and
something that we know for sure
00:18:09.63\00:18:12.00
is going to cause depression.
00:18:12.10\00:18:13.92
Yes. Is that
true? That's correct.
00:18:14.12\00:18:16.34
In fact, one of the things...
You know, we have as physicians
00:18:16.55\00:18:19.78
and even
psychiatrists around this nation
00:18:19.88\00:18:23.33
I think for too long
have treated depression
00:18:23.53\00:18:27.05
as the same disease throughout.
00:18:27.25\00:18:30.06
In other words, I as an
internal medicine physician
00:18:30.36\00:18:34.55
label people with
congestive heart failure.
00:18:34.75\00:18:37.77
That's a diagnosis.
00:18:37.87\00:18:38.95
But when I was in
training I was told
00:18:39.05\00:18:43.15
very emphatically "don't
ever just label someone with
00:18:43.35\00:18:45.71
congestive heart failure.
Find out the underlying cause
00:18:45.81\00:18:48.31
of that
congestive heart failure.
00:18:48.52\00:18:49.65
Is it due to
coronary artery disease?
00:18:49.85\00:18:52.10
Is it due to
valvular heart disease?
00:18:52.30\00:18:53.97
Is it due to atrial fibrillation
and a rhythm problem?
00:18:54.18\00:18:57.20
et cetera because whatever
the underlying cause is,
00:18:57.40\00:19:00.54
if we treat that,
then we can get rid of the
00:19:00.74\00:19:03.18
congestive heart failure. "
00:19:03.28\00:19:04.58
And for years we have
lumped all depressed patients
00:19:04.78\00:19:08.09
in together... given them
a cookbook-type of approach
00:19:08.29\00:19:11.31
to treatment. And unfortunately
00:19:11.51\00:19:13.71
we are missing
the cause of this.
00:19:13.91\00:19:16.63
And if the causes are dealt with
00:19:16.83\00:19:18.45
then we won't
have to be reliant upon
00:19:18.65\00:19:23.37
all of the various
medications that are out there
00:19:23.57\00:19:26.36
to treat depression... all
of which have side effects.
00:19:26.56\00:19:28.59
So it's very
important in my practice
00:19:28.89\00:19:30.99
as an internal
medicine physician, Don,
00:19:31.19\00:19:34.01
maybe a lot of people
would be surprised about this
00:19:34.21\00:19:36.87
but it is shown that
about 1 out of every 3 people
00:19:37.07\00:19:41.66
that I see in my practice
in an outpatient setting
00:19:41.86\00:19:45.31
that come to me with
another disease process
00:19:45.51\00:19:48.03
actually have an element
of depression in their life.
00:19:48.23\00:19:51.40
So this is something
that I see about as commonly
00:19:51.60\00:19:55.10
as any
psychiatrist is going to see it.
00:19:55.31\00:19:57.15
And that's why I
thought it was imperative for me
00:19:57.36\00:19:59.10
to learn as much about
this process as possible.
00:19:59.21\00:20:01.46
But in so doing I
have come to the conclusion
00:20:01.76\00:20:04.24
that I should no longer
label someone as depressed
00:20:04.44\00:20:06.82
without attempting to
find the underlying cause
00:20:07.02\00:20:10.70
of depression. So really,
you know, that brings us back
00:20:10.91\00:20:15.03
to the very word "diagnosis. "
00:20:15.23\00:20:16.88
I heard someone
once describe it as
00:20:17.08\00:20:19.15
dia... which means,
you know, "to see through"
00:20:19.35\00:20:22.03
and gnosis... "to
know. " To really know
00:20:22.24\00:20:24.52
and see through
what's happening.
00:20:24.62\00:20:25.98
And in an acute care setting
I'm sure you see these people
00:20:26.01\00:20:30.06
that have heart attacks
and very traumatic things
00:20:30.26\00:20:32.54
and they're just set
up for this type of thing.
00:20:32.65\00:20:36.16
So what are some of
the real, then, causes?
00:20:36.36\00:20:38.55
As you diagnose and
you've seen people, what are
00:20:38.75\00:20:42.57
the real causes?
00:20:42.78\00:20:44.02
Well, one of the major
causes of depression is actually
00:20:44.22\00:20:47.30
a decrease in circulation to
00:20:47.40\00:20:49.84
the frontal lobe of the brain.
00:20:49.94\00:20:52.23
Actually in just about every
00:20:52.43\00:20:54.17
depressed patient this is one of
00:20:54.27\00:20:55.51
the things that we can almost
00:20:55.61\00:20:56.74
lump every
depressed patient into.
00:20:56.84\00:20:59.13
There is a decrease in activity
00:20:59.33\00:21:00.94
of what we call the pre-frontal
00:21:01.04\00:21:02.62
cortex by 40-50%.
00:21:02.72\00:21:04.83
Now how can you tell whether
00:21:05.03\00:21:06.62
or not there is
decreased activity?
00:21:06.82\00:21:08.82
You can't tell it
by looking at someone.
00:21:08.93\00:21:10.37
No you can't.
00:21:10.57\00:21:11.73
Actually the only
way of telling for sure
00:21:11.93\00:21:14.03
is by getting what
we call a PET scan.
00:21:14.23\00:21:17.24
A PET scan is not an
MRI which gives us a picture
00:21:17.44\00:21:20.92
of the brain but it actually
tells us about the activity.
00:21:21.02\00:21:24.62
If we were to take
our brain model here
00:21:24.82\00:21:27.00
that's on our set here today
00:21:27.10\00:21:31.40
the frontal lobe of
the brain is this portion
00:21:31.60\00:21:35.45
right in here in
the front portion.
00:21:35.65\00:21:38.12
And the pre-frontal
cortex is actually above that
00:21:38.32\00:21:43.00
or actually in front of
that. And the pre-frontal
00:21:43.20\00:21:46.74
cortex is really what controls
the rest of the frontal lobe.
00:21:46.94\00:21:52.19
This is where our highest
decision-making processes
00:21:52.39\00:21:55.13
are centered. This is where
the higher centers of morality
00:21:55.33\00:22:00.09
and spirituality and
the will are centered
00:22:00.29\00:22:02.35
is in the pre-frontal cortex.
00:22:02.55\00:22:04.50
And interestingly,
when we do a PET scan
00:22:04.70\00:22:06.93
we can see not only
what the brain looks like
00:22:07.13\00:22:10.77
but the activity.
Which portions of the brain
00:22:10.97\00:22:13.71
are being metabolically
active and are working.
00:22:13.81\00:22:16.08
And across the board just
about in depressed patients
00:22:16.38\00:22:19.41
this area of the brain has a
50% reduction in circulation.
00:22:19.62\00:22:24.64
So it is working at an impaired
state in depressed patients.
00:22:24.88\00:22:28.99
So then, you know, finding
out about whether or not your
00:22:30.09\00:22:34.10
frontal lobe is active just in
terms of - without a PET scan -
00:22:34.30\00:22:38.73
would be again... Back to
the beginning of the program
00:22:38.93\00:22:41.07
we talked about
having five of those symptoms
00:22:41.27\00:22:44.68
of depression. And If
you have five of those
00:22:44.88\00:22:47.44
you probably have
a major depression...
00:22:47.64\00:22:48.86
you probably have a
depression of the frontal lobe.
00:22:49.06\00:22:50.91
Would I be
accurate in saying that?
00:22:51.11\00:22:52.32
That's correct. It's
not really practical to get
00:22:52.42\00:22:54.57
a multi-thousand-dollar PET scan
00:22:54.77\00:22:56.85
on every patient to see
if they've got depressed
00:22:57.05\00:22:59.46
activity of the
pre-frontal cortex...
00:22:59.56\00:23:01.20
particularly since just
about every depressed patient
00:23:01.40\00:23:04.99
is going to have that.
00:23:05.02\00:23:06.26
And so what we do
that's standard with all of our
00:23:06.46\00:23:10.08
depressed patients is we
put them on a regimen that is
00:23:10.18\00:23:12.54
going to increase the
circulation to the frontal lobe
00:23:12.64\00:23:15.42
of the brain.
00:23:15.52\00:23:16.52
I know that we have more on that
00:23:16.72\00:23:18.03
graphic that you showed us
00:23:18.13\00:23:19.32
about cause of depression.
00:23:19.42\00:23:21.91
But I think that maybe after
we look at some of those causes
00:23:22.11\00:23:24.76
and maybe some less common
causes we will want to come back
00:23:24.96\00:23:28.07
to those symptoms
so people can say:
00:23:28.27\00:23:29.90
"Hey, I've been
watching this program...
00:23:30.10\00:23:31.49
maybe I just came into the
program... and I want to know
00:23:31.69\00:23:34.18
whether or not I'm depressed. "
00:23:34.28\00:23:35.77
And we can show
them those symptoms again
00:23:35.97\00:23:38.33
and then they can, you
know, make a decision about
00:23:38.53\00:23:41.37
where they are
on that continuum.
00:23:41.47\00:23:43.34
Let's go back to those
causes you were showing us.
00:23:43.54\00:23:45.97
OK. As far as other
causes of depression,
00:23:46.17\00:23:50.37
low brain serotonin levels.
00:23:50.57\00:23:52.44
That's a chemical that is
00:23:52.64\00:23:54.36
extensively used in the frontal
00:23:54.47\00:23:56.04
lobe of the brain. If the brain
00:23:56.14\00:23:57.42
is not making it appropriately,
00:23:57.52\00:23:59.94
depression will come about.
00:24:00.04\00:24:02.01
Insufficient dietary tryptophan.
00:24:02.21\00:24:04.28
If there's not enough of the
00:24:04.48\00:24:05.59
amino acid tryptophan in the
00:24:05.69\00:24:07.17
diet, the serotonin cannot be
00:24:07.27\00:24:09.30
synthesized. And that's one of
00:24:09.40\00:24:11.06
the reasons for potentially
00:24:11.16\00:24:12.44
a low serotonin level.
00:24:12.54\00:24:13.97
And so we have to place patients
00:24:14.17\00:24:16.38
on that program on a high...
00:24:16.48\00:24:18.21
diet that is
higher in tryptophans.
00:24:18.32\00:24:20.64
One of the rather common causes
00:24:20.84\00:24:23.66
of depression is a low omega-3
00:24:23.86\00:24:25.53
fatty acid intake. Hmmm.
00:24:25.63\00:24:27.52
Omega-3 fats are different
00:24:27.62\00:24:30.00
from the routine fats that most
00:24:30.20\00:24:32.01
people consume every day which
00:24:32.11\00:24:33.38
are what we call the omega-6
00:24:33.48\00:24:35.19
fats. And omega-3 fats
00:24:35.29\00:24:37.98
are present not only in fish
00:24:38.18\00:24:41.25
but in flax seed and green soy,
00:24:41.45\00:24:43.53
in walnuts.
00:24:43.73\00:24:45.29
And if individuals are not
00:24:45.50\00:24:47.00
eating enough of these plant
00:24:47.10\00:24:48.89
products of omega-3 fatty acids,
00:24:48.99\00:24:52.06
they can actually
develop depression
00:24:52.26\00:24:53.97
just from a low omega-3
00:24:54.07\00:24:55.41
fatty acid intake. It's one of
00:24:55.51\00:24:56.83
the actually necessary
00:24:56.93\00:24:59.37
constituents of a good diet
00:24:59.47\00:25:02.15
is a diet high in omega-3.
00:25:02.35\00:25:04.13
Low folate levels.
00:25:04.33\00:25:06.16
Individuals that have low folate
00:25:06.37\00:25:08.43
levels because
they're not getting enough
00:25:08.53\00:25:10.15
folate in their diet
00:25:10.28\00:25:11.53
actually develop depression
00:25:11.73\00:25:14.75
that is not treated
00:25:14.95\00:25:16.42
with medication. It can be
00:25:16.62\00:25:18.26
treated, but unfortunately the
00:25:18.29\00:25:19.90
patients don't respond to it.
00:25:20.00\00:25:21.29
And it's not until we get their
00:25:21.49\00:25:22.51
folate levels up that they
00:25:22.61\00:25:24.38
actually do
respond to treatment.
00:25:24.48\00:25:26.45
In addition, atherosclerosis
00:25:26.65\00:25:29.75
actually due to cholesterol
plaques in the artery
00:25:29.95\00:25:34.33
supplying the brain
can cause mini strokes
00:25:34.53\00:25:37.17
to the pre-frontal cortex
00:25:37.37\00:25:38.51
and to emotional
areas of the brain
00:25:38.71\00:25:40.57
that actually
bring about depression.
00:25:40.77\00:25:43.11
So one of the same
causes of heart disease
00:25:43.31\00:25:45.78
can actually be a
cause of depression.
00:25:45.98\00:25:47.63
And this tends to
occur as far as depression
00:25:47.83\00:25:50.34
in the elderly is concerned.
It's one of the reasons why
00:25:50.44\00:25:53.00
heart disease patients
particularly have an increased
00:25:53.20\00:25:55.88
risk of developing
depression is because
00:25:55.98\00:25:58.03
the same problem with
the arteries in the heart
00:25:58.24\00:26:00.11
is going on the brain as well.
00:26:00.31\00:26:01.87
Dr. Nedley, what
you've been sharing with us
00:26:03.13\00:26:05.15
has been very helpful.
00:26:05.25\00:26:07.02
If you've been listening
today and you're wondering
00:26:07.22\00:26:09.35
whether or not you are
depressed, at the beginning
00:26:09.56\00:26:12.22
of this program we had
a list - a graphic - that
00:26:12.32\00:26:15.43
showed us the signs and symptoms
00:26:15.54\00:26:17.36
of those that are
suffering major depression.
00:26:17.47\00:26:19.44
I want to show you that
graphic in just a moment here.
00:26:19.64\00:26:23.35
And Dr. Nedley, just remind us
00:26:23.49\00:26:25.19
here by looking at this graphic
00:26:25.39\00:26:26.93
what are the signs and symptoms
00:26:27.13\00:26:30.02
of someone that
really does have depression
00:26:30.22\00:26:32.42
so people that
are watching can know.
00:26:32.62\00:26:33.94
Well, they have to have 5
of the following 9 symptoms:
00:26:34.15\00:26:37.08
If anyone has 5 of those 9,
00:26:55.23\00:26:57.27
they are suffering
from major depression.
00:26:57.37\00:26:58.96
We need to find the cause
00:26:59.16\00:27:00.39
and then put them on
appropriate treatment.
00:27:00.59\00:27:02.58
One of the things
you've mentioned today
00:27:02.98\00:27:05.44
in terms of treating depression
00:27:05.54\00:27:07.76
is increasing the amount of
blood that comes to that front
00:27:08.06\00:27:11.29
part of our
brain... the frontal lobe.
00:27:11.39\00:27:13.42
And those of you who are
watching today are probably
00:27:13.62\00:27:15.83
saying: "How do I do
that? I want to have health
00:27:15.93\00:27:17.74
for a lifetime. I
don't want to be depressed. "
00:27:17.84\00:27:20.12
I want to point your attention
as we close this program
00:27:20.42\00:27:23.48
to this excellent
resource: Proof Positive.
00:27:23.68\00:27:26.42
And we hope that as a
result of today's time
00:27:26.62\00:27:30.42
you will have
health for a lifetime.
00:27:30.52\00:27:33.23