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Skills Or Pills: When Are Antidepressants Right For You?

Dr Daniel Amen and Tana Amen BSN RN On The Brain Warrior's Way Podcast

For some people, antidepressants can help improve the quality of life. For others, it only makes things worse. In the second episode of the “Skills or Pills?” series, Dr. Daniel Amen and Tana Amen tackle depression. They discuss at what point antidepressants are a reasonable choice, and when other natural methods should be tried, such as exercise, nutrition, mediation, or supplements.

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Dr. Daniel Amen: Welcome to The Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body.
Dr. Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics where we have been transforming lives for 30 years using tools like brain SPECT imaging to personalize treatment to your brain. For more information, visit amenclinics.com.
Tana Amen: The Brain Warrior's Way Podcast is also brought to you BrainMD where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com.
Dr. Daniel Amen: Skills or pills? We're going to talk about depression. What's the one thing you do that boosts your mood quickly? We'd love if you'd post the answer to that question. The use of antidepressants has-
Tana Amen: Oh, my gosh.
Dr. Daniel Amen: ... skyrocketed since 1987. That's the year Prozac was approved by the FDA. Is it marketing, or has the level of depression-
Tana Amen: Maybe both?
Dr. Daniel Amen: ... skyrocketed in the United States despite we have more, we feel less?
Tana Amen: Right, so interesting question because when people just go to their doctor and get on... We've talked about this over and over and over, and this is something I've certainly experienced firsthand. I just talked to someone yesterday who experienced the same thing.
When I was really depressed when I was 24 and had just gone through all the problems with thyroid cancer and then all sorts of other problems as a result of that, I went into this deep depression, wanted to die, so went to see a psychiatrist. They put me on Prozac because that was the prominent antidepressant at the time, and it made me numb. It didn't make me feel good or bad. At least I didn't want to die, but what I found was, in that numb state, I found myself behaving in ways that were never like me before. I definitely had less empathy. I definitely was more impulsive.
When you talk about should you go on pills or should you do things naturally, I think I mean a big part of it-
Dr. Daniel Amen: Or skills.
Tana Amen: Right, skills. In my mind, it really depends. Number one, you definitely can't just go get on the first antidepressant without knowing what antidepressants do, and how they affect the brain, and what kind of a brain you have. I know this firsthand so... And I know so many people.
Dr. Daniel Amen: Right, because you have a sleepy frontal lobe, and the Prozac-
Tana Amen: It made my frontal lobe sleepier.
Dr. Daniel Amen: How it works is it calms down your emotional brain, but also the front part of your brain, and so you're happier, but also more impulsive and-
Tana Amen: I didn't really care about much.
Dr. Daniel Amen: As you don't care, it can negatively impact your empathy-
Tana Amen: And your relationships.
Dr. Daniel Amen: ... which can impact your relationships.
Tana Amen: Whereas something like Wellbutrin might have been a better option for someone like me, but if you don't know and you don't know your brain type... I took myself off of it. Exercise was the thing that works for me and meditation. Those two things combined, prayer, meditation, for me, they're the same. I use them together. Prayer and meditation and exercise are my go-to must. I must do those things. They're not even an option.
Dr. Daniel Amen: Let's talk about so when should you think about medication and when should you think about skills? I've been doing this 40 years. If I had my way, if I was a good ruler, I would start teaching the skills to counteract depression in second grade.
Tana Amen: Absolutely.
Dr. Daniel Amen: Some of the skills, and you listed one, which is exercise, critically important, learning how to not believe every stupid thought you have, so learning how to kill the ants, the automatic negative thoughts, absolutely essential. I think it's as important as English.
Tana Amen: Everywhere we go-
Dr. Daniel Amen: It's just a class in logic, really, that is so important.
Tana Amen: Because it's so insidious. Everywhere we go, people struggle with this.
Dr. Daniel Amen: Nutrition. There is this great study in Australia, it just came out, where researchers went to two of the outer islands. One of the outer islands had fast food restaurants. The other outer island didn't. They measured a random group of people on both islands. The group that had fast food restaurants had lower levels of omega-3 fatty acids-
Tana Amen: Makes sense.
Dr. Daniel Amen: ... and five times, five times the level of depression. Given the standard American diet that has overrun America including the White House... The White House had one of the national champion teams and, for the fifth time, he served fast food.
Tana Amen: Interesting.
Dr. Daniel Amen: I'm like, "That's insane," because we know that increases depression.
Tana Amen: Let me just really quickly because people will say, "Well, I take omega-3 fatty... I take a fish oil pill so, so what? I can eat fast food." It doesn't quite work like that. If you are eating a lot of processed food and fast food, it's loaded with omega-6 fatty acids. What the problem becomes is the ratio. It will help a little bit to take your fish oil definitely. You don't definitely don't not want to not take it, but that ratio, if your omega-6s far outweigh your omega-3s and you're overloading your system with the omega-6s, that's where inflammation happens. That's what drops that ratio, and that's why you don't want that to happen.
Dr. Daniel Amen: Okay, so simple things, learning how to not believe every stupid thing you think, exercise, getting your diet right. The more colorful vegetables you can put in your diet, the better that is. When it comes to depression, if it has come and stayed and you do the skills, then maybe, like in your case, you have a genetic history of depression.
Tana Amen: Well, and I also was going through a medical issue, a acute medical-
Dr. Daniel Amen: If we just look at some of the factors that may lead to medication is pretty intense family history of depression on your dad's side. Trauma growing up, trauma can actually reset the limbic or emotional system of the brain. Those things make it more likely if the natural things don't work. In my mind, do the natural things first and then, based on your brain type, we talk about do you have a brain that works too hard? Then we use our serotonin interventions, either supplements or medications. If your brain doesn't work hard enough, we'll use the more stimulating supplements like SAM-e or medications like Wellbutrin.
Tana Amen: There's also, and it was part of what we teach you in all of our books and all of our... in the beginning of the podcast. There's also the acute stuff like, in my case, I just has thyroid cancer for which I had to be off of all thyroid medication. I had no natural thyroid in my body at all.
Dr. Daniel Amen: They don't do that anymore.
Tana Amen: No, they don't, but you don't know what your state is unless you get your blood tested. You might have low thyroid. You need to know all of that stuff because biological markers can also make a difference. You want to make sure that you're checking all of that. No one told me that, "Oh, by the way, you're going to get depressed because we're taking you off your thyroid."
Dr. Daniel Amen: Once they replaced it, you would have been better.
Tana Amen: Lazarus.
Dr. Daniel Amen: Looking back, that if they would have warned you-
Tana Amen: Right, prepared me.
Dr. Daniel Amen: ... and replaced it like they're doing now and then optimized your C-reactive protein, your vitamin D level-
Tana Amen: None of that. They did none of that.
Dr. Daniel Amen: ... your hormone markers, that you might have been able to skip medicine, but maybe not, at which point then targeted medications to your brain then make sense, but still we're in this part of psychiatry where nobody looks at your brain, which I continue to argue is insane. It's like how do we know unless we actually look? That's been my brain war for the last 30 years.
Tana Amen: I just remember the first... It cracks me up thinking back to that. You looked at my... the first time you saw my brain scan, and you're like, "Huh. When did you have trauma, emotional trauma?" I'm like, "Never. I'm fine." "When did you have a brain injury?" "Never. I'm fine." I remember you looked at me going, "Hmm," well, I'm going to change the word but, "fouled-up, insecure, neurotic, and emotional," and I'm like, "What?" I was like ...
Dr. Daniel Amen: Did I really say you were fine?
Tana Amen: Yes. No, I said I was fine. You said I was fouled-up, insecure, neurotic, and emotional. You didn't even know me that well.
Dr. Daniel Amen: That was in one of the game things where I was putting you down in order to get you to attach to me as a-
Tana Amen: Oh, that would never work. I can spot that a mile away.
Dr. Daniel Amen: All right, so skills always. If you struggle with depression, your first thought, if you come at it from a place of love and experience, the first thought is, "What skills do I need?" Even when you feel like staying in bed, get up.
Tana Amen: Yeah. Oh, yeah.
Dr. Daniel Amen: Because what we have discovered on our imaging work is people with depression have, often, really low blood flow to the front part of their brain at rest, but when they try to concentrate, it gets better. They feel really, really bad and, if they lay in bed, they just continue to feel really bad. Even though they feel like they don't have the energy to get up and go do something, when they get up and go do something, they actually feel better. From an exercise standpoint, which you brought up, head to head against Zoloft. After 12 weeks, walking like you're late 45 minutes four times a week was equally effective and, after 10 months, it was more effective.
Tana Amen: Interesting. Over 400 years ago, Hippocrates said, "If you feel down, get up and go for a walk, and if you still feel bad, go for another walk."
Dr. Daniel Amen: Not 400 years ago, my love.
Tana Amen: When was it?
Dr. Daniel Amen: It was four-
Tana Amen: Oh, yeah.
Dr. Daniel Amen: It was back 2,500 years ago.
Tana Amen: Yeah, 2,500 years. Sorry. Yeah. Then what was it? No, Socrates was...
Dr. Daniel Amen: Socrates was before.
Tana Amen: I don't remember.
Dr. Daniel Amen: Galen was about 170 AD.
Tana Amen: Dear Lord.
Dr. Daniel Amen: Galen was who was the Roman physician who-
Tana Amen: That's what I'm thinking.
Dr. Daniel Amen: He was 170 AD. He completely believed in what Hippocrates believed in, which was diet, exercise, laughing. Now, they also added bloodletting, which is a bad thing.
Tana Amen: Was it 400 and something BC? Is that what I'm thinking?
Dr. Daniel Amen: Yeah.
Tana Amen: Yeah.
Dr. Daniel Amen: Galen was actually the first one who believed you should talk about it, so he's sort of-
Tana Amen: Oh, interesting.
Dr. Daniel Amen: ... the father of psychotherapy. It's really not Freud. The physician Galen thought talking about the problems in your life can actually make a big difference, and so don't suffer alone.
What's the one thing people have learned? What's the one thing you've learned on how you can make your mood better? Write that to us. Send that to us. We love the interaction and-
Tana Amen: What have you done? What do you do that if... those of you who-
Dr. Daniel Amen: What can you do differently?
Tana Amen: Right.
Dr. Daniel Amen: If you can just post the one thing you learned from this podcast on any of your social media channels and use the hashtag brainwarriorsway.
Tana Amen: If you are enjoying The Brain Warrior's Way Podcast, please don't forget to subscribe so you'll always know when there's a new episode. While you're at it, feel free to give us a review or five-star rating as that helps others find the podcast.
Dr. Daniel Amen: If you're interested in coming to Amen Clinics, use the code PODCAST10 to get a 10% discount on a full evaluation at amenclinics.com. For more information, give us a call at 855-978-1363.