Annette had struggled with mild depression ever since she was in high school. For much of her life, she managed to keep the symptoms at bay.
But when she graduated from college and encountered the stress of her first job, she found herself facing more intense depression punctuated with panic attacks, bouts of insomnia, and fatigue. She also began gaining weight. By her late twenties, she was twenty pounds overweight and relying on over-the-counter sleep aids.
For several months, Annette resisted taking antidepressants, hoping to find relief when she finally settled in at work and resolved her stormy relationship with her boyfriend.
Meanwhile, though, she developed a painful case of acid reflux, for which her primary care physician prescribed a proton pump inhibitor (PPI).
“That was a really hard time,” Annette told me as we were going over her case history. “I felt like my whole body was just falling apart. My stomach hurt, my heart hurt, my mind hurt. It was like my entire body had just turned against me, and everything I did to try and fix it only made everything worse.”
Unfortunately, by her early thirties, Annette’s depression had worsened, and she suffered frequent crying jags. She had finally agreed to take Paxil, an antidepressant, which helped a little—but not nearly enough.
Her doctor also prescribed her some Xanax for her panic attacks, which helped as well. But Annette hated feeling dependent on drugs and she also worried about becoming addicted.
Meanwhile, despite the meds, Annette’s sleep problems continued, her reflux was barely under control, and, no matter how strenuously she dieted, she was 30 pounds over her ideal weight.
She had also developed a raging case of acne that covered her back and chest. She felt exhausted most of the time and complained of being foggy all of the time, unable to focus or to motivate herself.
“Bad as it was before, it’s even worse now,” Annette said shakily. “Not being able to sleep makes me absolutely crazy—I can’t think straight at all. Even when I get a good night’s sleep, my brain doesn’t work right.
And I can’t stand being so tired all the time. It’s like I’m just dragging myself through every minute of the day, waiting for it all to be over.”
By the time I saw her at age thirty-eight, then, Annette was on three different prescription medications: a PPI, Paxil, and Xanax. Her cluster of both brain and gut symptoms plus the prescription drugs she took to medicate them is not in the least unusual. Some 59 percent of all US adults are taking at least unusual.
Some 59 percent of all US adults are taking at least one prescription drug. Meanwhile, the percentage of Americans taking antidepressants—specifically, a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor) is rising rapidly—from 6.8 percent in 1999 to 13 percent in 2012, according to a study of nearly 38,000 people published in the Journal of the American Medical Association.
The patients who come to see me have suffered for years, even decades, with depression, anxiety, fatigue, and, most distressingly of all, the sense that their brain “just isn’t working.”
Their brains have begun to fail them in ways that defy conventional categories. Some feel that their personality mysteriously is being altered.
Others wonder why they can’t remember clearly or why they can no longer make quick, powerful decisions. My patients have suffered a whole host of problems that evade diagnosis—but that make every day a misery.
And they tell me the conventional medications they’ve been prescribed—the typical polypharmacy of two, three, five, seven prescription drugs—aren’t really helping.
True, these medications might alleviate some symptoms (although sometimes they fail to do even that). But they don’t come anywhere close to true healing.
They frequently don’t fully eliminate anxiety or depression, don’t promote sustained mental acuity, and don’t even begin address the other health problems.
They often produce upsetting side effects, which feel like a punitive trade-off for the improvement in mood. They certainly don’t create a deep, long-term sense of vitality, optimism, and purpose.
COMMON SYMPTOMS ASSOCIATED WITH ANTIDEPRESSANTS AND/OR ANTIANXIETY MEDICATIONS
• Brain fog — the sense that your brain is “slowing down”; loss of mental sharpness or the sense that your thoughts don’t “go as deep” as they used to.
• Changes in appetite
• Dizziness and light-headedness
• Fatigue
• Loss of libido and sexual function
• Overall blunting of emotional repertoire
• Sleep disruption
• Weight gain
Such was the case for Annette. Indeed, each of Annette’s medications relieved her symptoms to some degree.
But ultimately, they were Band-Aid solutions that failed to heal the underlying problem. Worse, her medications kept her locked in a vicious cycle where she was actually continuing to steadily lose mental function. How could this be?
Annette’s brain was staggering under the burden of an unhealthy diet and challenging lifestyle, including toxic exposure (to factory-farmed food, unfiltered water, chemical-laden shampoos and lotions) and life stress.
Diet, toxins, and stress all disrupted Annette’s gut and imbalanced her microbiome, while her many prescription drugs added to the burden. Because her gut and microbiome were under attack, her brain was losing function.
ASSAULTS ON ANNETTE’S WHOLE BRAIN
• Poor diet
• Medications
• Toxic exposure in food, water, personal-care products
• Stress
The psychiatrist and gastroenterologist had treated Annette’s brain and gut separately, and not only did the treatments not help her—they were making her worse!
What Annette really needed was someone who understood that her separate problems were really one problem.
When I told Annette that all of her seemingly disparate symptoms were actually part of a single syndrome, she was astonished.
“It never occurred to me that my digestive issues had anything to do with feeling depressed or anxious,” she told me. “You’re telling me they’re related?”
“They’re not only related—they’re all part of the same whole,” I told her. “And the way to fix any one of them—let alone all of them—is to address that whole. For you to feel truly well, we have to treat your Whole Brain.”
The Brain
Your brain is made up of neurons, or nerve cells. One of the hallmarks of good brain function is good communication among neurons, which enables your brain to process thought and emotion.
For this neural communication, your brain relies on neurotransmitters, key biochemicals that include the following:
• Serotonin, a feel-good chemical that promotes buoyancy, optimism, self-confidence, and calm
• Dopamine, a stimulating chemical that’s present whenever we feel a thrill, a major challenge, or a special reward, such as winning a huge prize or falling in love
• GABA, associated with meeting challenges, rising to the occasion, and experiencing anxiety
• Norepinephrine, a stress hormone associated with alertness, focus, and feeling “wired”
Good communication among neurons is one of the most important aspects of good brain function.
If you are suffering from poor brain function—including anxiety, depression, or brain fog—the problem is often created by an imbalance of brain chemicals that promote this communication.
To think clearly and to enjoy a calm and balanced mood, you must maintain just the right levels of these biochemicals within your brain.
What most doctors don’t realize—but which the latest science affirms—is that to keep those brain chemicals at the right level, you need a healthy gut and microbiome.
The Power of the Whole Brain
Going forward, whenever you think about your mood or your ability to think, I want you to think about the powerful triad that composes your Whole Brain:
• Brain
• Gut
• Microbiome
If you or your doctor focuses only on the brain, you will be leaving out two essential components of brain health.
To think clearly and to balance your mood, you need a healthy brain, of course. But you can’t have a healthy brain without also having a healthy gut and microbiome. It can’t be done.
Your gut and microbiome make the chemicals that your brain needs—which is why healing your gut and creating a healthy microbiome are integral aspects of the Whole Brain Protocol.
How the Whole Brain Protocol Helped Annette
Over the years, Annette had come to view antidepressants as her only resource to overcome depression. She knew that antidepressants had helped create a number of symptoms—including weight gain, loss of sex drive and sexual function, and an overall emotional “blunting,” as she described it.
But she was also terrified of falling into a painful depression, and so at first she just wanted me to find her a newer, stronger, more powerful medication. “Please just make it go away!” she said to me one day.
Instead, I started Annette on the Whole Brain Protocol. I knew that once we diversified her microbiome, healed her gut, and supported her thyroid, Annette would discover that her thoughts, her emotions, and perhaps even her beliefs were different.
Studies have shown, for example, that when the brain contains more serotonin, people tend to be far more optimistic about their own capacity for success.
Since healing your gut and balancing your microbiome will increase your levels of serotonin—among many other effects—you might find yourself changing some of your beliefs about the world and yourself.
Sure enough, within two weeks on the Whole Brain Protocol, Annette began to feel better.
And within a few months, she felt restored to herself in a way that she hadn’t experienced for a long time—“Maybe ever,” as she put it.
In post, I’m going to introduce you to a cutting-edge body of research that shows why healing the microbiome can have an extraordinary impact on mood and cognition. My clinical experience bears this out:
When I help my patients restore a healthy microbiome, they experience remarkable transformations—their depression lifts, their anxiety subsides, their brain fog clears, and their memory improves.
These are all terrific outcomes. But there is an even better result, something that transforms my patients and myself whenever I am privileged to witness it.
I see that when my patients have finally created a healthy, vibrant microbial community, they begin to experience an awakening of what I call their will to wholeness—their vitality, their relationship to life itself. This is true healing—and it is the goal of this post.
I have found that the brain benefits most when we focus not only on healing the body, but also the will. Now, by will, I do not mean willpower—I would never say that people could simply “will their way” out of depression or use willpower to defeat their anxiety!
I mean instead that fundamental life force, the deepest part of us that seeks to receive and to give as part of our engagement with other humans, with ourselves, and with the universe around us.
Consequently, as part of her treatment, I invited Annette to spend some time thinking about her purpose in life.
What kind of life did she want to lead? What mattered to her most? I knew, too, that once Annette felt even a little better, her will would reignite.
As her Whole Brain regained its strength, as her emotions were freed from depression’s shadow, as her thoughts and beliefs began to lift and expand, Annette would feel once again the will to receive for herself and the will to give to others.
As she felt more connected to herself and with the world, her will would “come back to life” and her whole self would be suffused with enthusiasm and health.
As she felt better physically and as her Whole Brain function improved, Annette found herself more able to consider her life’s purpose, to think about her relationship to others, and to feel what I can only call a return to her authentic self.
“I finally feel like me!” she said to me on our last visit. “Like I’m a person, living my life, instead of just a bunch of symptoms trying to make it through the day.”
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