Medical Literature

How Can I Be Treated If SSRI’S Make Me Sick?

QUESTION:

Dr. Heller, I am 37, and I think that I have suffered from anxiety and depression since childhood.  At about the age of 30, I was diagnosed by my doctor with GAD and depression.  According to my experience and your screening criteria, I think that “fractured happiness” and the inattentive type of ADD are also parts of my overall condition.  I have tried almost all of the SSRI’s, and generally they let me see what non-depressed, non-anxious thinking was like.  What a revelation! However, side effects have been a big problem.  Prozac made me hyper.  Paxil made me feel the best, but it also caused a rapid weight gain.  Zoloft made me feel wired.  Adding Trazodone caused a quick addition of 10 pounds despite a lot of exercise.  I tried Wellbutrin with Paxil and Celexa respectively but this did not lessen my side effects.  This includes memory glitches that were very disturbing.  Currently, I am on Serzone by itself, and it seems to have made my anxiety worse. Many family members, from both sides, have ADD, depression and anxiety.  Are these conditions related to one another?  Considering the fact that I have multiple issues, which medications would you suggest for me? (I have had my thyroid checked on several occasions.  It has always been normal.)

ANSWER:

The problem is the GAD and an overactive serotonin 1-A receptor.  This is the gene involved in the cognitive generalized anxiety disorder.  SSRI’s increase most serotonins, including this one.  BuSpar lowers that receptor so that SSRI’s and stimulants can be taken.

How Can my Friend Discover That Hope Exists?

QUESTION:

Dear Dr. Heller,

A friend who exhibits depression often – goes into hiding with himself for days. He has a problem with anger. He takes everything personally and explodes at people – rants and raves – loudly and expressively with his hands and arms. He is a large man, so he scares people – even though he is mostly verbal, no one knows when he might snap and become physical. I have tried to tell him that everyone is afraid to approach or talk to him or ask him anything, because they are afraid of his rage – even about very minor things. He has gotten worse over the past 5 years. I have tried to tell him this, but he does not see that he is verbally abusive and disrespectful to other human beings in how he speaks to them (yells at them). When he is quieter, calmed down, he will admit he has a problem but doesn’t know where to start to find the right help. He keeps procrastinating in going to get help – and always has an excuse – including that it is ‘everyone else’s fault’ that he reacts as he does. I keep telling him that he ‘over-reacts’ abnormally to things – in comparison to other humans. He ends up unhappy and depressed way too often and over too many things that are not that “big of a deal” . He has not been able to maintain a relationship, nor has he been in any long-term relationship, with any woman since he was in his early 20’s.

What can I send him to read? Where can I direct him? He is more likely to read and study before he will seek actual one-on-one counseling. Thanks.

 

ANSWER:

That’s what the covers of my book have been designed for. If the BPD is present – which seems likely – the cover of my first book “Life at the Border” can be printed from this website. The cover of “Biological Unhappiness” can also be printed up. The back cover shows many of these symptoms and can be found on the home page. The “Screening Test” will likely be of assistance as well. Most people with anger problems are suffering and would like for their suffering to end. That’s the purpose of my work.

Is Your information For Real?

QUESTION:

Dear Dr. Heller,

Life with my borderline husband has been pure hell. Medicines and therapy have made things worse. In the past year we have both been arrested due to his uncontrollable violence, neither of us has EVER been arrested before in our lives.

Just when things were seeming hopeless, I realized that you, this wonderful man I have read so much about, are very close to us. We live Outside of Orlando. My question to you is, is it really possible to actually get an appointment with you? Can it be as easy as it sounds on your web site?

When I saw your fees I nearly feel out of my chair. We have spent so much time, money, and effort getting nowhere. Is it really true that hope exists and I don’t have to relinquish my husband who I love more than anything in the world to the horror of BPD? If the answer to these questions is yes, then I hope to be seeing you as soon as possible. Either way I would like to thank you from the bottom of my heart for giving hope to the hopeless, you are a remarkable human being.

I hope you will continue to improve the lives of so many. God bless you.

 

ANSWER:

I appreciate the kind words. I have many, many patients from Orlando and would be happy to see you. I genuinely enjoy treating the BPD because of the enormous possibility of helping people have better lives and understand the goodness inside of themselves. The information is accurate.

How About Flax Seed Oil?

QUESTION:

Dear Dr. Heller,

My daughter’s psychiatrist recently diagnosed her with bipolar disorder and put her on flax seed oil pills (6/grams daily), along with Paxil (10mg). She said the clinical studies proved it was just as effective as depakote. Do you agree?

Thanks for your advice.

ANSWER:

No!!!!! According to Drs. Papolos in “The Bipolar Child” book (page 109), neither flax seed oil (which can trigger hypomania) nor cod liver oil (toxic in high doses) should be used. The “omega-3 fatty acids” from concentrated fish oils do work. Studies at Harvard show they can help – especially with rapidly cycling children. These studies were “double blinded” – meaning neither the doctors nor the patients (or parents) knew who was taking the oils and who was taking placebo. There is good science behind taking these oils, and a proposed mechanism of action does exist. It would be interesting to see if there is a direct correlation between bipolar and consumption of fish that have high levels of omega-3 fatty acids.

The dose is unclear, but likely between 5 and 10 grams daily. While omega-3 fatty acids are considered non-toxic, it is recommended that antioxidants should also be taken. The dose is controversial. Drs. Papolos recommend 400iu’s of vitamin E and 600mg of vitamin C. The exact doses of vitamin E that are necessary is unclear, as high doses may be toxic and it’s unclear what doses children actually need. The recommendations for vitamin C have dropped recently, particularly in view of reports of increased coronary artery toxicity from taking mild supplementation of vitamin C. Dr. Andrew Weil, author of “Spontaneous Healing” and other books and Newsletters, has lowered his vitamin C recommendation down to 500mg daily.

Fish Oils For Children With Bipolar Disorder?

QUESTION:

Dear Dr. Heller,

My daughter’s psychiatrist recently diagnosed her with bipolar disorder and put her on flax seed oil pills (6/grams daily), along with Paxil (10mg). She said the clinical studies proved it was just as effective as depakote. Do you agree? Thanks for your advice.

ANSWER:

No!!!!! According to Drs. Papolos in “The Bipolar Child” book (page 109), neither flax seed oil (which can trigger hypomania) nor cod liver oil (toxic in high doses) should be used. The “omega-3 fatty acids” from concentrated fish oils do work. Studies at Harvard show they can help – especially with rapidly cycling children. These studies were “double blinded” – meaning neither the doctors nor the patients (or parents) knew who was taking the oils and who was taking placebo. There is good science behind taking these oils, and a proposed mechanism of action does exist. It would be interesting to see if there is a direct correlation between bipolar and consumption of fish that have high levels of omega-3 fatty acids.

The dose is unclear, but likely between 5 and 10 grams daily. While omega-3 fatty acids are considered non-toxic, it is recommended that antioxidants should also be taken. The dose is controversial. Drs. Papolos recommend 400iu’s of vitamin E and 600mg of vitamin C. The exact doses of vitamin E that are necessary is unclear, as high doses may be toxic and it’s unclear what doses children actually need. The recommendations for vitamin C have dropped recently, particularly in view of reports of increased coronary artery toxicity from taking mild supplementation of vitamin C. Dr. Andrew Weil, author of “Spontaneous Healing” and other books and Newsletters, has lowered his vitamin C recommendation down to 500mg daily.

What Should I Do First? – Biological Unhappiness

QUESTION:

I’m sure I have BPD but I’m too ashamed to tell anyone.  I’d rather not go on feeling like this.  What should I do?  I’m going crazy.

ANSWER:

It’s important to realize that hope absolutely does exist.  I’d highly recommend the following steps:

1)    Review the screening test I use for my patients, and investigate any diagnoses that might fit you.  The Biological Unhappiness Disorders and Official Criteria section will help for the other diagnoses.

2)    Read about the BPD at length.  The borderline personality disorder section has lots of information, and my Website links to many others.  The books I’ve written are designed to answer your question thoroughly.  My first book “Life at the Border – Understanding and Recovering from the Borderline Personality Disorder” is on the recommended reading list at the National Institute of Mental Health.

3)    Once you understand the diagnoses that are present, you need to learn about the medications that work and how they work.  My approach to medical treatment of the BPD explains what I do and why.

4)    Once your chronic symptoms are under control you need a formal plan for stress, which I explain in the Dysphoria Instruction Sheet I use for my patients.

5)    You will then have to find a physician to prescribe the medications (usually a Psychiatrist, Family Physician, Internist, or OB/GYN).  You will likely need to do some shopping to find an interested medical practitioner.  The Article for Primary Care Physicians and its update have material these physicians can refer to and understand.  The literature is referenced in this Website, as in my medication plan.

6)    You will need psychological counseling, and the necessary issues are discussed in “Life at the Border“.  I also highly recommend Retraining the Brain  which is discussed at length in both books, and in the Website.  Listening to Zig Ziglar is an excellent step you can begin right away.