Category: Ask the Doctor

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.

 

What Can I Do To Help My Abused Fiancee?

    What Can I Do To Help My Abused Fiancée?

    QUESTION:

    Dear Dr. Heller,

    I came across your website while looking for information that might enable me to help understand my fiancé.

    The material that I have already read, about the effects of child abuse, said that people who are abused as children have a lot of problems trusting people and discussing their emotions.  And that is so true of him.  He never wants to talk about how he feels, especially when he’s upset or angry, and we have a slight problem with trust.  I was just wondering if you would take the time to give me some advice on how I can help him overcome the effects of being abused as a child.

    Your help is greatly appreciated.

     

    ANSWER:

    1)    He needs professional counseling – especially before you get married and the intimacy fears cause marital problems. 2)    He needs his diagnoses treated, whether from the BPD, PTSD, etc.  The screening test I use for my patients may be of great help to both of you.

Separator (Biological Unhappiness)

 

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Am I Feeling Sad For No Reason?

QUESTION:

Dr. Heller,

HI, I JUST WANTED TO ASK IF THERE IS A WAY TO FIND OUT IF MY FEELING SAD FOR NO REASON IS A BIOLOGICAL THING.  I HEARD I HAD A GREAT GRANDFATHER KILL HIMSELF AT 93 AND ALMOST EVERY GIRL IN MY FAMILY HAS BEEN DEPRESSED OR UNHAPPY AT SOME POINT.  I ALWAYS THINK I AM DYING.  I AM ONLY 25 AND WAS DEPRESSED AT 19 FOR 1 FULL YEAR.  I HELPED MY SELF WITH STRENGTH AND HELP FROM MY FAMILY – HUSBAND, PARENTS AND SIBLINGS.  I AM PREGNANT WITH MY THIRD BABY AND ALWAYS FEEL SAD ON CLOUDY DAYS FOR ANY REASON.  ALL I THINK ABOUT IS HOW AFRAID I AM TO DIE.  WHAT CAN I DO?

UNHAPPY IN NY

ANSWER:

You shouldn’t be feeling this bad.  It’s neither normal nor healthy.  The screening test I use for my patients will be of help to you in finding the diagnoses.  I encourage you to spend time on the Website, and my books may be of great help to you as well.  Please understand that you absolutely, positively don’t have to feel this way.

What Can I Do For My Fear Of Flying?

QUESTION:

Dear Dr. Heller,

I have developed over time an extremely high anxiety when flying.  It has gotten so bad I don’t think I can board another plane.  My job requires that I travel 6 to 10 days a month(20k miles a mo.)  I am going to lose my job over this.  My doctor won’t prescribe a tranquilizer for me.  I am at the end of my rope:  Lose my job (and thus my family and home) or my life in a plane crash.  What can I do?

ANSWER:

Medication is likely required, at least in the short term.  I recommend you do the screening test I use for my patients, it will likely be of assistance to you.  Making all the diagnoses and treating them is very important. There are many specialists in this field who can work with you to desensitize yourself towards this fear.