January 2012

The Anger Quotient

I wrote this blog back in June, but I think it time to repeat it. The holidays are over and all that good cheer and those good ideas for New Year’s resolutions have worn off. The regular day to day stresses are wearing many thin. So, I think this will be a good reminder to take a deep breath and think about what is important.

Have you ever had one of those weeks where every step you take, something or someone is making you angry? I was having one of those weeks until I heard a quote on a daytime talk show taken from St. Augustine: “Resentment and anger is like taking poison and expecting the other person to die”. First, this wisdom immediately deflated my anger and then it led me to question the point of anger in the first place.

Anger has been with us since the beginning of mankind. The emotion of anger has intrinsically been an impetus for change. It may cause discomfort, however when dealt with constructively, it moves us to act and improve the circumstance causing the discomfort. When dealt with destructively, anger can cause violence, self-loathing and depression.

As a physician, I see the physical effects of this on a daily basis. Depression, heart disease, and obesity (that can cause diabetes, high blood pressure and certain cancers) can often result from prolonged anger, resentment and hostility. Many patients I see heal and improve when we address the underlying anger and resentment in their lives.

With all that is going on in the world right now, it seems there is anger at every turn. The media is busy reporting various feuds; politicians are angry with one another, and the opposing parties. Doctors are angry with insurance companies, and patients are angry because they are not getting what they want from their doctors.

I think if we all stopped for a moment when we become angry and truly thought about what was going on internally, we could make great changes in ourselves and in the world. If we find that anger is consuming us, it is time to get help before it destroys us.

“The best work of the world is done in the tension between anger and control.” ~ G. Stanley Hall

A Novel Treatment For Depression

If it seems that almost everyone you know is on antidepressants, your perceptions would be correct. Major depressive disorder affects up to 12% of men and 25% of women. Antidepressants can be effective in treating this disorder but only result in a remission in 30% of those treated. The response rate to medication (meaning there is some improvement) can be up to 70%.

The most popular antidepressants of choice are the selective serotonin reuptake inhibitors like Prozac and Zoloft. These medications block the reuptake of serotonin by the brain keeping up levels available to the central nervous system.

New research has found that there may be something out there that can augment and perhaps treat depression alone. It gets to the very core of the problem and believe it or not it is not a medication. It is a vitamin. I know this sounds too good to be true, but it is not. Let me explain.

Folic acid is an essential B vitamin. It is found in green leafy vegetables, eggs, cereals and fortified foods (to name a few). When you take in folic acid in your diet it is absorbed by the small intestine where it is converted by a series of enzymes and ultimately into L-methylfolate. This metabolite is used to make serotonin, norepinephrine and dopamine, which are all important for mood regulation.

Scientists have identified 40 mutations on the gene responsible for making the enzyme that converts folic acid into L-methylfolate. The most common genotype is known as C677T. If there is one mutation on this gene your ability to convert folic acid is reduced by 34%. If you have two mutations, it is reduced by 71%. Now you probably are seeing where I am going with this.

If you have a defective enzyme then you cannot convert folic acid to L-methylfolate properly and you will have lower serotonin, norepinephrine and dopamine levels. These gene mutations are extremely common. The treatment is simple. It is a prescription of L-methylfolate. This is a vitamin that is considered medicinal food. If given in the proper amounts (7.5 to 15 mgs) it can improve depression relatively quickly. In a study of elderly depressed patients, the response rate at 6 weeks was 81%. Results are often seen in just two weeks.

It is well tolerated with no more side effects than placebo. It does not interact with other medications. If an antidepressant has produced a positive response but the patient is still somewhat depressed L-methylfolate can help.

If you are depressed and/or on medication for depression, I recommend you ask your doctor to see if you have the genetic abnormality that I mentioned. The test is MTHFR. When I treat my depressed patients with this vitamin, I have seen amazing results. It just makes sense. If serotonin levels are genetically low then why not find a healthy way to boost them?

Find Purpose To Find The Path To Health

I give a lot of medical advice. Sometimes I feel like a broken record by repeatedly relaying the message that the secret of health is to maintain a healthy lifestyle. However, there is another more important secret that goes beyond the day-to-day choices that include food and exercise. It addresses personal power and what drives us. What I am talking about is having a sense of purpose.

I know to some this may sound like psychobabble. However, let me tell you about the nun study. Since 1986, a group of researchers has been studying nuns while they are alive and examining their brains after they die. They have been able to identify some of the risk factors for Alzheimer’s disease. They have found that those with a positive outlook who were continually exercising their brains were less likely to develop the disease.

The most interesting finding was that there were some nuns who died and then Alzheimer’s disease was found on autopsy, but they showed no signs of the disease in life. Those women had a positive attitude and a sense of purpose. That seemed to be enough to keep them healthy and functional.

A study of 155 senior citizens done in Chicago found that those seniors with a sense of purpose were 2.4% more likely to remain mentally sharp than those who did not. Those who were outgoing and self-satisfied were 50% less likely to develop Alzheimer’s. This attitude may boost the immune system and protect blood vessels.

There are so many things that we do not know. But, I am convinced that we all possess an amazing power. That is the power of our minds. It could be what is behind the placebo effect or perhaps it is just what overall wellness is about. Regardless, if you want to find the path to healing or maximum health, it is important to find your passion and you own personal path in life and then follow it!

Tips For Getting Fit

It is a new year and you have decided this is the year you are going to get into good shape. You have it all figured out. You find a gym, a class, and you even have a cute workout outfit picked out. That is wonderful. What you need to know is that most people are motivated at the beginning of a fitness program but they tend to fall off the wagon after several weeks. The key is to stay motivated and adopt simple techniques that will serve you throughout the year and your life. Here are a few:

1. If you are mindful, you will begin to notice how much better you feel by eating healthy, moving and losing weight. That in and of itself will be motivating.

2. Set small, reachable goals. The best example of this was an interview I heard on the Today show. A woman who had lost 100 pounds said that she looked at her weight loss as losing ten pounds ten times. She basically set out to lose 10 pounds at a time. If she had looked at losing 100 pounds it would have felt impossible.

3. Reward yourself when you reach your goal with something other than food! It could be something small such as a CD or a new purse or briefcase. It could be big such as a vacation or money that you reward yourself with.

4. Don’t do it alone. It helps to have the motivation of your friends and family. Just as being overweight can be contagious so can improving attitudes towards food and lifestyle changes. Including a family member or friend in your program can increase your chance of success.

5. If you can’t find a friend or family member to join your program, consider using a trainer or nutritionist. Even if you only meet with them once a month, you will have someone to support you and to be accountable to. It can really help.

Good luck with your workout routine. Following these few small tips can make a big difference in how you feel and help you to succeed.


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