Doctors Express Frustration With Misdiagnosed Depression
“The antidepressant is incidental. Most of the time it’s the placebo effect,” says Hyla Cass, MD, holistic psychiatrist and author of 8 Weeks To Vibrant Health and St. John’s Wort: Nature’s Blues Buster. She practices psychiatry looking at nutritional aspects, toxicities, hormonal function and how they all overlap and affect health.
Dr. Cass began seeing a connection to thyroid function and psychiatric disorders when, “The attention to the hormones wasn’t really there. They don’t even teach in medical school about integrative psychiatry. I just started to look at people’s lab work. Going back to medical basics and asking a lot of questions. I noticed a lot of symptoms of depression were thyroid problems.”
These symptoms include feeling tired, can’t get up in the morning, the feeling you could sleep all day long, weight gain, constipation, cold hands, cold body in general, a lack of social energy. Many of these symptoms are the same symptoms as depression. She also noticed other thyroid issues such as thinning of the hair, thinning of the outer third of the eyebrow, miscarriages, infertility, polycystic ovaries and cold feet.
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She stresses the need to look at the body as a whole.
“The most commonly prescribed anti-depression medications really show no benefit over placebo for mild and moderate depression and a slight benefit for serious benefit over placebo,” says Dr. David Brownstein, MD. He goes on to say, “Exercise beats antidepressant medication in almost every study it’s been looked at. Every facet of depression could really fall under a hormone imbalance, and particularly hypothyroid condition. We need to take a broader look at things, hands on to the patient.”
The STAR*D trial (Sequence Treatment Alternative to Relieve Depression) used over 4,000 patients testing the effectiveness between anti-depressants and a placebo. The results were overwhelming. There was no remarkable difference between the two groups.
Dr. Cass says, “You want to treat the brain as an organ. It releases a lot of our energy that holds a lot of our symptoms. Something is not going to just go away with the right kind of talk therapy. Evidence shows anti-depressants don’t really work but they get side effects and when they get side effects they think they’re working.”
The undisclosed challenge she sees is, “Doctors are under a tremendous pressure to produce. They see their patient for 15 minutes and it’s one, two, three and they’re out, they get a prescription. The whole medical system is not good. A lot of doctors are leaving because it’s not good on them and they see it’s not good on their patients.”
This is the most remarkable aspect.
The NIH recently reported, “Physicians’ suicide rates have repeatedly been reported to be higher than those of the general population or other academics.”
After she left the profession Dr. Diane Shannan said, “Medicine was not conducive to my health.”
Many physicians are choosing to run cash only practices today in order to avoid certain controls and regulations that prohibit their choice of treatment. Older doctors have advised younger doctors to “run – it’s not too late to change majors.”
What works is different than what is working in the medical field today.
Certain doctors are becoming more and more valuable as they are thinking independently from the system, not following pharmaceutical company advisement to prescribe antidepressants for depression but instead prescribing dessicated thyroid. The biggest wall they are encountering with their peers is testing frequently shows a normal thyroid level even though symptoms reflect differently. Many doctors only prescribe pharmaceutically promoted synthetic thyroid yet the doctors stepping out are seeing greater results from natural thyroid, dessicated.
Dr. Cass often orders tests to see if the thyroid stimulating hormone, TSH, is working properly along with a panel of other tests to direct a source. TSH, comes from the pituitary and stimulates the thyroid.
Dr. Brownstein says, “If doctors aren’t checking this T3 level, this active form of thyroid hormone, they could totally miss that these patients aren’t converting T4 into T3 and not recognize that all those symptoms (tiredness, hair loss, coldness) could directly be related to the inability to convert inactive to active thyroid hormone.”
He stresses he’s, “Frustrated with the lack of knowledge in conventional medicine. It’s just frustrating because it’s not just regular doctors it’s endocrinologists who don’t do a full thyroid panel in patients.”
Dr. Cass says, “It’s frustrating as a psychiatrist because I’m the one diagnosing and ultimately treating because if I send them back to an endocrinologist, their family doctor or their internist, they still won’t be treated appropriately.”
She adds certain supplements help with the conversion including B vitamins, selenium, magnesium, minerals and copper (click here to read more).
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Other sources:
http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out-doctors-decision-to-quit
http://www.ncbi.nlm.nih.gov/pubmed/15569903
http://www.nimh.nih.gov/funding/clinical-trials-for-researchers/practical/stard/allmedicationlevels.shtml
http://www.nimh.nih.gov/funding/clinical-trials-for-researchers/practical/stard/index.shtml
http://thethyroidsummit.com/hyla-cass-md/
