Is Your Depression or Anxiety Just a Mental Bad Habit?

Depression and anxiety are common problems for humans. So common that almost all of us will experience one or the other or both in our lifetimes. In truth, both depression and anxiety are normal and healthy reactions to life stressors, grief, and trauma and they have their uses in terms of survival and adaptation. The problem comes, then, when they linger beyond their useful time.

The Neurotransmitter-Only Myth

In modern medicine we tend to compartmentalize and idealize situations in which we can blame a problem on one concrete and measurable thing. Like serotonin. Serotonin is a great thing to blame in medicine. Not only is it concrete and measurable, but we have drugs to change how it is used and processed and therefore, it’s “fixable.” That is all nice and neat and it would be perfect, if this strategy actually worked. Like, really worked.

I am not at all suggesting that this is a bad route of treatment for depression – it’s actually a pretty good one and lots of people see improvement of their symptoms and sometimes even resolution with a drug that affects serotonin, like an SSRI. But, lots of people don’t, which means we have a ways to go.

Last week, we talked about other factors that can lead to depression, and those are generally physical states. These are typically also pretty straightforward to address and will often bump a person from meh, to good. That is tremendous. But what about what is left?

Mental Bad Habits, Also Known As Neuroplasticity

The factor in troubled mental health that I feel is most overlooked is the bad habit factor. Unfortunately, this is a giant factor in our mental health because there is an important survival-related brain function that prioritizes neural pathways that we use frequently, which we call “neuroplasticity.”

Neuroplasticity is part of the way your brain learns what is important to you. The pathways between neurons that you use most frequently get strengthened and prioritized because they matter to you.

Picture it like a path through tall grass. The first time you walk through the tall grass and weeds you have to push through weedy tangles, the plants pull at your legs and they’re so close together that you can feel resistance as you walk. The fifth time you walk the same path, you notice the plants are trampled in that area, there is a natural space opening up and walking is easier. The five hundredth time, there is a dirt trail there where the plants have stopped growing because the path is traveled so frequently. It’s clear and easy and there is no resistance.

Your brain is exactly the same way – the more you use a certain pathway, the easier it becomes to continue to use that pathway. This principle applies to many mental states that could be considered mental bad habits.

  • Anxiety
  • Catastrophizing
  • Depression
  • Negative self-talk
  • Obsessive thoughts
  • Intrusive thoughts
  • Guilty or self-reproaching thoughts.
  • Lack and scarcity

This also applies to many mental states that can be considered mental good habits.

  • Gratitude
  • Mindfulness
  • Acceptance
  • Forgiveness
  • Self acceptance
  • Abundance

Now, does this mean that if you focus on retraining your brain that a lifetime of depression and anxiety can disappear? In all honesty, I think it does, but it also takes a significant amount of work, and sometimes there really are nutritional deficiencies, physical problems, or neurotransmitter imbalances that need to be corrected as well.

Breaking A Mental Bad Habit

There are three techniques that I think are incredibly helpful in breaking a bad habit. The key to all of these is experimenting to see what seems to work best for your particular bad habit, and then repeating the technique over and over again. Mostly, this boils down to practice. So here are the techniques to choose from:

The Fantasy

Say your issue is catastrophizing or anxiety and you get into a place of “what if.” “What if I lose my job and I can’t keep up with the bills and I have to choose between keeping the house or …” We all have these thoughts sometime and they are largely unproductive. This isn’t when most people do effective planning, this is just when they spin out into fear and anxiety. So, here’s what you do.

  1. Notice you’re spinning out. This is actually the hardest part because if you get into this thought frequently, it often runs in the background without you placing any attention on it.
  2. Choose something awesome instead. With the above job-loss fantasy (which is in most cases just a fantasy), replace it with an opposite fantasy. “What if I win the lottery and buy my own jet and …”
  3. Enjoy it for a minute. Really get into the replacement fantasy. Figure out what you would do, imagine how it would feel waking up every day knowing that you can do whatever you want. Think of all the things you could enjoy.
  4. Repeat. Every time you notice anxious thoughts, do this same thing. It takes practice, but you will notice the anxious thoughts coming less frequently, feeling less emotionally compelling, and vanishing more quickly.

The Stop and Drop

This is my personal favorite, just because it’s a nice gap in a crowded mental landscape. Again, the hardest part is noticing your mind.

  1. Notice you’re having a mental bad habit. If you’re doing your mental bad habit – judging yourself, feeling bad about something, obsessing, the first step is always to notice you’re doing it. This means recognizing the thought or feeling in the moment.
  2. Stop. In that moment stop what you’re doing for a few seconds, take a deep breath, and notice your body, your hands, your shoulders, the physical feeling that goes with your mental bad habit. Usually, people notice clenched jaws, fisted hands, bunched-up shoulders, clenched belly, that sort of thing. Let your body relax.
  3. Drop. Take another deep breath and keep your body relaxed and let the thoughts just drop. You don’t really have to do anything with the thought, just let it finish and go away and don’t choose to pick it up right away.
  4. Repeat. Again and again and again. This isn’t quick, but it is so effective. You are literally training your brain and just like training a dog or a horse, it’s all about persistence and repetition.

The Distraction

I learned this technique when my little girl was an early toddler and it applies to adult brains too.

  1. Notice your brain is in a bad place. Again, this first step is the hardest but if you start to pay attention, you will start to catch yourself in places you don’t want to be.
  2. Choose a distraction. Find your own version of a toddler distraction. Something your brain likes to do that isn’t a mental bad habit. It could be a book, a funny youtube video, or a quick game of some kind. Something that is mentally compelling enough to distract you entirely from that thought.
  3. Do your distraction for 1 – 3 minutes. It helps to set a timer so you don’t get lost in your distraction because that isn’t helpful either, but use your distraction as a way to bump your brain out of an unhealthy pattern. I’m not suggesting you binge watch Friends to stop your depression because ultimately, that isn’t the point. Distracting yourself for twelve hours straight really only counts as one episode of distraction. The key is to repeat at short intervals.
  4. Repeat. Every time you notice your bad habit, give yourself a quick distraction. It will happen

A Note About Recognizing How You’re Feeling In the Moment

This is actually the hardest part because at the end of the day, the mind is a wild landscape and it’s not actually under much control. Your mind mostly does it’s own thing and you actually tune in selectively. Tuning in more often means you’ll have to learn the signals your mind gives you. A big part of this process will be noticing the trigger thoughts, feelings and body sensations that actually tell you your mind is in a dark place.

Lots of what goes on in your mind stays in the dark corners, never really coming to your attention except maybe as a sour feeling in your stomach, tense shoulders, or the sinking feeling that you’ve done something wrong and you’ll never be good enough. All of those things start in your mind even if you don’t hear or listen to the thoughts. It’s especially hard to see if you’re in that state almost constantly. Just keep trying. Even if you notice it twice a day, that’s a huge step forward.

If you really don’t ever notice it, then set alarms for yourself to practice one of the above techniques randomly. Take 2-3 minutes out of your day as often as you can – even hourly while you’re awake. It all adds up and stopping any thought and replacing it with something either entirely neutral, like the stop and drop or joyful, like the fantasy, makes a difference in the tracks your brain will follow.

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MTHFR and Depression

Depression is a common thread among all humans – this isn’t limited to MTHFR folks in any way, but as folks with an MTHFR variant, balancing methylation can be an effective way of tackling depression that is often overlooked by doctors and practitioners.

We always hear about neurotransmitters and depression, so much so, that I feel we overlook the fact that there are any other possible contributors. The assumption becomes that if you’re depressed, your neurotransmitters must be off somehow and if we can fix those neurotransmitters, we can fix the depression.

The problem is, this theory doesn’t actually pan out for a lot of people – especially MTHFR people. A drug that boosts the activity of serotonin in the brain should work, but often doesn’t. It has a lot of merit to explore other cuases of depression as well – especially when so many of them are fixable.

MTHFR does, of course, affect neurotransmitters via the BH4 pathway, but my experience clinically has been that balancing all of the other things goes farther than pills for neurotransmitters in most people (there are some highly notable exceptions, of course.)

Many factors play into depression and some of these are related to MTHFR, and some aren’t.

  • Low Folate and Vitamin B12 Status – This link holds true whether the person in question has an MTHFR issue or not. Lower nutritional status regarding folate and B12 means a higher risk of depression. Also, higher serum B12 and folate are shown to predict better treatment outcomes.
  • MTHFR? – It is clear that lower folate levels can increase the risk of depression, and that MTHFR can increase the risk of lower folate levels, but it isn’t absolutely clear if MTHFR increases the risk of depression independently from folate status.  There are several ways that it could – MTHFR polymorphisms have an impact on neurotransmitter formation, and also on DNA methylation, which can boost depression by itself.
  • C677T Status? – Again, this is questionable. This meta-analysis shows a link between C677T status and depression, but the fascinating thing is that another study shows that the strength of the link changes in different geographical areas. This could be due to local changes in diet, but it could also represent a big wild-card factor that tells us we have a lot to learn in this area.
  • High homocysteine – Of course high homocysteine could be a result of low folate status, but there is a clear link between homocysteine and depression (and, don’t forget, a link between MTHFR and homocysteine.)
  • Inflammation – In a classic chicken-or-egg scenario, inflammation and depression are terminally linked. If inflammation rises, so too does depression and likewise, if depression worsens, so too does inflammation. With MTHFR we do have a greater tendency toward both, so it matters to keep your inflammatory processes in check.
  • Oxidative stress – Oxidative stress is your body’s total level of reactive oxygen species (free radicals). Studies show that people with higher levels of markers for oxidative stress also have higher levels of depression and poorer responses to treatment. With MTHFR, we have the potential to have lower glutathione, which is the master antioxidant, meaning we may have higher levels of oxidative stress.
  • Insulin Resistance and Blood Sugar Issues – Research is mixed in this area. There is a clear link between depression and diabetes, but insulin resistance, which is one of the stepping stones on the path to type 2 diabetes, is less clear. The immediate and obvious link between blood sugar fluctuations and mood, is much less difficult. As anyone with a hungry toddler can tell you, the jump between hungry and “hangry” is a short one. Again, with MTHFR we do have a slightly increased tendency towards blood sugar issues, insulin resistance, and ultimately diabetes.
  • Hormones – Again, the links here aren’t clear. Low estrogen in women is linked to perimenopausal depression. Low Testosterone in men is likewise linked to depression. High estrogen presents mood and behavior shifts, and high progesterone brings on the waterworks (between naps). What is clear is that balanced hormones certainly lead to better and steadier moods, where fluctuations or abnormalities might put us into the roughs. MTHFR is, of course, involved in hormone regulation and processing, so righting the balance can be a highly productive step.
  • Sleep – A giant link exists between sleep quality and depression, and most of us have firsthand experience of that (is anybody else’s household entirely grumpy if their sleep is interrupted?)
  • Sedentary Lifestyle – There isn’t particularly a link between MTHFR and sedentary lifestyles, which is great news. There is, however, a big link between sedentary behavior and depression and also between exercise and improved quality of life mentally, emotionally, and physically. This isn’t an MTHFR issue in any way, but I would feel remiss if I left it out of the causes of depression list.

Each of the factors above is measurable and trackable and highly treatable, with or without an MTHFR mutation. Each of those factors can be worked on independently, but also any step toward a healthier lifestyle is going to help in many of those areas.

For example, balancing your methylation (which for us MTHFR folks usually means either taking a good form of folate or if we don’t tolerate folate, then finding a good work-around) will help to raise folate levels, lower homocysteine, and reduce both inflammation and oxidative stress. So one change is influencing four big contributing factors to depression. Does that mean balancing your methylation is going to fix your depression completely? Not necessarily, but it does get us closer to the goal and also improve your chances of responding better to other therapeutic interventions as well.

So from this list, we have a number of natural treatments for depression:

  • Folate, high folate diet, and anything that will help you to balance your methylation
  • B12
  • Exercise
  • Any kind of sleep therapy
  • Lower glycemic index diet for blood sugars
  • Reducing inflammatory foods
  • Antioxidants – especially the ones that cross the blood-brain barrier
  • Anything that will help you balance your hormones
  • Any anti-inflammatory

Every one of those is a book in and of itself, but seriously that is a lot of options to try, and all of them will lead to greater health regardless.

There are also two special factors that we haven’t talked about yet. One pertains more strongly to MTHFR folks, and the other is just a human-nature problem.

  • Childhood Trauma – A significant portion of depression in adults stems from childhood trauma, and unfortunately, people with the MTHFR mutations may be more susceptible to life-long depressive tendencies from childhood traumas than average. This is fixable, but it will take some work. This could be self-guided help through spiritual seeking, prayer, meditation, and self-healing techniques. It could also be professional help in the form of therapy, hypnosis, EMDR, or a myriad of other options.
  • Habit – This conversation is really neglected and so next week’s topic is going to be about expanding the habit idea and giving you some life hacks that you can start to practice at home, but any mental state, no matter what else contributes to it, has the potential for a habit component. This could be depression, anxiety, obsessive thoughts, intrusive thoughts, whatever. And sometimes you have to train yourself to break the habit in the same way that you would with any other bad habit.

I feel like all of this could appear daunting, but if you look at it another way, it also opens up so many opportunities for healing that are often overlooked. It can be incredibly discouraging when your doctor runs out of options for depression, but chances are they haven’t even scratched the surface of this list. Typically doctors look at sleep, blood sugar, and neurotransmitters in terms of depression. You now have the opportunity to dive deeper.

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Undermethylation – an MTHFR Basic State

Undermethylation, as we have discussed, is the most common state according to the research of Dr. Carl Pfeiffer in his book Nutrition and Mental Illness, An Orthomolecular Approach To Balancing Body Chemistry. Undermethylation really isn’t one state – it’s a tendency based on your genes, lifestyle, stressors, diet, and environment. Undermethylation is also a tendency that flows in a spectrum, from very mild symptoms to far more severe ones.

If you’re not sure if you’re an undermethylator, methylation neutral, or an overmethylator then visit this post for a comparative chart. As with everything else, even the most severely undermethylated person will have some associated traits and not others – this is all very individual. The biggest constants are high achievement/perfectionism, seasonal allergies, and depression.

Undermethylators Are Blessed With Many Positive Traits.

  • High motivation
  • High drive to achieve
  • Perfectionist
  • Competitive
  • Strong-willed

There Can Be A Darker Side:

  • Obsessive-compulsive traits or disorder
  • Anorexia
  • Workaholism
  • Other addictions
  • Ritualistic behavior

Undermethylation Can Lead to Physical or Medical Issues

  • Seasonal and inhalant allergies – this picture is dominated by high histamine and this is one of the most common problems even in relatively moderate or healthy undermethylation.
  • Headaches – these could be hormonal, allergic, stress-related, or migraine.
  • High HIstamine
  • Ulcers
  • Addictions – softer addictions like workaholism in more healthy situations, which can progress to harder addictions.
  • Depression – depression is very common in this group and it can be quite severe.

At The Extreme End of Pathology Undermethylators Can Be Prone To:

  • Paranoia, delusions, or phobias – the FBI or CIA is after them, their neighbor is an alien, etc….
  • Denial of or tendency to hide illness – illness just doesn’t go with perfection very well.
  • Hearing voices – Dr. Pfeiffer estimated this to be 5-10% of this group.
  • Major Depression
  • Suicidal Tendencies

Nutritional Tendencies In Undermethylation

  • Bad Reactions to B Vitamins – not every undermethylator experiences this, but many do. B vitamins, especially folate and B12, can cause bad reactions.
  • Often low calcium and/or magnesium
  • Often low methionine
  • Often low B6
  • Often low serotonin – can be extremely low
  • Often low melatonin – made from serotonin, so tracks along with it.

Medication and Supplement Reactions in Undermethylation

This represents what is typical for the group, but drug and nutrient reactions can be very personal, so this is a general guideline and not a certainty. This information is both from Dr. Pfeiffer’s book (see above), this article, and my own experience with clients.

Typically Good ReactionTypically Bad Reaction
SSRI medications (although may still be troubled by side effects)Benzodiazepines
AntihistaminesFolic Acid, Folate, Folinic Acid, 5-LMTHF
MethionineCholine
SAMe, DMG or TMG (all methyl donors)Histidine
St John’s Wort, melatoninDMAE
Calcium and magnesium (1:1 ratio), zincCopper
Antioxidants – A, C, E, alpha-lipoic acid, resveratrol, ECGC, etc…High folate foods including dark green leafy veggies and beans/pulses
Inositol
B6
Omega-3 fatty acids

Finding your best path forward is still a bit of trial and error, but this can give you some starting points. Remember, all of this depends not only on your MTHFR polymorphism, but all the other polymorphisms you might have (of which there are likely hundreds if not thousands) so be patient with yourself when you’re finding the best nutrients for your body.

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Overmethylation – an MTHFR Basic State

Overmethylation, as we have discussed, is the least common state according to the research of Dr. Carl Pfeiffer in his book Nutrition and Mental Illness, An Orthomolecular Approach To Balancing Body Chemistry. Ovmethylation isn’t caused by just one thing – it’s a tendency based on your genes, lifestyle, stressors, diet, and environment. Interestingly – you can be an overmethylator without having an MTHFR mutation at all. Overmethylation also flows on a spectrum, from very mild symptoms to far more severe ones.

If you’re not sure if you’re an undermethylator, methylation neutral, or an overmethylator then visit this post for a comparative chart. As with everything else, even the most severely overmethylated person will have some traits and not others – this is all very individual. The biggest constants are artistic or creative tendencies, empathy and/or social activism, and anxiety.

Overmethylators Are Blessed With Many Positive Traits.

  • Creative
  • Highly artistic or musical
  • Highly empathic and sensitive
  • March to the beat of their own drum
  • Passionate and self-sacrificing
  • High pain threshold

Some of These Traits Have a Darker Side:

  • Obsessive or manic focus on what is important to them (social cause, activism, artistic project)
  • Ruminating – hard to shut brain off
  • Sleep disorders
  • Anxiety
  • A tendency toward self-enhancement (extreme plastic surgery, implants of all types), tattoos, piercings

Overmethylation Can Lead to Physical and Medical Issues

  • Food and chemical sensitivities – this picture is dominated by low histamine which then translates to alternate immune pathway sensitivities.
  • Pain – head, neck, and general body pain.
  • Low Histamine
  • Anxiety or panic
  • Sleep disorders – especially with physical or mental restlessness.
  • Depression – depression – especially with an anxiety component
  • Hyperactivity, ADHD – in combo with restlessness and anxiety

At The Extreme End of Pathology Overmethylators Can Be Prone To:

  • Schizophrenia
  • Panic attacks
  • Self-mutilation or self-harm
  • Major Depression
  • Bipolar Disorder
  • Psychosis including post-partum psychosis

Nutritional Tendencies In Overmethylation

  • Great Reactions to B Vitamins – most overmethylators are low in B vitamins generally, but especially folate and B12 and typically do well with higher than average dosages.
  • Often high copper levels, which can be balanced by increasing zinc
  • Often low histamine
  • Often low B3 and B6
  • Often intolerant to estrogen therapies including birth control and HRT
  • Serotonin, dopamine and norepinephrine may be elevated

Medication and Supplement Reactions in Overmethylation

This represents what is typical for the group, but drug and nutrient reactions can be very personal, so this is a general guideline and not a certainty. This information is both from Dr. Pfeiffer’s book (see above), this article, and my own experience with clients.

Typically Good ReactionTypically Bad Reaction
BenzodiazepinesSSRI Antidepressants
Lithium (Rx) or Lithium OrotateAntihistamines
High-folate foodsEstrogen – birth control pills, hormone replacement therapy
Folate, Folinic Acid, 5-LMTHFSAMe
B12Methionine
B3, B6Copper
ZincTryptophan, phenylalanine
Antioxidants – C, E, A, NAC, etc…St John’s Wort
ManganeseTyrosine
MagnesiumDMG, TMG (methyl donors)
CholineInositol
DMAE
Omega-3 fatty acids

You can read more about overmethylation here.

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