ADD and ADHD are increasingly common problems. It is estimated
that 4.4% of adults have ADHD (although this is certainly a low
estimate) and the figure is much higher for children: 11%. What is
worse is that these numbers continue to rise.
They are prescribed stimulants from an early age. According to Dr.
Vora, these stimulants are very effective, but the side effects of
ADHD medications can far outweigh the benefits.
One of the main problems with the stimulants used to treat ADHD is,
counterintuitively, the fact that they are so effective.
Dr. Vora wings that with many mental health medications, we don't
really know if they work; antidepressants, for example, work just as
well as a placebo for mild to moderate depression. But, according to
Vora, "stimulants do work."
That means that many people diagnosed with ADHD take these
medications early and take them for a long time, and that's where the
problems arise.
Dr. Vora has many patients who have been taking stimulants for many
years, often since childhood, and this can lead to long-term problems
and difficulties as they reach adulthood.
"There's a real psychological and physiological dependence," Vora
says, explaining that many of his patients tell him they can't even get
out of bed until they've taken their Adderall (or Vyvanse, or Ritalin, or
Concerta...). Because of the potency of these medications and the
length of time most people take them, getting off ADHD medications
can have its own set of side effects. Vora says that stimulants give people
a sense of false energy and alertness, allowing them to skimp on nutrition and sleep
and perform at an extremely high level.
Then, when the drugs are removed, there is a "reward," as Vora
describes it. This can manifest in people being glued to their couch,
depressed, exhausted and insatiably hungry, as well as contributing
to adrenal fatigue. Because of all of the above, it can take months,
even years, to come off these powerful stimulants.
"These drugs are not benign," Vora reiterates. "I don't dispute that
some people really do have blue symptoms of ADHD, I just think
there's a better way to manage it, and I hope people can learn about
that alternative so they can do that before they go down this road
of medication."
The link between gut health and mental health.
One of the other serious side effects of ADHD medications is that it
has a negative impact on patients' gut health.
Dr. Vora attributes this to the fact that stimulants prevent their
parasympathetic nervous system (also known as the "rest and digest"
system) from activating. Over the years, this can severely damage
your body and your gut because it is never given a chance to rest,
repair and digest properly.
This is a big problem because the intestine not only deals with
digestion, but also plays an important
digestion, but it also plays a role in mental health.
"The gut microbiome affects everything, and it affects everything
quite profoundly," says Dr. Vora.
To explain the link between gut health and mental health, he explains
that the brain, like the liver or kidneys, is a physical organ, which
means that if something is physiologically wrong in your body, it will
have an impact on your brain. And it turns out that the biggest impact
comes from physiological imbalances in the gut.
See, we're in a symbiotic relationship with bacteria and viruses within
our gut, each of which has a particular role to perform. For some of
those microbes, that role is to synthesize neurotransmitters, which
help our brain function normally. So, if something is wrong with your
gut, whether it's inflammation, poor digestion, or any other gut
problem, it may mean that your gut's
gut, it may mean that vital neurotransmitters such as serotonin and
GABA (gamma-aminobutyric acid) are not being produced properly.
This, in turn, leads to mental health problems.
Consider, then, what Dr. Vora explained above, along with the fact
that low serotonin levels are linked to depression and low GABA levels
are linked to anxiety, and the link between gut health and mental
health suddenly seems even stronger.
How sleep affects mental health.
As a practitioner of integrative psychiatry, Dr. Vora turns to holistic,
lifestyle-based changes that can help patients address the root cause
of their problem, rather than simply pulling out her prescription pad.
However, it can seem like there are an overwhelming number of
options when it comes to those changes: there's diet, supplements,
meditation, acupuncture, yoga,
relationships, environment and many, many more.
But there's one thing Dr. Vora always likes to start with: sleep.
She suggests simple changes like taking your phone out of the
bedroom and making the lights in your home dimmer at night, both of
which encourage your natural circadian rhythm and prepare you for
better sleep.
This is important with regard to mental health because, as Dr. Vora
says, "once someone sleeps better, everything else is easier."
Anxiety, depression and gut health all improve when someone sleeps
well, and when all those aspects of health are more manageable, then
it's easier to make other changes.
The full interview with Dr. Vora to learn more about her unique and
integrative approach to psychiatry, including the role acupuncture
and yoga play in her practice, why she doesn't believe the cause of
anxiety and depression is a "Zoloft deficiency," a disruption of the role
of epigenetics in our mental health, and much more.
You can also listen to an audio version of our interview with Dr. Ellen
Vora on The WellBe Podcast.
Do you agree with Dr. Vora's approach?
Did anything she said resonate with you?
The information contained in this article comes from an interview with
Dr. Ellen Vora, MD, psychiatrist, acupuncturist and yoga teacher. She
is board certified in integrative and holistic medicine. Her
qualifications and training include receiving her undergraduate
degree from Yale and her MD degree from Columbia University. You
can learn more about Dr. Vora and her practice here.
You deserve a better life!
With gratitude
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