Depression and Anxiety Part 2

Question 1

Mood Disorders may be the
early
manifestation of underlying processes
which later frequently (30 50%)
manifest as

Answer 1

neurodegenerative

disorders.

Question 2

Mechanisms by which sugar affects mood/anxiety

• uses up ____ vitamin?
• inhibits ____?
• with high fat reduces ______

Answer 2

Decreases BDNF
Makes pro-inflamm cytokines
Uses up B Vit
ANS stress
Inhibits Krebs Cycle Function in some patients

also with high fat, reduces neuronal plastiicity

Question 3

tryptophan deficiency (also tyrosine) - can cause...
Tx with...

Answer 3

depression!

Tx with 5HT (crosses BBB better than tryptophan)

Question 4

which type of omega 3 FA for depression

Answer 4

EPA (more anti-inflammatory and better for depression) 1-2 g/day
(Also omega 3s generally help for anxiety at lower doses)

Question 5

vit D and depression

Answer 5

supplementing helped dep!

Question 6

Zinc and depression

inhibits glutamine or GABA?

Answer 6

zinc levels lower in dep
Zinc inhibits glutaminergic (vs. GABA) so has antidepressant effects
needed for serotonin receptors

Question 7

high risk groups for Zn deficiency

Answer 7

adolescents
inflammation
post-partum

Question 8

Zinc: copper ratios ideal

Answer 8

RBC - 16:1

serum - 1:1

Question 9

Minerals in GAD patients

Answer 9

lower Zinc

Higher iron, Cu, Mn

Question 10

Zinc and PMS

Answer 10

levels lower in luteal phase

Question 11

Copper excess with low zinc seen in…

Answer 11

anxiety
aggression
women on OCPs
female hormone-related mood d/o

Question 12

Nutritional adjuncts in depression

Answer 12

SAM-e, methylfolate, zinc, Vit D, omega-3

Question 13

If concerned about MTHFR also need to check

Answer 13

down stream labs, not just genetic testing

Question 14

suicide and methylation

Answer 14

childhood trauma –> overmethylation

Question 15

folate and depression

Answer 15

SSRI plus folate led to improvement in Sx

Question 16

assessing for B12 deficiency

Answer 16

MMA not sensitive

B12 serum levels may not be accurate

Question 17

PPIs and dep

Answer 17

PPIs assoc with higher rates of depression and also higher levels of PPIs

Question 18

Nutrient Supplementation for Depression/Anxiety

Answer 18

EPA
Vit D
Mag
Vit B2, B6, B12 
folate
SAMe
5-HTP
Tyrosine
NAC
Zinc
Inositol

Question 19

Inositol caution

Answer 19

can cause mania and diarrhea

start low, go slow!

Question 20

caution with methylfolate

Answer 20

watch for worsening

Question 21

consider for mania

Answer 21

SAMe

Question 22

caution with EPA

Answer 22

easy bruising

glucoreg in DM

Question 23

Caution with 5-HTP or trypt plus SAMe

Answer 23

serotonin syndrome

excitotoxicity

Question 24

zinc excess

Answer 24

memory issues, copper def

Question 25

SAMe caution

Answer 25

switching and agitation in bipolar

Question 26

Vit D caution

Answer 26

Ca excess, kidney stones

Question 27

folate excess

Answer 27

hypermethylation, prostate CA, agitation

Question 28

exercise and anxiety

Answer 28

both cardio and strength training helped

Question 29

Physical activity alone can treat _______ depression symptoms.

Answer 29

mild to moderate

Question 30

How to naturally increase BDNF levels?

Answer 30

exercise

Question 31

depression and the microbiome

Answer 31

Altered microbiome:

• dec bifido, lacto, fecali
• increased clostridium, strep, klebsiella
• Increased IP
• Increased anti-LPS

Question 32

GF diet and dep

Answer 32

improved mood d/o

Question 33

supp for depression/anxiety

Answer 33

5 HTP,
Vit D and B vitamins,
Methylfolate
inositol - like glucose, mediates signaling in brain

Question 34

celecoxib and depression

Answer 34

lowers it without adverse events

Question 35

Bipolar I is highly correlated with

Answer 35

schizophrenia.

Question 36

Bipolar II is highly coorelated with

Answer 36

MDD

Question 37

α-KGDH

Answer 37

KGDH is the primary site of control of the flow through
the KREBS cycle.
inhibited by oxid stress

Question 38

T3 needed for ___ receptors

Answer 38

serotonin (so is Zinc!)