In one of Dr. Dave’s recent installments, A Tale of Two (Hundred Twenty Seven) Depressions, he emphasized the diverse nature of the diagnosis called “depression.” For example, although it is one of the most common mental disorders in the world, depression is not a single entity but rather a description of several distinct but overlapping clinical conditions each with its own unique symptoms and biological correlates.
Because of this and before you take any treatment – meds, supplements, or lifestyle – for symptoms of depression, it is crucial to know what type of depression you have.
For example, based on the current classification system (Diagnostic and Statistical Manual of Mental Disorders – DSM), individuals with depression may exhibit more than 220 unique combinations of symptoms. Even so, the standard in most clinical settings is to treat all of these distinct presentations the same way: with the cheapest generic antidepressant medication insurance will pay for. This approach flies directly in the face of our practice philosophy of tailoring treatment to your specific constellation of symptoms, co-existing medical conditions, early life experiences, unique genetic make-up, and measurable imbalances in neurotransmitters and hormones.
For instance, you can meet criteria for depression and be unable to sleep or sleep too much, be unable to eat or eat too much, be unable to sit still or be unable to move. Common sense and, increasingly, scientific literature strongly suggests that such widely disparate symptom clusters represent vastly different disorders.
This variability in clinical symptoms reflects a similar variability in biological dysregulations among depressed persons.
It is this heterogeneity of symptoms and biological correlates that is responsible for how poorly commonly prescribed antidepressant medications work. In spite of the widespread use of antidepressants, 2 out of 3 patients still suffer from residual depressive symptoms. In fact, only about half of those taking antidepressant drugs experience any reduction in their symptoms, while nearly 90% of users suffer from significant side effects: fatigue, sexual dysfunction, weight gain, somnolence, emotional blunting, and “brain fog.”
More specifically, the net effect of most antidepressant medications is to increase the activity of your existing supply of serotonin. That is all well and good if you suffer from low-serotonin depression. Unfortunately, low-serotonin depression represents only about 1/3 of all depressed individuals.
Not only do such drugs not treat symptoms of low-dopamine depression, they may actually make them worse. Moreover, serotonin-dominant antidepressants (SSRIs and most SNRIs) over time reduce dopamine levels further compounding your already low dopamine status.
Symptoms of Low-Dopamine Depression
So, what exactly does low-dopamine depression look like? Good question. In general, such depressions are associated with the following:
- Absence/reduction of positive mood and thoughts – “brain fog,” complacency, apathy, anhedonia (inability to experience pleasure), and “burnout”
- Leaden paralysis
- Excessive sleepiness
- Increased appetite (carbohydrate cravings) with weight gain
- Metabolic syndrome
- PTSD, fibomyalgia, chronic fatigue
- Overactive immune system with pain and inflammation
- Low cortisol and low excitatory neurotransmitters
In addition to causing some types of depression, low dopamine levels can cause slow and stiff muscles, dissatisfaction with life, addictions, cravings, compulsions, low sex drive, poor attention, decreased motivation, and lack of focus.
Symptoms of Dopamine Deficiency in General
Even if not depressed, you may still be suffering from dopamine deficiency.
- Do you often feel depressed, flat, bored, and apathetic?
- Are you low on physical or mental energy? Do you feel tired a lot; have to push yourself to exercise?
- Is your drive, enthusiasm, and motivation on the low side?
- Do you have difficulty focusing or concentrating?
- Are you easily chilled? Do you have cold hands or feet?
- Do you tend to put on weight too easily?
- Do you feel the need to get more alert and motivated by consuming a lot of coffee or other “uppers” like sugar, diet soda, ephedra, or cocaine?
If you answered yes to any of the above you could have low dopamine levels.
Test dopamine levels with the NeuroScreen neurotransmitter test. A simple urine test can determine your dopamine levels.