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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by roo on February 13, 2001, at 8:46:03
Has anyone out there ever thought they had depression,
and later learned they actually had a hormonal imbalance?
If so, share your experiences with me. I have been
diagnosed with 'cyclical depression'. I feel pretty
good half the month, and pretty damn shitty the other
half. I am just beginning to chart my moods and menstrual
cycles to see if there's any connection. I've been
reading a lot about peri-menopause and relating to a lot
of the symptoms (although I'm only 32, I only have one
ovary, which could contribute to imbalanced hormones).
I've made an appt. with an endocrinologist to get my
hormones tested. Just curious if any other women out
there have explored this possibility.
Posted by Cam W. on February 13, 2001, at 11:41:09
In reply to Hormonal Imbalance or Depression?, posted by roo on February 13, 2001, at 8:46:03
Roo - Hormonal imbalances can cause depression. This is very common. Depression commonly results from endocrine disorders such as acromegaly, Cushing's syndrome, hypothyroidism, hyperparathyroidism, diabetes mellitus, Addison's disease, etc.
Many other medical disorders also cause depression (eg Alzheimer's, Parkinsonism, TB, lupus, emphysema, AIDS, CFS, malnutrition, cancers, tumors, etc.). The depression occurs not only as a lack of coping, but more likely as a direct result of the mechanisms of the disease.
All of the body systems seem to interwine (ie talk to each other), so when you disturb one you are disturbing them all. The endocrine system and stress system (HPA axis) are particularily interwined. Both involve the hypothalamus and pituitary gland.
Many times just correcting the hormonal imbalance will not correct the depression and it is necessary to take antidepressants to get the HPA axis back online. Do not be surprized if you are treated for both.
Hope this helps - Cam
Posted by willow on February 13, 2001, at 12:17:40
In reply to Re: Hormonal Imbalance can cause Depression? » roo, posted by Cam W. on February 13, 2001, at 11:41:09
"The endocrine system and stress system (HPA axis) are particularily interwined. Both involve the hypothalamus and pituitary gland."
or what do the hypothalamus and pituitary gland do? I regularly get high levels of testostorone for a woman 160+. I've been diagnosed with CFS, but suspect that it is related to a depressive disorder or somatisation. (I'm staring to have very positive results with effexor xr 150mg! : )
By the way welcome back!
Posted by willow on February 13, 2001, at 12:23:25
In reply to Hormonal Imbalance or Depression?, posted by roo on February 13, 2001, at 8:46:03
"Has anyone out there ever thought they had depression, and later learned they actually had a hormonal imbalance?"
The thought has crossed my mind but never investigated it. I can not take "birth control pills" because they give me depression and migraines. My last depressive episode or symptoms started with a bad headache before my mentstrual cycle started. The headache lasted only the day but was replaced by severe cognitive problems. Let me know what happens with your visit!
Posted by willow on February 13, 2001, at 12:29:50
In reply to Roo ..., posted by willow on February 13, 2001, at 12:23:25
I was told I wouldn't be able to have children and that I may get physical changes because of my hormone levels. Then I had my first bout with fatigue years later, caused by too much stress at the time, and I was treated with impramine (sp? one of the older ADS.) I couldn't stay on it because it made me cry all the time and feel buzzed. Anyway my menstrual cycle which I hadn't had but about once a year started to regulate. Was it because of a underlying depression the hormone imbalance? I've been able to have three children, with somewhat irregular cycles in between them, but once I stopped nursing the last one my cycles have been regular yet I have all these "symptoms" CFS. Weird?!
Posted by Noa on February 13, 2001, at 13:43:17
In reply to ps., posted by willow on February 13, 2001, at 12:29:50
Willow,
I have been tested for Polycystic Ovary Syndrome, which includes high testosterone levels, but I seem to test negative for it despite having a lot of the symptoms. Another thing I was tested for that includes high testosterone is congenital adrenal hyperplagia, which is actually a common hereditary disorder.
My endo did say that both of these can contribute to depression.
Posted by Cam W. on February 13, 2001, at 13:50:56
In reply to Cam what is ..., posted by willow on February 13, 2001, at 12:17:40
Willow - Thanks for the welcome back. I'm glad to be back, I think.
Sure, give me the tough questions.
The hypothalamus is a brain structure under the thalamus and is kinda like the brain's "quarterback", in many ways. It contains hormones and other neurosecretions that control many metabolic activities (eg body's water balance, sugar & fat metabolism, body temperature regulation, etc). More importantly, for our discussion it "calls signals", ie pumps out inhibiting and releasing hormones.
Some example of these hormones are corticotropin-releasing hormone (CRH), follicle-stimulating hormone-releasing hormone (FSHRH), growth hormone-releasing hormone (GH-RH), antidiuretic hormone (ADH), luteinizing hormone-releasing hormone (LH-RH), etc. The hypothalamus basically integrates the sympathetic and parasympathetic nervous system activities.
These hormones stimulate the pituitary (the body's "running back" or "halfback") to release hormones which are sent to organs and structures in the body, including sexual organs and the adrenal glands (which produces and secrets a variety of substances, including cortisol which is involved in depression via the HPA axis), causing release of still more hormones and enzymes.
The pituitary (an endocrine gland), upon hormonal signaling by the hypothalamus, releases it's own hormones which influence growth, sexual development, thyroid function, and, as mentioned above, adrenocortical function. It does this by chemically signaling other endocrine glands (testes, ovaries, part of the pancreas, adrenal cortex and medulla, thyroid) to release various substances.
I hope that the above explanation shows the interaction of the endocrine system and stress (cortisol) systems. (it's been a long time since I tried to put many of the functions of these structures together, instead of focusing on individual actions).
Basically, I guess, the hypothalamus responds to bodily conditions (eg stresses - heat, cold, fear, anger, lust, etc) and then tells the pituitary to do something about it. The pituitary signals the appropriate bodily organs and systems and tells them to return to normal (called homeostasis). Disruption of this signaling leads to disorders like depression, diabetes, aberent sexual drives, hyper- or hypothyroidism, ad nauseum).
I do hope that I am making some sense here because I am doing this more or less off of the top of my head. Someone who is closer to school age, and has taken classes in this stuff more recently than I have can probably give a better explanation than I have (but I tried).
I hope this helps somewhat, Willow. I realize that what I am trying to say is not too clear.
Can anyone out there give a clearer explanation of what I am saying and fix any mistakes that I have made. It would be appreciated.
Thanks - Cam
Posted by willow on February 13, 2001, at 14:20:13
In reply to Re: Cam what is ..., posted by Cam W. on February 13, 2001, at 13:50:56
"Sure, give me the tough questions."
You helped me to understand by adding words I could relate to like "halfback." I liked playing soccer and this was my position.
"... control many metabolic activities (eg body's water balance, sugar & fat metabolism, body temperature regulation, etc). More importantly, for our discussion it "calls signals", ie pumps out inhibiting and releasing hormones. ...
Basically, I guess, the hypothalamus responds to bodily conditions (eg stresses - heat, cold, fear, anger, lust, etc) and then tells the pituitary to do something about it. The pituitary signals the appropriate bodily organs and systems and tells them to return to normal (called homeostasis)."
Okay! So how do you get the hypothalamus to respond properly. (This is just guess work, but it is my major complaint, to the doctor, my body does not react approipriately to stressors, good or bad.) Besides leading a very sedate lifestyle?
Posted by Noa on February 13, 2001, at 15:23:04
In reply to Re: Cam what is ..., posted by willow on February 13, 2001, at 14:20:13
is by Charles Nemeroff, MD, entitled The Neurobiology of Depression. The URL is:
Posted by Cam W. on February 13, 2001, at 16:02:46
In reply to Re: Cam what is ..., posted by willow on February 13, 2001, at 14:20:13
> Okay! So how do you get the hypothalamus to respond properly. (This is just guess work, but it is my major complaint, to the doctor, my body does not react approipriately to stressors, good or bad.) Besides leading a very sedate lifestyle?Willow - To get your hypothalamus to "work properly" you will have to somehow "recouple" your HPA axis (hypothalamus-pituitary-adrenal axis). Antidepressants can do this, but finding the right one can be time consuming, frustrating, and is a system of trial and error (ie the antidepressant that affects the neurotransmitter system(s) that have resulted in the uncoupling of the HPA axis).
The Sci Am article Noa refers to is "very good and very readable. I recommend everyone interested in depression read it. While it is not the full story, it is very pertinent to what depression is (or may be). Thanks Noa!
Willow, your problem may not be HPA related, but it is best to rule that out first. This can best be done with a trial and error approach (with best clinical guesses) of a series of antidepressants. Another guess that comes to mind is a problem with your GABAergic system. How do benzodiazepines affect your symptoms?
Read the article and if you have any questions, I will be glad to answer them the best I can.
Good luck with your research - Cam
Posted by MarkinBoston on February 13, 2001, at 18:59:03
In reply to Re: Cam what is ..., posted by Cam W. on February 13, 2001, at 13:50:56
> Can anyone out there give a clearer explanation of what I am saying and fix any mistakes that I have made. It would be appreciated.
Seemed OK except that virtually all these systems have some sort of negative feedback loop of some sort that will inhibit the release of more hormone. One feedback system is indirect. In men, its the Estradiol level that inhibits GnRH. Estradiol is generated by aromatase conversion of testosterone. So, dysfunctions somewhere in the primary chain or the negative feedback loop can cause wrong numbers.
Willow, was your free T measured as well? Its the level of the active stuff, not bound to SHBG or albumn.
Posted by willow on February 13, 2001, at 20:26:25
In reply to Re: Cam what is ..., posted by MarkinBoston on February 13, 2001, at 18:59:03
I don't know. Originally I think it was a blood test and a couple days sample of urine and they x-rayed my head. When the doctor explained what the testosterone levels meant I thought he was "nuts." I didn't go back to him. Since then it has shown up occasionally on tests.
But the next time it does go high again I'll inquire about the T thing, what I'll ask if the measurement is of the active stuff. On the plus side before the CFS I was good in math, they say that's related to this hormone.
I went to the link Noa provided. It's more technical than I am. It kinda explained why the effexor is working for me. I hope the blood pressure issue doesn't make them want to take it away from me.
No more questions of this sort from me. I think you guys satisfied my curiosity.
Thanks
Willow
Posted by roo on February 14, 2001, at 12:45:50
In reply to Roo ..., posted by willow on February 13, 2001, at 12:23:25
> Willow--I'll let you know what happens with the
visit...It's not until April though...I started
reading stuff by Dr. Lee (writes books on menopause
and peri-menopause "What your Doctor won't tell you
about Menopause") and could relate to a lot of
the symptoms...but I've heard a few people also say
he's a quack. I took birth control pills and got
depressed too, and it took away my sex drive as well.
The ideas of taking synthetic hormones kinda makes
me wince...but I'm thinking if my hormone levels
are tested and seem out of whack, that maybe i'll
see an acupucturist or something...I don't know, we'll
see.
Posted by willow on February 14, 2001, at 13:21:23
In reply to Re: Roo ...willow, posted by roo on February 14, 2001, at 12:45:50
Roo
Please do post back in April and I hope all goes well for you!
Willow
Posted by Noa on February 14, 2001, at 14:18:59
In reply to Re: Roo ...willow, posted by willow on February 14, 2001, at 13:21:23
Just came from the library, and they had (in the new book section) Dr. Vliet's book, Screaming to be Heard, which is about hormones.
This is the end of the thread.
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