WHY WE TREAT MENTAL ILLNESS

New evidence tends to suggest that the root of mental disease may be different than what we thought it was. Instead of people being “weak-willed” or having a “prozac deficiency disorder,” it is becoming apparent that in many if not most cases of mental illness there is a strong component of nutrient deficiencies. Add to this the fact that most people with mental illness have certain genetic defects that can make the processing of certain vitamins difficult, and you can begin to understand the epidemic we’re facing in the mental wellness arena.

Vance Medical offers a variety of supplements that aid in brain nutrition such as Lavela, Kava Calm, Methyl Protect, Niacinamide, B12 and EMP Lightning Stiks. Each of these helps improve areas of mental illness and mood and give you the nutrients you need to help your brain “work right.”

Very commonly psychiatric illness tends to run in families, and it has long been assumed that there must be some genetic component. Due to the vast amount of work done in the Human Genome Project, we have discovered several genes which have defects of varying frequency that can be associated with various types of mental illness. Some of these, MTHFR in particular, can be very common.

Recognizing the genetic defects can be helpful in certain cases to figure out the best way to treat the patient.

Most antidepressants work by artificially raising the level of chemicals called neurotransmitters (eg. serotonin, dopamine, etc) in the brain. Unfortunately, while they can make people feel better, they do nothing to address the problem of there frequently being insufficient neurotransmitters to begin with.

​Neurotransmitter therapy seeks to treat the problem in a different way, by giving people either the chemical itself or a precursor to it that can easily be turned into the needed neurotransmitter. Hopefully, by doing this, the levels of the individual chemicals can actually be raised instead of artificially elevated.

A small portion of the Neural Reflex Therapy protocols can help with various mental health issues, like anxiety, phobias, or PTSD. This is a manual therapy which can stimulate either relaxation or correct processing of memories. Within a few minutes patients can frequently feel much more calm and relaxed, often with reduced intrusive thoughts or memories. We have found it to be very helpful for most of the people we have used it on.

What is Ketamine?
Ketamine is a general anesthetic drug which has been used for all sorts of surgeries world-wide for over 50 years. It is remarkably safe and has even been put on the World Health Organization’s list of indispensable medicines that every country should have.

History of Ketamine
Discovered in the 1960’s, ketamine was found to provide extraordinarily safe anesthesia, and was used extensively in the Vietnam War. It has since been used frequently around the world for general anesthesia, especially in developing countries. In the 1980’s it was occasionally used as a recreational drug (related to PCP), and since then has been used less in the United States. Over the last 10-15 years, it has been recognized increasingly to have significant effects on mood. Multiple studies have shown that it benefits much faster than traditional antidepressants or other medicines.

How Does It Work?
Although the entire mechanism of action is unknown, ketamine is known to affect the NMDA (N-methyl-D-aspartate) receptors in the brain, altering the levels of active glutamate. Questions remain as to whether this is the cause of benefit with mood disorders, but it is quite possible. It also has a dissociative effect causing odd sensations. During the infusion, people generally feel very relaxed, and it’s possible that the level of dissociation could possibly help people process events in their lives better.

Conditions Ketamine Might Help

• Treatment of resistant major depressive disorder
• Treatment of resistant generalized anxiety disorder
• Post-Traumatic Stress Disorder (PTSD)
• Suicidality
• Complex Regional Pain Syndrome (CRPS)
• Fibromyalgia
• Chronic pain 

What Happens During an Infusion?
Before starting IV Ketamine, patients receive a full medical evaluation, with a review of symptoms, history, medicines tried, etc. Additional medical tests are ordered as needed. Typically six separate ketamine infusions are given with a two-week period, as this can lead to a more sustained benefit. For the infusion itself, an IV line is started and the ketamine is infused at a very specific dose and rate which is closely monitored. Vital signs (pulse, blood pressure, oxygenation levels, etc.) are also closely monitored. Typically the environment is reasonably darkened, and very relaxing music is played in the background. Patients are easily able to respond to questioning during the entire process, but may want to close their eyes since their vision tends to not track well during infusion. During the infusion, people generally feel very relaxed and peaceful. Sometimes other medicines are given to assist with this. Sometimes patients will fall asleep but will be easily aroused. Infusions can last from 30-90 minutes, and afterwards patients are observed until they can walk and communicate without difficulty. They are instructed to not drive for 24 hours, and must be taken home by a friend or family member (we will not infuse without this arranged in advance).

Side Effects
It is possible that with the infusions, patients can have some hallucinations or feel increased depression or anxiety. Occasionally after an individual treatment patients can have increased depression, although this is typically much improved with the next dose. Respiratory depression, while possible is much more rare than with other anesthetics. Elevated blood pressure can occur. Not infrequently patients will have nausea following the therapy, so medicine for this is frequently given.
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How Do I Find Out More?
If this therapy looks like it might be helpful for you or someone you love, call our office to schedule a consult with Dr. Vance for an evaluation to see if ketamine might be an appropriate treatment option.

The PTSD protocol is a collection of manual therapies that when grouped together tend to work very well for people struggling with Post-Traumatic Stress Disorder. While there are no guarantees, we have generally been able to permanently eliminate PTSD symptoms for any particular trauma or event. In our experience, patients usually need just one but occasionally two or rarely three treatments.

​In order for the protocol to work well, two criteria need to be met: 1) the trauma needs to have occurred at least 1 month in the past, and 2) you need to put yourself emotionally back in the middle of the situation at up to about 8/10 on an anxiety scale. The treatment typically takes 30-45 minutes. You do not have to say what happened, only where you are on the anxiety scale. Usually people start around 8/10, and as the treatment progresses it gradually comes down to a 1/10 or even a 0/10.

​Oftentimes different visits will be needed for separate unrelated traumas.

What is MTHFR?
MTHFR stands for MethyleneTetraHydroFolate Reductase. It is a gene that processes folic acid, one of the essential nutrients, to a form your body can use.

History of MTHFR
Methylenetetrahydrofolate Reductase (MTHFR) is a gene that was discovered while they were working on the Human Genome Project. Defects in this gene were found to be very common in the population, so they decided to look into this further. While there are many possible defects in the gene, the most common ones are C677T and A1298C. The names have to do with where on the gene the defect is and what the abnormality is.

What does MTHFR Do?

• As mentioned above, it can methylate (process) folic acid and other vitamins to a form your body can use
• It is essential for your body to make proteins, utilize antioxidants, and process fats
• It helps synthesize neurotransmitters such as serotonin, dopamine, and melatonin which influence your mood, sleep, cognitive function, and memory
• It is involved in the growth, repair and maintenance of your cells
• It is needed for the elimination of toxins and heavy metals
• It helps control inflammation
• It activates and regulates the immune system

Problems associated with MTHFR

• Depression and anxiety
• Other mental disorders
• A variety of cancers
• Stroke
• Heart problems
• Congenital defects
• Irritable bowel syndrome
• Miscarriages
• Migraines
• Chemical sensitivities
• Fibromyalgia
• Chronic fatigue syndrome
• Diabetes
• Sleep issues
• And many more

How is it diagnosed and treated?
Diagnosis can sometimes be made by family history but often it requires a specialized blood test. Elevated folate and B12 levels can be suggestive of this disorder. Occasionally the diagnosis is made presumptively. Treatment consists of treating with pre-activated vitamins – ones that are already in a form your body can use. Not uncommonly people will do remarkably well with these therapies alone, although some people need additional assistance with their various diagnoses.