BLOG No. SIX

Welcome back to my sixth blog on anxiety and depression. In previous blogs we have learned about the neurochemistry changes that drive a lot of anxiety and depression, predominantly the imbalance of GABA (relaxer) and glutamate (exciter). As you remember, when glutamate overtakes GABA, type 2 dopamine rises and serotonin can fall, causing mood disorders, panic attacks, and the like.

And in my previous blogs, I have mostly discussed medications, which help rebalance these chemicals, thus restoring homeostasis (normalcy and balance). And although I said that the counseling could be helpful, I definitely spent more energy on medications. No, I am not on the payroll of any pharmaceutical companies. It’s just that my late father always told me to avoid the appearance of evil.

A man walks into a library. He asked the librarian, “Do you have a book on how to commit suicide?” She replies, “yes, but I will not show you where it is at.” “Why?” the man asks. “Because I am pretty sure you’re not going to return it.”

But now I would like to circle back and ask the question:

Can counseling alone, sans drugs, change our neurological makeup?

After extensive study and research, reading and digging, I can report to you that the answer is a resounding, definitive…maybe. Wow, dude, really helpful. really.

Okay, don’t get your little Victoria’s Secrets all in a wad, (although I’m not sure how a thong would actually get into a wad.. It’s just not big enough.) Regarding this subject, there just isn’t a lot of conclusive evidence yet, but let’s discuss what we do know.

F A C T S :

There was a study in 2017 that looked at cognitive behavioral therapy (CBT) on obsessive-compulsive disorder (OCD). It’s important to note that OCD is slowly being understood as a D2 dopamine thing, caused by a glutamate thing. In other words, this trial was just to see if CBT could affect glutamate and D2 dopamine (think anxiety/depression and its cohorts). CBT was performed on about 50 pediatric patients with OCD and (1) some patients reported improvement after six months, and (2) MRI and PET scanning actually noted some changes in various parts of the brain.

So, the answer to the question is yes.

... but it should be noted that several patients dropped out of the study, as the CBT took great amounts of time and work—just to change the neurotransmitters a little bit. And there are other studies with a CBT that note slow but steady progress in anxiety and depression, be it not earth shattering. Perhaps CBT might be a nice adjunct (helpful addition), or just helpful in milder cases of depression and anxiety. Or perhaps, this might be good therapy for someone who is in no hurry to get better, and might be willing to spend two or three years in therapy.

It should also be noted that the therapy was CBT, not just general counseling. CBT is a combination of cognitive therapy (founded by Aaron Beck) and behavioral therapy (founded by B.F. Skinner). When the two were blended together, a powerful tool was developed. (Perhaps, Democrats and Republicans might learn something from the blending). Understand, most counselors are not trained in CBT, just like most doctors are not trained to remove a gallbladder.

I believe CBT could assist in some cases of D2 driven anxiety and depression, but unfortunately, for now, medications are still the foundation.

Well, I’m getting to the bottom of my Chardonnay and I see a little bit of spittle. I suspect the server has spit in it again. Well, let’s just see if I leave another 50 cent tip again! Hummmph! (JK my servers love me) Until we meet again, when I discuss something exciting called the STAR-D trials.

So long, and keep the faith!