Because the trauma, loss & demagogic politics of the past 3 years I had expected to ebb appear to be still with us, I have decided to make a special push toward mental health— focusing on non-drug approaches to treating and protecting against insomnia, anxiety, depression and other mood disorders.

[DISCLAIMER: This information is offered for educational purposes only & does not in any way constitute medical counsel.]

The approach of Dr. James Greenblatt (Walden, MA), which actually mirrors that of an 1980's era, ground-breaking, way ahead of his time, Bethesda-area integrative psychiatrist Dr. Robert Heyada, seems especially thoughtful and respectful of all the inter-connecting inputs that play key roles in psycho-emotional wellness. His clever mnemonic ZEBRA can be a helpful check-list vastly under-appreciated by the conventional world of medicine and psychiatry: zinc (and other key minerals), essential fatty acids, B vitamins, rebalancing gut microflora, and amino acids.

Zinc (and other key minerals)
Essential fatty acids (balance)
B-vitamins
Rebalancing gut microflora
Amino acids (as in adequate protein & protein digestion, as they are the precursors of neurotransmitters)

While it's best not to short-change any in the list, in my experience looking into gut microflora imbalances, omega-3 fatty acid and mineral deficiencies often yield the most dramatic results, with B vitamin adequacy and amino acids running a close second.

And while it's preferable to get one's essential fatty acids daily quota from food, this can be challenging. Freshly ground flaxseed (~10g daily), walnuts and chia seed are Dr. Kara Fitzgerald's preferred sources. Algae-based products are also nice. Gamma linoleic acid, an omega-6 EFA, is also anti-inflammatory, so not all omega-6's are to be rationed. Sources in descending order of GLA content are: borage oil (~21%), black currant oil (~17%), evening primrose oil (~9%). It's also super easy to measure omega-3:6 ratios these days— and well worth it.

And please do not rely on alcohol for coping or relaxation; it is very harsh on the digestive epithelia, our "friendly" flora, the gut mucus lining; and its chronic use lays the ground for nasty fungal overgrowths. It is also a neurotoxin. For harm reduction, enjoy only the highest quality, additive free, probably preferably red, wine— sipped with (or after) a meal.

For some, whether aging/aged or merely stuck in a sympathetic, "fight or flight" state, the A in zebra will require consideration and/or testing of both protein intake and digestive function. If stomach acid and pancreatic enzymes are no longer robust (both GI-MAP and GI Effects can tell you this), you may need to consider digestive support and/or amino acid supplementation. To complicate things further, bacterial and/or fungal overgrowths in the small intestine can also inhibit proper absorption— of all three macronutrients.

And I have posted below some of the products Dr. Greenblatt has developed for Pure Encapsulations, as well as how he might suggest both using them and deciding (via nutritional and/or functional testing) if they might be helpful. Feel free to contact me for the complete protocols.

Clicking on a given product link below will take you to our page on the Pure Encapsulations site. There you can get full product information as well as an opportunity to purchase "direct from the source" with no shady or unvetted intermediaries. They also have pretty generous same day free shipping terms.

Mood: Amino Replete, SeroPlus, Lithium Orotate (1-5 mg), Rhodiola Rosea, Magnesium Glycinate, PureMelt B12-Folate, PureGenomics MV

Supportive testing: OAT (GPL now Mosaic), Neurotransmitter Profile (ZRT), trace minerals hair analysis (Doctors Data), urine lithium (ZRT), cortisol panel (AM and PM), RBC (or even better, buccal) magnesium, serum B12, MTHFR genotype

Memory: CurcumaSorb Mind, CogniPhos, DopaPlus (esp. if COMT Val-Val), Lithium Orotate (1-5 mg), PureMelt B12-Folate, NAC, PureGenomics MV

Supportive testing: COMT genotype, trace mineral hair analysis (Doctors Data), urine lithium (ZRT), serum B12, MTHFR genotype, Oxidative Stress Analysis 2.0 (Genova Diagnostics)

Mental Alertness: DopaPlus (esp if COMT Val-Val), CurcumaSorb Mind, Magnesium Glycinate, EPA/DHA Essentials, Zinc 30, Lithium Orotate (1-5 mg) (personally, I prefer UltraZinZinc)

Supportive testing: COMT genotype, RBC magnesium, Omega-3 fatty acids testing, copper:zinc ratio, trace mineral hair analysis (Doctors Data), urine lithium (ZRT)

Microbiome: PureLean Fiber, PureGG, Poly-Prebiotic (or Powder), Probiotic-5 (better still: get all these through daily diet-- and home ferment!)

Supportive testing: PCR commensal bacteria (GI-MAP or GI Effects), OAT (GPL now Mosaic), SCFA, beta-glucuronidase (included in GI-MAP and GI Effects tests)

Sleep: Melatonin (or Melatonin-SR), SeroPlus, GlyMag-Z or Magnesium Glycinate, l-Theanine

Supportive testing: Sleep Balance Home Testing (ZRT), Self-Reported Stress Level, RBC Magnesium (I would add OAT & Adrenal Stress testing)

Rule out overnight hypoglycemia, especially if you routinely waken at 2 or 3 a.m. For trouble falling alseep due to a monkey mind (i.e., endless rumination, worrying, regretting), (myo)-inositol supplementation has been quite helpful for many. Also, gauge your level of physical activity for the day: did you get outside? did you do anything fun? Aim to walk a minimum of 2 miles, outdoors, daily. (4 miles daily is the dementia prevention prescription.) Try to work in a little resistance training 2-3 times a week and an activity that wrings out or releases musculoskeletal tension. And no (or very little, and only with a meal) alcohol after 6 pm.

Stress: Magnesium Glycinate, SeroPlus, Inositol Powder, l-Theanine, EPA/DHA (Essentials or lemon liquid), PureMelt B12-Folate, PureGenomics MV

Supportive testing: RBC magnesium, Self-Reported Stress Level, Omega-3 fatty acids testing, serum B12, MTHFR Genotype

Obsessive Thinking: Inositol Powder, SeroPlus, NAC, Magnesium Glycinate, Probiotic-5, Lithium Orotate (1-5 mg)

Supportive testing: Oxidative Stress Analysis 2.0 (Genova Diagnostics), RBC magnesium, OAT (GPL now Mosaic), trace mineral hair analysis (Doctors Data), urine lithium (ZRT)

MOOD DISORDERS