Exploring the Connection Between Metabolic Health and Mental Health

In this insightful snippet, Dr. William Sauve likens  the intricate balance of GABA (Gamma-aminobutyric acid) and glutamate in the brain, as neurological "brake" and "gas” pedals. This happens to be a hot topic in psychiatry at the moment for treating depression and anxiety, however, as Dr. Sauve verbally thinks through the mechanisms, it becomes clear metabolic syndrome is one of the key drivers of depression and anxiety. 

This underscores the vital importance of optimizing your metabolism. 

Key points covered include:

  • The fundamental roles of GABA and glutamate in regulating brain activity, with GABA acting to calm or suppress activity, and glutamate enhancing or exciting it.

  • An emerging focus within psychiatry on the interplay between GABA and glutamate for treating depression and anxiety. 

  • Parsing out the nuances of glutamate as a driver of::

    • Neuroplasticity, learning, neurogenesis, potentiation

    • Arousal, excitation, Hyper awareness as part of the stress response.

  • The metabolic connection of hyperinsulinemia and inflammation in chronic overstimulation of glutamate, potentially leading to excessive arousal, anxiety, and a constant state of fight or flight, especially among younger populations.

  • A discussion on esketamine, an FDA-approved treatment for depression derived from ketamine, which operates by promoting glutamate activity to foster neuroplasticity and combat depression.

  • Dr. Suave's concerns about prescribing esketamine to individuals with metabolic syndrome Including hyperinsulinemia, due to their already elevated glutamate levels, suggesting it might worsen their condition.

  • The potential necessity of addressing metabolic syndrome before commencing esketamine treatment, to avoid "throwing gas on the fire" of an already hyperglutamatergic condition.

  • The challenges of communicating the importance of treating underlying metabolic issues before starting esketamine treatment to patients suffering from depression and anxiety.

The takeaway: In most cases of people suffering from anxiety and depression the root cause driving  these mental health challenges is metabolic.

This episode offers a deeper look into the biochemical intricacies of mental health treatment. It illustrates how the underlying metabolic dysregulation actually is a principal factor of the condition. Naturally this means taking a different, more holistic approach than simply treating the presenting condition which is very often a symptom of an underlying metabolic disorder/imbalance. 

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