ADHD and Depression – an unlikely couple?

ADHD and Depression –  What on earth could link these two conditions?

Well you know already what I am going to say based on the reading I have been doing.  Yes – the blend of gut-bacteria in your system.

So how does the blend of gut-bacteria affect something that seems so definitely rooted in the brain – your moods – your despair – your excitability – your concentration levels?  depression

Last week I mentioned that the gut bacteria can produce hormones. They also produce the chemicals that other parts of your body use to turn into hormones. Without the building blocks the hormone cannot be made. This is true of the hormones that control our moods. So a depressed gut biome – will produce a depressed brain (via the hormone controls)

Again Dr Perlmutter shows how the indicators for inflammation are inextricably linked to the symptoms of depression and of ADHD.

In the case of Depression he quotes a Belgian research team “There is now evidence that major depression (MMD) is accompanied by an activation of the inflammatory response system and that pro-inflammatory cytokines and lipopolysaccarides (LPS) may induce depressive symptoms”  {Antibodies to the presence of LPS has been cited before as a marker for inflammation} The same researchers also noted that depression was often accompanied by gastrointestinal symptoms. LPS not only has the ability to make the gut wall more permeable, but it can also cross the blood-brain barrier and allow pro-inflammatory chemicals to attack the brain.

High blood-sugar is again cited as one of the factors – and the way that this can alter the gut-bacteria make-up has been already shown (with high fructose corn syrup – used to sweeten so much mass produced food and drink – being the worst type to ingest) as well as gut-permeability allowing these inflammatory substances into the system.

I do not know personally about depression – but I know enough people who suffer with it to know that it can be very complicated – and I hesitate to suggest that the gut-biome is the whole story. However, a happy gut-biome may be part and, as an easy part to deal with, seems to require at least a second glance. After all, unlike taking many prescribed medications, eating pro-biotics, (live yoghurt, live sauerkraut, kefir, etc or a tablet blend of bacteria) and feeding them with good pre-biotic foods stuff (onion, turmeric, jerusalem artichokes and more) does not have health-damaging side effects.

Somehow I think of Depression and ADHD as being almost opposites. One where there is no hope, nothing to be done, a state in which inaction is most likely and the other where everything captures the attention for a brief time – hyper-actively flitting between stimuli, getting nothing done through lack of concentration on any one thing.

adhdDr Perlmutter starts by pointing out that 11% of all American children are diagnosed with ADHD and two thirds are on medication for it. This is a frighteningly high number. He also points out that American children  are not genetically different to other children – and that there must be something else going on.

In one study it was found that there was a predominance of three markers in the lives of ADHD patients as opposed to those who did not suffer from ADHD – they were far more likely to have been born by C-section, and or, not to have been breastfed (or not for very long) and they were very likely to have had ear-infections requiring heavy antibiotic intervention.

Some of this must be sounding familiar by now – all the things that pre-dispose someone to a disrupted gut biome. The history is there, and when the investigations are made the  inflammatory markers are there too.

Symptomatically, most of these ADHD children also have gastrointestinal problems. From one huge study it was shown that they were threefold more likely to be constipated – and 67% more likely to have faecal incontinence. Here is something that chimed in with children I have known with ADHD from my time in teaching in Primary schools – in that parents have said to me ‘he’s so active he forgets to go until it’s too late’ (referring to a child that, even long after being potty-trained will mess their pants a bit before they get to the toilet) or ‘he never stays still long enough to go and it builds up’ about children that get constipated.

What if this wasn’t due to being too active – but to do with a disrupted gut-biome – which also resulted in one or other of these outward signs? This is the angle that Dr Permutter treats his ADHD patients from, correcting the gut-biome with pro-biotics (the right bacteria) and a diet including the pre-biotics, that those bacteria need to thrive, and cutting back on the carbs and sugars that feed the other bacteria; that unbalance the gut-biome –  and with great success. Children calming down almost to be unrecognisable as the child who first came for treatment. Yet – millions is spent on medication without trying to look at the underlying causes before treatment.

This still doesn’t explain how come the same imbalance may make one person depressed and another hyperactive … well, this is where the base genetics come into it. It is suggested that the genetic pre-disposition to ADHD could be ‘switched on’ by the imbalance (via the epi-genetic effect), and ‘switched-off’ again when the correct balance is restored.

Moreover, there is the evidence about GABA. GABA is a very important neuro-transmiiter that is made in the gut, and requires specific chemical inputs gained from food – and is has been found to be largely deficient in the brains of people with ADHD (and incidentally also of those with Tourettes) To make GABA (which is an inhibitory neuro-transmiiter) the gut needs the right bacteria (lactobacillus and bifidobacterium have been identified so far) to change glutamine to GABA, with the chemical co-factors of zinc and vitamin B6 (both only gained from food) to make the change. With GABA in the brain the electrical charges on neurons are subdued – making them less likely to excite and trigger nearby neurones – and thereby it reduces ‘impulsivity’.

Finally, in this section – I’m sure you’ve heard of Ritalin – a medication to calm down ADHD children. Back in 2003 – before the rise of interest in the gut-biome – a very small experiment was done using twenty ADHD children. Half were given Ritalin – the other half were given probiotics (like lactobacillus) and a nutritional supplement including essential fatty acids. To the researchers’ astonishment – the results showed the same outcome for both groups – both sets of ADHD children became more focussed and calm. I know which I would prefer my children to be taking if they had need to.

Any of this ring any bells out there?

Would you have ever linked depression and ADHD?

Do share – you know I like to talk 🙂


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