A Paradigm for Evaluating Anxiety and Mood Disorders
By Christopher Mote, DO, DC, IFMCP
Large segments of the global population suffer the effects of a burned-out brain and subsequent symptoms of anxiety, depression, sleeplessness, fatigue, poor memory and concentration, and chronic pain. Functional medicine clinicians have long referred to this constellation of symptoms as “adrenal fatigue,” but by refocusing on the true dysfunction, the hypothalamus and its inability to organize a proper stress response, we can help patients overcome their anxiety and mood disorders.
What causes brain burnout?
Before devising a treatment plan, it is essential to understand the contributing factors that lead to a burned-out brain. There are three broad categories to consider, most often in combination:
Excessive or prolonged stress with chronic activation of the HPA axis that eventually depletes neurotransmitter levels in the hypothalamus and leads to poor response to stress.
Mental and emotional stress, including jobs, relationships, finances, global pandemics
Poor sleep patterns, including insufficient time in bed, biochemical imbalances such as low melatonin, and sleep apnea
Poor glycemic control, including habitual skipping of meals, high-carbohydrate diets, frequent alcohol use
Inflammation, including inflammatory diets, chronic GI pathogens, oral infections and more
Testing to consider: Salivary and/or urinary testing that measures the cortisol awakening response (CAR) is the best-known test for HPA axis function
Lipophilic biotoxins that disrupt neurologic communications, which leads to aberrant control by the hypothalamus over other body systems, such as the autonomic nervous system. Postural orthostatic tachycardia syndrome (POTS), central sleep apnea and elevated TSH with normal T4/T3 are some examples of clinical presentations that frequently have biotoxins as contributing factors. The following are the most common biotoxins that clinicians should be aware of:
Mycotoxins produced by mold
Lipopolysaccharides (LPS) from gram-negative bacteria such as H. pylori and SIBO
Exotoxins and hemolysins produced by the nasal mucosal bacteria, i.e. MARCoNS
Other chronic infections such as oral/periodontal, tick-born and others
Testing to consider: Urinary mycotoxins testing, stool pathogen testing, nasal culture, and cone-beam CT are helpful for identifying these biotoxins
Nutritional deficiencies that disrupt cellular operations including, but not limited to, mitochondrial dysfunction (notably, mitochondrial respiration consumes 20% of the body’s oxygen and yet the brain represents only 2% of body mass). The most common deficiencies seen in testing include B vitamins, magnesium, glutathione and omega-3 EFAs.
Testing to consider: Organic acids testing, micronutrient testing
The bottom line
There are many considerations when evaluating patients dealing with brain burnout. It is necessary to consider functional testing for underlying causative factors such as HPA axis dysfunction, biotoxins and nutritional deficiencies. Armed with this knowledge, we can provide patients a treatment plan that best fits their needs, and help them overcome the debilitating symptoms of a burned-out brain.
Want to keep learning about ways to assess and treat stressed-out patients? Check out the SOS Stress Recovery Program In-Practice Guide, your go-to resource for resolving stress-related illnesses.
Christopher Mote, DO, DC, IFMCP
Christopher Mote, DO, DC, IFMCP earned his doctorate in osteopathy from the Chicago College of Osteopathic Medicine at Midwestern University. He earned his doctorate in chiropractic and Bachelor of Science in human biology from the National University of Health Sciences (NUHS) in Lombard, Illinois, and is certified in Functional Diagnostic Medicine.
Dr. Mote also serves as the SOS Stress Recovery Program Clinical Expert at the Lifestyle Matrix Resource Center. With a focus on addressing the root cause of health concerns, Dr. Mote specializes in the diagnosis and treatment of chronic health disorders.