BLOG No. TWENTY NINE

Welcome back to my blog on anxiety and depression. I have had some good feedback regarding my clinical case blogs, so I will share a few more if you will indulge me. I think that seeing how this glutamic theory works in the real world can be enlightening.

“Sara” was a nice young mother of two little ones that was frequently passing out or having episodes of “near pass outs”. She had been to the emergency room numerous times, given fluids, and then sent home. She was seen by a cardiologist and was told she had low blood pressure. All she needed to do was keep her blood pressure up and the fainting would go away. “Stay blood pressure, stay… good blood pressure, good blood pressure!”... Yeah, that’s going work.

A friend told her that I was good at fixing things like this, so I saw her as a new patient. After spending about a half hour with her, it came to light that she suffered from a lot of anxiety, depression, racing thoughts, and quick anger. I explained to her that her low blood pressure episodes could be caused by her anxiety and depression. Reasonably, she was skeptical.

Three nuns were chatting in the monastery, when the first nun said, “Sisters, you’ll never believe what I found! There are condoms in Father Smith’s desk drawer!”

“What did you do?” The second nun asked.

“Well, I punched holes in them all several weeks ago!” she answered. And that’s when the third nun fainted.

Anxiety, depression, and the emotions arise in the deep part of the brain called the limbic system. Sometimes this part of the brain is called the ancient brain, because it is the oldest as far as evolution goes. This part of the brain and its surrounding structures control basic functions of the body, likes sweating, heart rate, and blood pressure, via autonomics ( sympathetic and parasympathetic).

My theory was that chemical imbalances in her limbic system were over-stimulating the parasympathetic system and causing the blood pressure to drop quickly. (Sympathetic raises blood pressure and parasympathetic lowers blood pressure).

Knowing that she was having racing thoughts, insomnia, panic attacks, and rapid changes in mood, I knew what chemical I was dealing with: It was D2 dopamine. (If you were thinking serotonin, you should not only stop voting, you should also not reproduce). After three weeks on Lamictal, her symptoms were gone as well as the fainting (just spoke to her yesterday).

Well, my Chardonnay pipeline from California is causing a riff with the EPA, so I better go. Until next time, when we will discuss another clinical case, this is Dr. G saying, keep the faith!