How to improve your mood without hurting your brain

What the research actually says

If you’re concerned because you’ve been taking an anticholinergic drug

If you’ve been taking or took an anticholinergic drug in your 40s, 50s, or 60s, you’re likely concerned about your risk for dementia. The first thing you need to know is that increased risk does not mean it’s inevitable that you receive the diagnosis; not everyone who takes one or more of these drugs gets dementia.  If you took or are taking one of these drugs in your 20s or 30s, you’re likely wondering how this affects your risk. To be completely transparent, we’re not quite sure. All of the available research was conducted on middle-aged to older individuals, and the general consensus is that each exposure to the medication for at least the 20 years prior to the dementia diagnosis leads to increased risk. We don’t have enough information yet to draw conclusions about the risk associated with taking these drugs earlier in life. Now, let’s address your concern. Here’s what I tell my patients who are in either of these categories: your quality of life is our priority, both now and in your later years. In order to prioritize your quality of life, we’ve got to be able to balance risks and benefits. This means that if an antidepressant with mild anticholinergic effects is the only thing that has been able to help you get out of bed in the morning and continue to enjoy the things and people you’ve always loved, then the benefit is worth the slightly increased risk, at least until we can address your mood using other therapies and wean off of the medication. In situations like these, I always recommend doing the best that we can until we can do better.

If you’re concerned about dementia but haven’t started taking medication

If you have a personal history of depression and a family history of dementia, but you haven’t started taking medication to address your concerns, consider trying less invasive treatment options prior to starting psychotropic medication.  For example, I screen all of my patients, including those with recent onset and those with long-standing concerns of depression, for thyroid and reproductive hormone disorders. I do this because these two types of health concerns can actually masquerade as depression. When we correct these imbalances, we see an improvement in or a complete resolution of depressive symptoms in most cases.

Hypericum perforatum (St. John’s Wort)

Another option is to support optimal mental wellbeing using natural supplements. St. John’s wort is an herb that has been demonstrated to be as effective as serotonin-specific reuptake inhibitors in addressing mild to moderate depression. This herb interacts with many antidepressants and many other prescription medications, so don’t use it unless you’re not taking any medication or you’re working with a provider who is knowledgeable concerning both pharmaceutical medication and herbal therapies. 

Withania somnifera (ashwagandha)

Ashwagandha is another herb that has been demonstrated to have antidepressant and anti-anxiety effects. This herb supports a more normal response to chronic stressors because of its positive effects on the hypothalamic-pituitary-adrenal axis, so it is most beneficial in cases of stress- or trauma-induced depression.  

Crocus sativus (saffron)

Bacopa monnieri (Brahmi)

The conclusion of it all