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Supercharge your brain and ditch anxiety and depression for good!

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Dr. Vivian DeNise of Patients Medical and Dr. Sandlin Lowe of The Amen Clinic New York explain the causes of anxiety and depression, the cutting-edge technology that can be used to diagnose deficiencies in the brain that cause these conditions and several non-invasive holistic medical approaches that we use to treat.

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Supercharge your brain and ditch anxiety and depression for good!

  1. 1. Dr.Vivian DeNise, Patients MedicalDr. Sandlin Lowe, Amen Clinic NewYork
  2. 2.  A full-service, holistic medical center Integrate modern medicine with holisticpracticeswww.patientsmedical.com
  3. 3.  Promote healing and prevent disease Focus on the root cause of symptoms Avoid a “Band-Aid” curewww.patientsmedical.com
  4. 4. Defining Integrative Medicinewww.patientsmedical.com
  5. 5. Reference sheets with supporting information.And the event evaluation.www.patientsmedical.com
  6. 6. Introducing our speakers:Vivian DeNise, DOABAARM, FAARMIntegrative Internal MedicineHolistic Pediatricswww.patientsmedical.com
  7. 7.  Completed her medical degree at NewYorkCollege of Osteopathic Medicine Certified in Integrative Medicine with theAmerican Academy of Anti-Aging Medicine(A4M) Earned her Fellowship in Anti-Aging andRegenerative Medicine (FAARM) and hasbeen certified by the American Board ofAnti-Aging/Regenerative Medicine(ABAARM)www.patientsmedical.com
  8. 8.  Specialties include BrainWellness Anxiety Depression Thyroid Disorders Balancing Adrenal Function Detoxification Hormonal Imbalances Nutritional Deficiencies Weight Loss Gastro-Intestinal Problems Women’s and Men’sWellness Pediatrics And many more!www.patientsmedical.com
  9. 9. Introducing our special guest speaker:Dr. Sandlin LowePsychiatristAmen Clinic NewYorkwww.patientsmedical.com
  10. 10.  Completed his medical degree atTulaneUniversity in New Orleans On Faculty of NYU School of Medicine inPsychiatry as well as Physiology andNeuroscience Departments Consulting Neuropsychiatrist to NYU School ofMedicine Brain Research Laboratories Collaborating Psychiatrist at NYU LangoneCenter for Neuromagnetism Chief of PsychiatryAssessment Services at NYUWoodhull Medical and Mental Health Center Co-founder and Director of the GlobalAlliancefor Innovation in Neuroscience, Inc (GAIN)www.patientsmedical.com
  11. 11.  Specialties include Dementia Traumatic Brain Injury Autism and Spectral Disorders NeurodevelopmentalDisorderswww.patientsmedical.com
  12. 12. Patients Medical and Amen Clinic NewYork have joined forces!Now, you have the benefit of working with both centers now with anintegrated experience including: Comprehensive physical and exam with Board CertifiedIntegrative Physician, Dr.Vivian DeNise Complete blood work and holistic health history Access to Amen Psychiatrists SPECT imaging and other unique diagnostics Customized treatment protocols that blend conventional andholistic therapies, proven effective for treating a range of medicaland psychiatric conditionswww.patientsmedical.com
  13. 13. …between physical and mental/emotional care.www.patientsmedical.com
  14. 14. www.patientsmedical.comNon- Pharmaceutical Treatment Approacheswith Dr. Sandlin Lowe
  15. 15. A Holistic and Integrative Approach to Evaluation andManagement of Illness.www.patientsmedical.com
  16. 16. Brain SPECT Imagingwww.patientsmedical.com
  17. 17. ICD 10 CRITERIA FOR DEPRESSIONDepressive episodeIn typical mild, moderate, or severe depressive episodes, the patient suffersfrom lowering of mood, reduction of energy, and decrease in activity. Capacityfor enjoyment, interest, and concentration is reduced, and marked tirednessafter even minimum effort is common. Sleep is usually disturbed and appetitediminished. Self-esteem and self-confidence are almost always reduced and,even in the mild form, some ideas of guilt or worthlessness are often present.The lowered mood varies little from day to day, is unresponsive tocircumstances and may be accompanied by so-called "somatic" symptoms,such as loss of interest and pleasurable feelings, waking in the morning severalhours before the usual time, depression worst in the morning, markedpsychomotor retardation, agitation, loss of appetite, weight loss, and loss oflibido. Depending upon the number and severity of the symptoms, adepressive episode may be specified as mild, moderate or severe.www.patientsmedical.com
  18. 18. ICD 10 CRITERIA FOR DEPRESSIONRecurrent depressive disorderA disorder characterized by repeated episodes of depression as described fordepressive episode without any history of independent episodes of moodelevation and increased energy (mania).There may, however, be brief episodesof mild mood elevation and overactivity (hypomania) immediately after adepressive episode, sometimes precipitated by antidepressant treatment.Themore severe forms of recurrent depressive disorder (F33.2 and F33.3) havemuch in common with earlier concepts such as manic-depressive depression,melancholia, vital depression and endogenous depression.The first episodemay occur at any age from childhood to old age, the onset may be either acuteor insidious, and the duration varies from a few weeks to many months.Therisk that a patient with recurrent depressive disorder will have an episode ofmania never disappears completely, however many depressive episodes havebeen experienced. If such an episode does occur, the diagnosis should bechanged to bipolar affective.www.patientsmedical.com
  19. 19. NOT A SINGLE DISORDER BUTA CLUSTER OF CLOSELY RELATED DISORDERSKNOWINGTHE SPECIFIC SUB-TYPE IS CRITICALTO EFFECTIVETREATMENTDR. AMEN HAS IDENTIFIED 7 NEUROBIOLOGICAL SUB-TYPESType 1) Pure AnxietyType 2) Pure DepressionType 3) Mixed Depression and AnxietyType 4) Over Focused Depression and AnxietyType 5) Cyclic Depression and AnxietyType 6) Temporal Lobe Anxiety and DepressionType 7) Unfocused Depression and Anxietywww.patientsmedical.com
  20. 20. THE 7 SUB-TYPES EMERGE FROM 3 MAJOR PATTERNS SEEN ONBRAIN SPECT IMAGESDecreased prefrontal cortex activity at rest, especially on the left side isa consistent SPECT finding in depressionThe severity of depression is often related to the degree of frontalhypometabolismResearchers have also seen increased limbic system activity as well indepression (thalamus, amygdala, cingulate gyrus, and deep temporallobes)When depressed patients perform a concentration task the leftprefrontal cortex often activates to normal levelswww.patientsmedical.com
  21. 21. SPECT BRAIN IMAGING CAN BE HELPFUL INTHE DIAGNOSIS ANDTREATMENT IN COMPLEX OR RESISTANT DEPRESSIVE DISORDERS BY:1) Differentiating it from other disorders,2) Enhancing compliance by the patient being able to “see thechanges in the brain,”3) By determining the neurobiological sub-type of the depression3 MAJOR PATTERNSOF SPECT BRAIN IMAGES ARE OF INTERESTwww.patientsmedical.com
  22. 22. www.patientsmedical.comThis subtype is often associated withmoodiness, negativity, low energy,sleep and appetite problems and poorconcentration. It often responds best todopaminergic or noradrenergicinterventions such as buproprion,imipramine or desipramine.
  23. 23. www.patientsmedical.comThis subtype is often associated withsadness, negativity, irritability,cognitive inflexibility, worrying, andgetting stuck or locked intonegative thought patterns.It often responds best to theserotonergic antidepressants suchas fluoxetine, sertraline, paroxetine,and venlafaxine.
  24. 24. www.patientsmedical.comThis is often the most serious subtype andit is often associated with sadness,irritability, rage (toward others or self insuicidal behavior), mild paranoia, atypicalpain (atypical headaches or abdominalpain) and insomnia. We have seen thissubtype often made significantly worse byserotonergic medications.Anticonvulsants, such as gabapentin ordivalproate are often better choices.
  25. 25. www.patientsmedical.comNON-PHARMACEUTICAL APPROACHESTOTHETREATMENT OF DEPRESSION:Applied Field EnergyTreatments1) ElectroconvulsiveTherapy (ECT)2) Transcranial Magnetic Stimulation (TMS)3) Cranial Electrical Stimulation (CES)4) Transcranial Direct Current Stimulation (TDCS)
  26. 26. www.patientsmedical.comElectroconvulsiveTherapyTranscranialMagneticStimulation
  27. 27. www.patientsmedical.comCranial ElectricalStimulationTranscranial DirectCurrent Stimulation
  28. 28. www.patientsmedical.comNON-PHARMACEUTICAL APPROACHESTOTHETREATMENT OF DEPRESSION:Life Style Changes1) Exercise2) Weight Reduction3) Diet and Nutrition4) AvoidingToxic Substances5) Transcendental Meditation
  29. 29. www.patientsmedical.comNON-PHARMACEUTICAL APPROACHESTOTHETREATMENT OF DEPRESSION:Nutraceuticals and Supplements1) Omega 3 Fish Oils – DHA and EPA2) Multivitamins (B-Complex and Folate)3) Vitamin D4) Minerals andTrace Elements5) Amino Acids6) Antioxidants7) ProBiotics
  30. 30. www.patientsmedical.comPharmaceuticalTreatments Nutraceutical AlternativesMost studied:S-adenosyl-methionine (SAMe),St. John’s Wort (SJW), theomega-3 fatty acids, and folicacid (5-methyltetrahydrofolateor MTHF)Promising:5-hydroxytryptophan (5HT),inositol, rhodiola, and chromium4 Classes of Antidepressants1) SSRIs2) Atypical Antidepressants3) Tricyclic Antidepressants4) MAOIs (Monoamine OxidaseInhibitors)
  31. 31. www.patientsmedical.comIntelligent combinations ofamino acids, antioxidants, andother biologically active agentstargeted for specific brainconditions and dysfunctions.
  32. 32. Human Umbilical CordMesenchymal Stem Cells(hUCMSC)Trophic Factors from hUCMSCCellular and RegenerativeMedicineTherapieswww.patientsmedical.com
  33. 33. www.patientsmedical.comThe Integrative Medical Approachwith Dr. Vivian DeNise
  34. 34. It is a reaction to stress andat times is beneficial.www.patientsmedical.com
  35. 35.  Anxiety disorders are the most commonmental illness in the U.S. Major Depressive disorders are the leadingcause of disability in the U.S. fromages 15-44.3yrs In children, anxiety disorders affect 1 in 8www.patientsmedical.com
  36. 36.  Bipolar disorder Eating disorders Headaches Irritable BowelSyndrome (IBS) Sleep disorders Substance abuse Stress Adult ADHD (AttentionDeficit/HyperactiveDisorder) BDD (BodyDysmorphic Disorder) Chronic pain Fibromyalgiawww.patientsmedical.com
  37. 37. www.patientsmedical.com
  38. 38.  Thyroid Disorders Adrenal Dysfunction Hormonal Imbalance Poor Gut Health Food Allergies Poor Nutrition Lack of Exercise Psychological Factors Medications Alcohol and/or DrugAbuse Candidiasiswww.patientsmedical.com
  39. 39. www.patientsmedical.com
  40. 40.  Anxiety/panic attacks Brittle nails Coarse, dry hair Cold hands and feet Constipation Decreased memory Low libido Depression Diffuse hair loss Dizziness/vertigo Dry, itchy ear canals Endometriosis Fatigue Fluid retention Gall stones Headache Increased appetite Infertility Insomnia Iron deficiency/anemia PMS Poor circulation Slower reflexes Swelling in body Weight gain And many others…www.patientsmedical.com
  41. 41.  Aging LowTSH High ReverseT3 Hashimoto’sThyroiditis Mineral deficiency such asIodine, Zinc, Selenium,Copper and Iron Vitamin Deficiency such asVitamins A,B2,B3, C and D3 Hormonal Imbalance such asLow Estradiol Medications: Beta Blockers,Birth Control Phtalate,Lithium, Chemotherapy Diabetes Heavy metals such as Lead,Mercury Toxins such as PCB’s,Pesticides, Phtalates Stress Poor Diet Excessive Alcohol Surgerywww.patientsmedical.com
  42. 42.  Chest pain Excessive sweating Hair loss Heart racing Heat intolerance Heightenedanxiety, irritability, moodiness or depression Increased bowelmovements Muscle weakness Staring gaze Shortness of breath Weight loss Insomnia Light or absentmenstrual cycles Puffiness around eyeswww.patientsmedical.com
  43. 43. www.patientsmedical.com
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  45. 45. www.patientsmedical.com
  46. 46. Secretes Epinephrine (adrenaline) NorepinephrineThese are secreted in crisis situations.www.patientsmedical.com
  47. 47. www.patientsmedical.comZonareticularisDHEA (S)ZonafasiculataCortisolZonaglomerulosaAldosterone
  48. 48. www.patientsmedical.comHypothalamusAnteriorPituitaryAdrenalCortexCRHACTHCortisol-
  49. 49.  Essential for maintaining blood sugar levelsin the proper balance Powerful anti-inflammatory Decreases the effect of white blood cells Direct effect on the heart and blood pressure Influences behavior, mood, excitability Regulation of adrenal sex hormoneswww.patientsmedical.com
  50. 50.  DecreasesT4 leading toa decrease inT3 alsoknown as Hypothyroidism Increases Insulin andInsulin Resistance Decreases Estrogen andProgesterone Binge eating Confusion Fatigue Irritability Low Energy Sleep disturbancewww.patientsmedical.com
  51. 51.  Pregnenalone DHEA Estrogen Progesterone Testosteronewww.patientsmedical.com
  52. 52. www.patientsmedical.comDHEAPROGESTERONEANDROSTEINDIONETESTOSTERONEDHT5 alphareductaseESTRONEAromataseAromataseCortisolALDOSTERONECholesterol PregnenaloneESTRADIOL
  53. 53.  Enhances nerve transmission and memory Help repair nerve damage Increases resistance to stress Modulates the neurotransmitter GABA Modulates the NMDA receptors Promotes mood elevation Regulates the balance between excitation andinhibition in the nervous systemwww.patientsmedical.com
  54. 54.  Aging Menopause Smoking STRESSwww.patientsmedical.com
  55. 55. www.patientsmedical.comDHEAPROGESTERONEANDROSTEINDIONETESTOSTERONEDHT5 alphareductaseESTRONEAromataseAromataseCortisolALDOSTERONECholesterol PregnenaloneESTRADIOL
  56. 56.  Norepinephrine Serotonin Dopamine Acetylcholine Cortisolwww.patientsmedical.com
  57. 57.  Increases NMDA receptors by 30% Enhances transmission of Dopamine Increases the availability of Acetylcholine Increases availability of Serotonin Increases GABA Increases Norepinephrine Increases sensitivity to Nerve Growth Factor Increases Choline Acetyltransferase Turns on Progesterone Receptors Increases Cortisolwww.patientsmedical.com
  58. 58.  Increases energy, mood and a feeling of well-being Increases verbal fluency and articulation Increases manual dexterity and speed Decreases distractibility Increases short and long term memory Decreased depression Decreased risk of Alzheimer’s diseasewww.patientsmedical.com
  59. 59.  Balances Estrogen Has a positive effect on sleeping Helps prevent anxiety, irritability and mood swings Relaxes smooth muscle in your gutwww.patientsmedical.com
  60. 60.  Antidepressants Hypothyroidism Deficiency inVitaminsA,B6, C and Zinc Excessive Arginineconsumption Saturated Fat Sugar Stresswww.patientsmedical.com
  61. 61.  Nutrition Food Allergies Infection Disease Surgerywww.patientsmedical.com
  62. 62. www.patientsmedical.com
  63. 63.  Anxiety Depression Fatigue Bloating Flatulence Diarrhea/ Constipation Migraines Weight gain or losswww.patientsmedical.com
  64. 64. www.patientsmedical.comDecreasedAbsorption ofVitaminsDecreasedimmuneresponseDecreasedproductionofSerotonin
  65. 65. The Leading Cause ofDepression and Anxiety in the Elderlywww.patientsmedical.com
  66. 66. Excessive rapid fall in blood sugar releasesepinephrine and norepinephrine causing a fight orflight response.www.patientsmedical.com
  67. 67. www.patientsmedical.com
  68. 68. Excessive intake can cause symptoms that areindistinguishable from an anxiety disorder.www.patientsmedical.com
  69. 69.  Type I Type IIwww.patientsmedical.com
  70. 70.  ADHD Arthritis Asthma Candida Chronic ear infections(inflammation) Chronic Fatigue Chronic Pain Cognitive and mooddisorders Diabetes Eczema, Acne, Hives Eating disorders Fibromyalgia Hay fever Headaches Hypoglycemia Insomnia Irritable bowelsyndrome Obesity Sinusitiswww.patientsmedical.com
  71. 71. www.patientsmedical.comInhalationorIngestionofAllergenInflammationProductionofCytokinesInflammationin differentareas of thebodyImmunedysfunctionAutismADHDAsthmaLeakyGutStress+ Interleukin-6
  72. 72.  Aspartame MSGwww.patientsmedical.com
  73. 73. www.patientsmedical.com
  74. 74. MSG (Monosodium Glutamate) can cause:• Numbness• Tingling• Facial pressure or tightness• Headache• Nausea• Rapid Heartbeat• Drowsiness• Chest pain• Difficulty breathingwww.patientsmedical.com
  75. 75. www.patientsmedical.comAlways contains MSG Glutamate MonopotassiumGlutamate Textured Protein Hydrolyzed protein Yeast Nutrient Calcium Caseinate Gelatin Glutamic Acid Flavorings such asnatural chickenflavoring Stock Seasonings Soy Sauce Broth Cornstarch Pectin Bouillion Barley MaltOften contains MSG or createsMSG during processing
  76. 76. www.patientsmedical.comAspartame = AsparticAcid + phenylalanine +methanolAccounts for > 75% of adverse reactions to foodadditives reported to FDA.
  77. 77. www.patientsmedical.com Numbness Muscle spasms Weight gain Rashes Depression Fatigue Irritability Tachycardia Insomnia Visual disturbances Hearing loss Palpitations Headaches/migraines Dizziness Seizures Nausea
  78. 78. www.patientsmedical.com Essential Fatty Acids:Oxmega-3, GLA(borageoil, Black Currant Seeds,Evening Primrose) Quercitin Pycnongenol Curcumin*the active ingredient inTumeric Transfer factor Zinc Vitamin E-preventsoxidation of EFA’s Vitamin A
  79. 79. www.patientsmedical.com Diary products Wheat Corn Eggs Citrus Coffee, tea, alcohol Refined sugar Food additives Known allergens Tap water Any known allergen Any food you eat morethan 3 times a week
  80. 80. www.patientsmedical.com Candidiasis Parasites Bacterial
  81. 81. www.patientsmedical.com Celiac Disease Crohn’s Disease
  82. 82. www.patientsmedical.com Bypass surgery Resection of the bowel
  83. 83. www.patientsmedical.com Lack of exercise decreasesendorphins Medications such as oralcontraceptives decreasevitamin B6 Alcohol and or drug abusedecrease folic acid andthiamine
  84. 84. www.patientsmedical.com Magnesium Vitamin B12 B complex Omega 3 L tryptophan DHEA Theanine SAMe Yoga Sleep Deep Breathing Massages Detoxification Nutrient IV therapy
  85. 85. www.patientsmedical.com
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  87. 87. www.patientsmedical.com
  88. 88. Fill out the pink form now to let us know whenyou would like to see the doctor.www.patientsmedical.com
  89. 89. www.patientsmedical.com Make an appointment to see Dr. DeNise so that she can giveyou a complete physical and holistic medical evaluation withblood work Once your total health (mind/body/spirit) has beenevaluated, Dr. DeNise will have you meet with Dr. Lowe, whowill do the Amen Clinic evaluations to determine the bestcourse of treatment Treatment plan will be customized for you by the twodoctors and communicated to you, giving you completesupport at all stages of your care
  90. 90. www.patientsmedical.comDr. RashmiGulati, MedicalDirectorDr. Kamau Kokayi,Holistic and ChineseMedicineDr. StuartWeg, Alternative PainManagementDr. Vivan DeNise,Integrative InternalMedicine and PedsDr. Eileen DiFrancescoPsychopharmacologyDr. Gino BottinoHolistic OncologyDr. Paul A. DreschnackPlastic SurgeryDr. L. Deanna HowardHolistic GYNDr. Victor I. RosenbergPlastic SurgeryDr. Marcia A. HarrisHolistic GYN andInternal MedicineDr. Alan Coffino,NephrologyDr. Ayman MattaHolistic Ophthalmology
  91. 91. www.patientsmedical.com
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  93. 93. www.patientsmedical.comTo get more information or to schedule anappointment,call 212-679-9667 oremail media@patientsmedical.com

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