October 8, 2001 -- Are you depressed? Anxious? Still suffering from a long-ago trauma? Psychotherapy and psychiatric drugs can help restore balance to your mind and body. But increasingly, there are more options. For instance, researchers now say hormone treatments offer a more natural approach to mental health.
So what are hormones? They're substances produced in our bodies to regulate our biological activities. Growth hormones control our development, stress hormones are released when our bodies detect a threat, and sex hormones control the maturation and function of our sex organs. And these are just the tip of the iceberg.
Uriel Halbreich, MD, is professor of psychiatry, obstetrics, and gynecology, and director of biobehavioral research at the State University of New York at Buffalo. He is also president of the International Society of Psychoneuroendocrinology, or ISPNE.
At a recent ISPNE conference, Halbreich spoke about how endocrinologists study hormones and how psychiatrists and neurologists study the brain. What falls through the cracks of this research is the important role that hormones play in our mental health. One of the roles of a psychoneuroendocrinologist is to help fill in those cracks.
In an interview with WebMD, Halbreich looks at some of the many ways hormones affect our brains, emotions, and well-being.
Replacing What's Been Lost
You probably already know that hormones are sometimes given to people to improve their health. Hormone replacement therapy, for instance, is commonly prescribed to women to reduce the symptoms of menopause. These can include hot flashes, depression, and sexual problems. In addition, replacing some of the female hormones that the body stops making may help stave off many diseases.
'It is used for prevention of osteoporosis and vascular disorders,' says Halbreich. 'It is [also] very good for prevention of cognitive decline and in the enhancement of certain [mental functions].' Replacing estrogen at menopause may delay the onset of Alzheimer's disease by five to seven years.
Hormone replacement therapy is not just for women. As men age, their bodies also produce fewer male hormones. There's evidence that replacing these hormones can help men stave off some of the effects of aging, including decline in intellectual functioning, osteoporosis, and Alzheimer's disease.
Balancing What's There
It's not just losses in natural hormones that can create problems. When the balance of your hormones is out of whack, helping restore this balance can go a long way toward restoring mental health.
For example, feelings of depression or anxiety may be one of the first signs that your thyroid (a gland in your neck that produces a hormone crucial for growth, development, and everyday function) is not working properly. An overactive thyroid can lead to anxiety and panic attacks, while an underactive thyroid can make you depressed. In fact, very minor reductions in thyroid hormone that don't have any important effect on your physical health may make you depressed. Taking medication that regulates your thyroid can eliminate these problems.
Hormones can also temporarily fall out of balance during certain points of a woman's menstrual cycle as well as right after having a baby. During both these times, women may suffer from depression and other mental health problems. Antidepressants have proven useful during these temporary bouts of the blues, but upcoming hormone therapies are showing promise and target the problem more directly.
Intriguing Possibilities
Probably what's most exciting is the potential role for hormone therapies in mental conditions not usually associated with hormone imbalances. The fact that hormone therapies work for some of these problems suggests that there is an as-yet-unknown role for hormones in other mental or emotional problems.
For addictions to alcohol, drugs, gambling, or even food, it might be possible to block pleasure hormones that reward these behaviors. This strategy might make it easier for people to quit.
Hormone treatments might also help anxiety, depression, and posttraumatic stress disorder. Here, so-called 'stress' hormones are the targets of treatment. These hormones are released when the body is under physical or emotional duress such as as physical illness or a fight with your spouse.
At the ISPNE conference, Michael Kellner, MD, presented results of his research with a hormone called ANP (for atrial natriuretic peptide). ANP is produced naturally by the body during a panic attack.
'It's a strange phenomenon that during a panic attack you do not have any activation of stress hormones,' says Kellner. 'Nobody knows why panic attacks last only a couple of minutes and then subside spontaneously.'
Kellner, a member of the department of psychiatry and psychotherapy at Hamburg University in Germany, says he believes that the body may release ANP during a panic attack as a signal that everything is, in fact, OK. It blocks the release of stress hormones and may tell the body to shut the attack off. As a result, drugs that help the body produce ANP or some similar hormone could be an excellent treatment for panic disorder and possibly other anxiety-related problems.
Psychiatrist Heike E. Künzel, MD, is a clinical researcher at the Max Planck Institute of Psychiatry in Munich, Germany. He has great hopes for treating depression with substances that block the action of a stress hormone called CRH (for corticotropin-releasing hormone). Her early results with one of these substances -- technically known as CRH-1 receptor blockers -- proved very encouraging. The drug reduced anxiety and depression without causing any significant side effects.
In fact, one study participant was disappointed when he had to be switched to a Prozac-like antidepressant when the study was over. He found the experimental drug to be more effective with fewer side effects.
