Tryptophan!!!

If you are interested in neuro science, then this is very good question. Let me take a stab and keep it as
simple as possible.
Dopamine, Oxytocin, Serotonin and Endorphin is all Happy neuro transmitters and plays a very
critical role in our happiness quotient.
Dopamine: This is Feel Good hormone which keeps you motivated and let you enjoy what you really
like. Why do you feel goodwhen you win a lottery, meet your sales target, catch your train on time
all.. or have your favorite ice cream it all stimulate dopamine. Cannabis or marijuana also make your
brain release dopamine and thats why folks get addicted to this overdose of dopamine. On the other
side of the spectrum, you might have met people who only like talking about them self, its not their
fault, its pure neuro science at work. When somebody talks about them self, their brain releases
dopamine and they want to continue doing that.
Oxytocin: This is Bonding hormone which help you create stronger bonds/trust/relationship with
people around you. When a mother breast feeds her baby, both release high amount of oxytocin leading
to strong bonding between them. Also the reason for bonding between couples/partners.. as this neuro
transmitter is released during the orgasm as well. Another example is, you tend to get closer to people
with good sense of humor, cause humor also help release oxytocin and you are more likely to bond
with people who makes you laugh.
Serotonin: This is what makes you Feel importantit plays a critical role in how you live your life.
A very simple way to keep the serotonin level up is by practice acknowledging/remembering your past
successes, happy moments and showing gratitude to people around you. Folks with high suicidal
tendency, or folks getting into anti-social activities lacks this neuro transmitter in their blood. Eat
bananas, get out in sun for 20 minutes, it helps release serotonin. It is also very important for a good
night sleep.
Endorphin: I would call this a Rock star hormone. This helps us overcome our stress and pain caused
due to physical activities. What do you think keeps a long distance runner or a fitness freak focused on
his/her regime? Its the Endorphin which keeps them going. It helps you recover from injuries and at
the same time improve your immunity as well. Humor and laughter also helps create Endorphin, thats
one of the reason docs recommend you to laugh out loud.
Hope this give you an overview of these four pillars of our happiness..Ola.

1. Dopamine
This neurotransmitter drives your brains reward system. If you are praised at work for doing a good
job, youll get a delicious dopamine hitresulting in feelings of well-being. It also drives pleasureseeking behaviour. Boost it by setting realistic goals (e.g., tidying your desk or sticking to your

workout schedule) and achieving them. And seek out pleasurable healthy activities that have a positive
impact on your life.

2. Serotonin
This mood-boosting neurotransmitter was made famous by SSRI (selective serotonin reuptake
inhibitor) antidepressants, which increase the brains serotonin levels. The most effective and natural
way to boost serotonin is by exercising daily; thats one reason a brisk walk does wonders for your
mood.

3. Oxytocin
Both a neurotransmitter and a hormone, oxytocin is often called the love hormone. Researchers from
Claremont University in California have done extensive research on its impact on women, linking
oxytocin release to life satisfaction levels. It may play a greater role in womens physiology and
happiness compared to mens. Spending time with loved ones and being kind to others stimulates
oxytocin. Dont you feel good just reading that? Stress blocks the release of oxytocin, so manage your
stress, too.

4. Estrogen
It helps form serotonin and protects you from irritability and anxiety, keeping your mood steady.
Estrogen decreases with menopause, and lifestyle factors such as smoking and extreme exercise can
also lower it. The estrogen/progesterone imbalance in perimenopause can also negatively affect mood.
Stress management can balance them, since stress hormones, such as cortisol, interfere with the
secretion, action and function of the two hormones.

5. Progesterone
This helps you to sleep well and prevents anxiety, irritability and mood swings. Levels drop as women
enter perimenopause after age 35 or 40, and this can be accelerated by excess stress and unhealthy
foods. Experts such as Dr. Sara Gottfried, author of The Hormone Cure, say taking care of yourself
and eating right is your first defence for balancing hormones before trying hormone replacement
therapy, including bioidentical progesterone and estrogen. Talk to your doctor to learn more.

Natural Ways to Boost Your Happy Hormones

Listening to music is a fabulous way to get a hit of dopamine: In a 2011 study published in Nature
Neuroscience, McGill University researchers reported that listening to music you love (especially if it
gives you chills) creates a boost in feel-good dopamine.
Carbohydrates increase serotonin levels, which partly explains why we crave sweet, starchy foods
when we are feeling down. For the best mood boost with the least negative impact, choose healthy,
high-fibre sources of carbs such as dense whole-grain bread or quinoa.
Get a boost of oxytocin by doing pleasurable things such as spending time cuddling with your partner,
your kids or your pet.
Increase estrogen with stress-relieving activities such as yoga, meditation, taking a hot bathor
whatever works for you.

 Keep progesterone levels at optimum levels by eating well and avoiding saturated fat and sugar,
getting regular physicals and avoiding stress.
NEUROTRANSMITTERS are the brain chemicals that communicate information throughout our
brain and body. They relay signals between nerve cells, called neurons. The brain uses
neurotransmitters to tell your heart to beat, your lungs to breathe, and your stomach to digest. They can
also affect mood, sleep, concentration, weight, and can cause adverse symptoms when they are out of
balance. Neurotransmitter levels can be depleted many ways. As a matter of fact, it is estimated that
86% of Americans have suboptimal neurotransmitter levels. Stress, poor diet, neurotoxins, genetic
predisposition, drugs (prescription and recreational), alcohol and caffeine usage can cause these levels
to be out of optimal range.
There are two kinds of neurotransmitters INHIBITORY and EXCITATORY. Excitatory
neurotransmitters are not necessarily exciting they are what stimulate the brain. Those that calm the
brain and help create balance are called inhibitory. Inhibitory neurotransmitters balance mood and are
easily depleted when the excitatory neurotransmitters are overactive.
Inhibitory Neurotransmitters
SEROTONIN is an inhibitory neurotransmitter which means that it does not stimulate the brain.
Adequate amounts of serotonin are necessary for a stable mood and to balance any excessive excitatory
(stimulating) neurotransmitter firing in the brain. If you use stimulant medications or caffeine in your
daily regimen it can cause a depletion of serotonin over time. Serotonin also regulates many other
processes such as carbohydrate cravings, sleep cycle, pain control and appropriate digestion. Low
serotonin levels are also associated with decreased immune system function.
GABA is an inhibitory neurotransmitter that is often referred to as natures VALIUM-like substance.
When GABA is out of range (high or low excretion values), it is likely that an excitatory
neurotransmitter is firing too often in the brain. GABA will be sent out to attempt to balance this
stimulating over-firing.
DOPAMINE is a special neurotransmitter because it is considered to be both excitatory and inhibitory.
Dopamine helps with depression as well as focus, which you will read about in the excitatory section.
Excitatory Neurotransmitters
DOPAMINE is our main focus neurotransmitter. When dopamine is either elevated or low we can
have focus issues such as not remembering where we put our keys, forgetting what a paragraph said
when we just finished reading it or simply daydreaming and not being able to stay on task. Dopamine
is also responsible for our drive or desire to get things done or motivation. Stimulants such as
medications for ADD/ADHD and caffeine cause dopamine to be pushed into the synapse so that focus
is improved. Unfortunately, stimulating dopamine consistently can cause a depletion of dopamine over
time.
NOREPINEPHRINE is an excitatory neurotransmitter that is responsible for stimulatory processes in
the body. Norepinephrine helps to make epinephrine as well. This neurotransmitter can cause
ANXIETY at elevated excretion levels as well as some MOOD DAMPENING effects. Low levels
of norepinephrine are associated with LOW ENERGY, DECREASED FOCUS ability and sleep cycle
problems.
EPINEPHRINE is an excitatory neurotransmitter that is reflective of stress. This neurotransmitter

will often be elevated when ADHD like symptoms are present. Long term STRESS or INSOMNIA can
cause epinephrine levels to be depleted (low). Epinephrine also regulates HEART RATE and BLOOD
PRESSURE.

Pulling Away (After Sex)

by Marnia Robinson

Dopamine. It's at the core of our sexual drives and survival needs, and it motivates us to do jus

mechanism within the reward center of the primitive brain has been around for millions of yea
Rats, humansindeed, all mammalsare very similar in this respect.

Dopamine is behind a lot of the desire we associate with eating and sexual intercourse. Similar

trigger dopamine (the "craving neurochemical") to stimulate the pleasure/reward center. So do

overeating and other, seemingly unrelated, activities. Go shopping: dopamine. Smoke a cigare

games: dopamine. Heroin: dopamine. Orgasm: dopamine. They all work somewhat differently
raise your dopamine.

You get a bigger blast of dopamine eating high-calorie, high-fat foods than eating low-calorie v

believe that you love ice cream, but you really love your blast of dopamine. You're genetically

high-calorie foods over others. Similarly, dopamine drives you to have sex over most other act

as the driving force, biology has designed you to engage in fertilization behavior to make more
to move on to new partners to create greater genetic variety among your offspring.

Your primitive brain accomplishes these goals of more progeny and promiscuity by manipulati

chemistry, and thus your desires and thoughts. High levels of dopamine increase sexual desire,

behave recklessly. The thrill of a new affair and the rush from using pornography are examples

Unfortunately, consistently high levels of dopamine lead to erratic behavior and compulsions t

survival. (See the "EXCESS" column in the chart below.) Most mammals, therefore, evolved w

periods when they "go into heat." The rest of the time they are more or less neutral about sex.

Humans, however, don't have a period of "heat" followed by a long period of indifference to se

mammals, we have the potential for on-going, dopamine-driven sexual desire. Yet we, too, self
switch" kicks in after too much passion.

Two events happen simultaneously. Dopamine plummets and prolactin soars. Dopamine is "go

"whoa!" This mechanism shifts your attention elsewhere: to hunting and gathering, taking care

shelters, and so forth. Without this natural, protective shutdown, you would pursue sex to the e

activities. When rats were wired so that they could push a lever in their cages to stimulate the n

dopamine acts, they just kept hitting the lever until they droppednot even pausing to eat or in
mates. Dopamine is highly addictive; the rise in prolactin puts the brakes on.

This event (drop in dopamine and rise in prolactin) is the cause of the emotional separation tha
days or weeks after a passionate encounter.

FEELINGS & B
ASSOCIATED

DOPAMINE LE

D
E
E

SS

E
N
T

"
N

As you can see from this c

dopamine is necessary for

dopamine drops, you feel l

wrong. Too much dopamin

behavior and restless anxie

These uncomfortable feeli

"

your partner. Bingo! Sudde

appealing. This is a very u

experience in your intimat

nx

"hangover," or "low-dopam

iet

ti

may feel abandoned, or as

things from you in ways th

may desperately seek new

partners, pornography, and

dopamine levels again.

a
N
o
P
l
e
a

Perhaps you can see how t

or attraction and repulsion

feel more like a roller-coas

fairytale. It is like starting

It shows up in lovers' lives

followed by behaviors that

(Prolactin can promote sep

Dopamine is not the only culprit that contributes to the behaviors

and mood swings that separate intimate partners emotionally.
Prolactin, the neurochemical that shoots up after orgasm, is
associated with many of the very symptoms that long-term couples
complain of in their relationships. (See chart below.)
Prolactin's effects can linger. For example, cocaine blasts the brain
with high levels of dopamine, and prolactin rises during
withdrawal. Indeed, addicts going through withdrawal required two
weeks for their prolactin levels to drop to normal. After mating,
female rats show surges in prolactin for up to two weekseven if
they don't get pregnant. Finally, prolactin is associated with the
stress of feeling hopeless. As partners grow distressed and
discouraged by the puzzling highs and lows in their relationships,
their higher prolactin levels can compound their distress. They
forget what it feels like to be in balance, and gradually lose their
natural sense of wellbeing.
Both low dopamine and high prolactin make your world look bleak
and increase your craving for better sex or new partners who

would raise your dopamine levels (and set you on another addictive
cycle of highs and lows). Together these neurochemicals probably
account for the "end of the honeymoon," which nearly all couples
experience within a year of marriage.

SYMPTOMS ASSOCIA

PROLA

WOMEN
Loss of libido
Mood changes / depression

MEN
Loss of libido
Mood
changes/depression

Hostility, anxiety

Impotence

Headache

Headache

Menopausal symptoms,
even when estrogen is

Infertility

sufficient
Signs of increased

Decreased

testosterone levels

testosterone levels

Weight gain

Weight gain

Intercourse may become

painful because of vaginal
dryness

Peripheral vision
problems

Infertility, irregular

Gynecomastia

menstruation

(growing breasts)

Peripheral vision problems

There are at least three source of emotional friction related to these

brain chemistry shifts. (1) Partners get out of sync. Dopamine
levels rise in one while the prolactin levels are still high in the
other. You may desperately want sex, while your partner has no
interest at all. (2) Partners project their state of mind onto each
other. When you feel rotten, or "hungry," or just plain "off," it's
normal to find fault with the person closest to you. It honestly
seems like you'd feel fine if he'd just be more generous, or she
would just stop shopping for more and more shoes and make love.
(3) Partners' brains get rewired over time, away from love and
toward defensiveness. The part of your primitive brain that is
designed to react to snakes and predators is now being activated by
your partner. Certainly your partner didn't threaten to poison you,
but sex with your partner later made you feel bad at a subconscious
(neurochemical) level. Actually, of course, you hurt yourself by
letting biology tell you how to have a good time in the bedroom.
Your subconscious, however, feels that your lover is the culprit.
Virtually no one identifies this hidden, biological source of distress.
Instead, the part of your brain that analyzes looks for other
explanations. You know, for example, that you don't feel right. Your
partner is acting weird. You're upset, and your honeymoon has
ended. Maybe you write your uneasiness off as a mood swing, or
get a prescription for an antidepressant. Or maybe you feel that
your partner is somehow to blame for the fact that you feel rotten.
"If only he would help more around the house." "If only she would
stop badgering me." And so on. Yet, when you try to fix each other,
you're addressing symptoms and ignoring the deeper problem

these neurochemical shifts.

To heal the underlying problem, you may just have to change the
way you make love. g

Generalized anxiety disorder

Definition
Generalized anxiety disorder, or GAD, is a disorder characterized by diffuse and chronic worry. Unlike
people with phobias or post-traumatic disorders, people with GAD do not have their worries provoked
by specific triggers; they may worry about almost anything having to do with ordinary life. It is not
unusual for patients diagnosed with GAD to shift the focus of their anxiety from one issue to another as
their daily circumstances change. For example, someone with GAD may start worrying about finances
when several bills arrive in the mail, and then fret about the state of his or her health when it is noticed
that one of the bills is for health insurance. Later in the day he or she may read a newspaper article that
moves the focus of the worry to a third concern.
A manual commonly used by mental health professionals is the Diagnostic and Statistical Manual of
Mental Disorders , also known as the DSM. This manual may also be identified more specifically by
edition, such as the DSM, fourth edition text revised, or DSM-IV-TR. The DSM-IV-TR classifies GAD
as an anxiety disorder.

Description
Generalized anxiety disorder is characterized by persistent worry that is excessive and that the patient
finds hard to control. Common worries associated with generalized anxiety disorder include work
responsibilities, money, health, safety, car repairs, and household chores. The ICD-10, which is the
European equivalent of DSMIV-TR, describes the anxiety that typifies GAD as "free-floating," which
means that it can attach itself to a wide number of issues or concerns in the patient's environment.
DSM-IV-TR specifies that the worry must occur "more days than not for a period of at least six
months"; ICD-10 states only that the patient "must have primary symptoms of anxiety most days for at
least several weeks at a time, and usually for several months." The patient usually recognizes that his or
her worry is out of proportion in its duration or intensity to the actual likelihood or impact of the feared
situation or event. For example, a husband or wife may worry about an accident happening to a spouse
who commutes to work by train, even though the worried partner knows objectively that rail travel is
much safer than automobile travel on major highways. The anxiety level of a patient with GAD may
rise and fall somewhat over a period of weeks or months but tends to become a chronic problem. The
disorder typically becomes worse during stressful periods in the patient's life.
DSM-IV-TR specifies interference with work, family life, social activities, or other areas of functioning
as a criterion for generalized anxiety disorder; ICD-10 does not mention interference with tasks or
other activities as a criterion for the disorder. Both diagnostic manuals mention such physical

symptoms as insomnia , sore muscles, headaches, digestive upsets, etc. as common accompaniments of
GAD, but only DSM-IV-TR specifies that an adult patient must experience three symptoms out of a list
of six (restlessness, being easily fatigued, having difficulty concentrating, being irritable, high levels of
muscle tension, and sleep disturbances) in order to be diagnosed with the disorder.
Patients diagnosed with GAD have a high rate of concurrent mental disorders, particularly major
depression disorder, other anxiety disorders, or a substance abuse disorder. They also frequently have
or develop such stress-related physical illnesses and conditions as tension headaches, irritable bowel
syndrome (IBS), temporomandibular joint dysfunction (TMJ), bruxism (grinding of the teeth during
sleep), and hypertension. In addition, the discomfort or complications associated with arthritis,
diabetes, and other chronic disorders are often intensified by GAD. Patients with GAD are more likely
to seek help from a primary care physician than a psychiatrist ; they are also more likely than patients
with other disorders to make frequent medical appointments, to undergo extensive or repeated
diagnostic testing, to describe their health as poor, and to smoke tobacco or abuse other substances. In
addition, patients with anxiety disorders have higher rates of mortality from all causes than people who
are less anxious.
In many cases, it is difficult for the patient's doctor to determine whether the anxiety preceded the
physical condition or followed it; sometimes people develop generalized anxiety disorder after being
diagnosed with a chronic organic health problem. In other instances, the wear and tear on the body
caused by persistent and recurrent worrying leads to physical diseases and disorders. There is an overall
"vicious circle" quality to the relationship between GAD and other disorders, whether mental or
organic.
Children diagnosed with GAD have much the same anxiety symptoms as adults. The mother of a sixyear-old boy with the disorder told his pediatrician that her son "acted like a little man" rather than a
typical first-grader. He would worry about such matters as arriving on time for school field trips,
whether the family had enough money for immediate needs, whether his friends would get hurt
climbing on the playground jungle gym, whether there was enough gas in the tank of the family car,
and similar concerns. The little boy had these worries in spite of the fact that his family was stable and
happy and had no serious financial or other problems.
GAD often has an insidious onset that begins relatively early in life, although it can be precipitated by a
sudden crisis at any age above six or seven years. The idea that GAD often begins in the childhood
years even though the symptoms may not become clearly noticeable until late adolescence or the early
adult years is gaining acceptance. About half of all patients diagnosed with the disorder report that their
worrying began in childhood or their teenage years. Many will say that they cannot remember a time in
their lives when they were not worried about something. This type of persistent anxiety can be regarded
as part of a person's temperament, or inborn disposition; it is sometimes called trait anxiety. It is not
unusual, however, for people to develop the disorder in their early adult years or even later in reaction
to chronic stress or anxiety-producing situations. For example, there are instances of persons
developing GAD after several years of taking care of a relative with dementia , living with domestic
violence, or living in close contact with a friend or relative with borderline personality disorder .
The specific worries of a person with GAD may be influenced by their ethnic background or culture.
DSMIV-TR's observation that being punctual is a common concern of patients with GAD reflects the
value that Western countries place on using time as efficiently as possible. One study of worry in
college students from different ethnic backgrounds found that Caucasian and African American
students tended to worry a variable amount about a wider range of concerns whereas Asian Americans
tended to worry more intensely about a smaller number of issues. Another study found that GAD in a
community sample of older Puerto Ricans overlapped with a culture-specific syndrome called ataque
de nervios , which resembles panic disorder but has features of other anxiety disorders as well as

dissociative symptoms. (People experience dissociative symptoms when their perception of reality is
temporarily altered they may feel as if they were in a trance, or that they were observing activity
around them instead of participating.) Further research is needed regarding the relationship between
people's ethnic backgrounds and their outward expression of anxiety symptoms.

Causes and symptoms

Causes
The causes of generalized anxiety disorder appear to be a mixture of genetic and environmental factors.
It has been known for some years that the disorder runs in families. Recent twin studies as well as the
ongoing mapping of the human genome point to a genetic factor in the development of GAD. A gene
related to panic disorder was identified in late 2001, which increases the likelihood that there is a gene
or genes that govern susceptibility to generalized anxiety. The role of the family environment (social
modeling ) in an individual's susceptibility to GAD is uncertain. Social modeling, the process of
learning behavioral and emotional response patterns from observing one's parents or other adults,
appears to be a more important factor for women than for men.
Another factor in the development of GAD is social expectations related to gender roles. A recent
Swiss study corroborated earlier findings that women have higher levels of emotional distress and
lower quality of life than men. The higher incidence of GAD in women has been linked to the diffuse
yet comprehensive expectations of women as caregivers. Many women assume responsibility for the
well-being and safety of other family members in addition to holding a job or completing graduate or
professional school. The global character of these responsibilities as well as their unrelenting nature has
been described as a mirror image of the persistent but nonspecific anxiety associated with GAD.
Socioeconomic status may also contribute to generalized anxiety. One British study found that GAD is
more closely associated with an accumulation of minor stressors than with any demographic factors.
Persons of lower socioeconomic status, however, have fewer resources for dealing with minor stressors
and so appear to be at greater risk for generalized anxiety.
One additional factor may be the patient's level of muscle tension. Several studies have found that
patients diagnosed with GAD tend to respond to physiological stress in a rigid, stereotyped manner.
Their autonomic reactions (reactions in the part of the nervous system that governs involuntary bodily
functions) are similar to those of people without GAD, but their muscular tension shows a significant
increase. It is not yet known, however, whether this level of muscle tension is a cause or an effect of
GAD.

Symptoms
The symptomatology of GAD has changed somewhat over time with redefinitions of the disorder in
successive editions of DSM. The first edition of DSM and DSM-II did not make a sharp distinction
between generalized anxiety disorder and panic disorder. After specific treatments were developed for
panic disorder, GAD was introduced in DSM-III as an anxiety disorder without panic attacks or
symptoms of major depression. This definition proved to be unreliable. As a result, DSM-IV
constructed its definition of GAD around the psychological symptoms of the disorder (excessive
worrying) rather than the physical (muscle tension) or autonomic symptoms of anxiety. DSM-IV-TR
continued that emphasis.
According to the DSM-IV-TR, the symptoms of GAD are:

 excessive anxiety and worry about a number of events or activities, occurring more days than
not for at least six months
worry that cannot be controlled
worry that is associated with several symptoms such as restlessness, fatigue , irritability, or
muscle tension
worry that causes distress or impairment in relationships, at work, or at school
In addition, to meet the diagnostic criteria for GAD,
the content or focus of the worry cannot change the diagnosis from GAD to another anxiety disorder
such as panic disorder, social phobia , or obsessive-compulsive disorder , and the anxiety cannot be
caused by a substance (a drug or a medication).
One categorization of GAD symptoms that some psychiatrists use in addition to the DSM framework
consists of three symptom clusters:
symptoms related to high levels of physiological arousal: muscle tension, irritability, fatigue,
restlessness, insomnia
symptoms related to distorted thinking processes: poor concentration, unrealistic assessment of
problems, recurrent worrying
symptoms associated with poor coping strategies: procrastination, avoidance, inadequate
problem-solving skills

Demographics
It is difficult to compare present statistics for generalized anxiety disorder with those of the 1980s and
early 1990s because of changes in the diagnostic criteria for GAD in successive editions of DSM. The
National Institute of Mental Health (NIMH) states that as of 2000, 2.8% of the general United States
population, or about four million people, have GAD during the course of a given year. One study that
used DSM-III-R criteria concluded that 5% of the United States population, or one person in every 20,
will develop GAD at some point in their lives. Another range of figures given for the lifetime
prevalence of GAD in the American population is 4.1%6.6%. The figure given for children in the
United States is also 5%. Women develop generalized anxiety disorder more frequently than men; the
sex ratio is variously given as 3:2 or 2:1. Prevalence across races and ethnic groups is more difficult to
determine because of cultural influences on expressions of anxiety.
Some psychiatrists think that generalized anxiety disorder is overdiagnosed in both adults and children.
One reason for this possibility is that diagnostic screening tests used by primary care physicians for
mental disorders produce a large number of false positives for GAD. One study of the PRIME-MD, a
screening instrument for mental disorders frequently used in primary care practices, found that 7% of
patients met the criteria for GAD. Follow-up in-depth interviews with the patients, however, revealed
that only a third of the GAD diagnoses could be confirmed.

Diagnosis
Diagnosis of GAD, particularly in primary care settings, is complicated by several factors. One is the
high level of comorbidity (co-occurrence) between GAD and other mental or physical disorders.
Another is the considerable overlap between anxiety disorders in general and depression. Some
practitioners believe that depression and GAD may not be separate disorders after all, because studies
have repeatedly confirmed the existence and common occurrence of a "mixed" anxiety/depression

syndrome.
Evaluating a patient for generalized anxiety disorder includes the following steps:
Patient interview. The doctor will ask the patient to describe the anxiety, and will note whether
it is acute (lasting hours to weeks) or persistent (lasting from months to years). If the patient
describes a recent stressful event, the doctor will evaluate him or her for "double anxiety,"
which refers to acute anxiety added to underlying persistent anxiety. The doctor may also give
the patient a diagnostic questionnaire to evaluate the presence of anxiety disorders. The
Hamilton Anxiety Scale is a commonly used instrument to assess anxiety disorders in general.
The Generalized Anxiety Disorder Questionnaire for DSM-IV (GAD-Q-IV) is a more recent
diagnostic tool, and is specific to GAD.
Medical evaluation. Nonpsychiatric disorders that are known to cause anxiety (hyperthyroidism,
Cushing's disease, mitral valve prolapse, carcinoid syndrome, and pheochromocytoma) must be
ruled out, as well as certain medications (steroids, digoxin, thyroxine, theophylline, and
selective serotonin reuptake inhibitors) that may also cause anxiety as a side effect. The patient
should be asked about his or her use of herbal preparations as well.
Substance abuse evaluation. Because anxiety is a common symptom of substance abuse and
withdrawal syndrome, the doctor will ask about the patient's use of caffeine, nicotine, alcohol,
and other common substances (including prescription medications) that may be abused.
Evaluation for other psychiatric disorders. This step is necessary because of the frequent
overlapping between GAD and depression or between GAD and other anxiety disorders.
In some instances the doctor will consult the patient's family for additional information about the onset
of the patient's anxiety symptoms, dietary habits, etc.

Treatments
There are several treatment types that have been found effective in treating GAD. Most patients with
the disorder are treated with a combination of medications and psychotherapy .

Medications
Pharmacologic therapy is usually prescribed for patients whose anxiety is severe enough to interfere
with daily functioning. Several different groups of medications have been used to treat generalized
anxiety disorder.
These medications include the following:
Benzodiazepines. This group of tranquilizers does not decrease worry, but lowers anxiety by
decreasing muscle tension and hypervigilance. They are often prescribed for patients with
double anxiety because they act very quickly. The benzodiazepines, however, have several
disadvantages: they are unsuitable for long-term therapy because they can cause dependence,
and GAD is a long-term-disorder; they cannot be given to patients who abuse alcohol; and they
cause short-term memory loss and difficulty in concentration. One British study found that
benzodiazepines significantly increased a patient's risk of involvement in a traffic accident.
Buspirone (BuSpar). Buspirone appears to be as effective as benzodiazepines and
antidepressants in controlling anxiety symptoms. It is slower to take effect (about twothree
weeks), but has fewer side effects. In addition, it treats the worry associated with GAD rather
than the muscle tension.
Tricyclic antidepressants. Imipramine (Tofranil), nortriptyline (Pamelor), and desipramine

(Norpramin) have been given to patients with GAD. They have, however, some problematic
side effects; imipramine has been associated with disturbances in heart rhythm, and the other
tricyclics often cause drowsiness, dry mouth, constipation, and confusion. They increase the
patient's risk of falls and other accidents.
Selective serotonin reuptake inhibitors. Paroxetine (Paxil), one of the SSRIs, was approved by
the Food and Drug Administration (FDA) in 2001 as a treatment for GAD. Venlafaxine
(Effexor) appears to be particularly beneficial to patients with a mixed anxiety/depression
syndrome; it is the first drug to be labeled by the FDA as an antidepressant as well as an
anxiolytic. Venlafaxine is also effective in treating patients with GAD whose symptoms are
primarily somatic (manifesting as physical symptoms, or bodily complaints).

Psychotherapy
Some studies have found cognitive therapy to be superior to medications and psychodynamic
psychotherapy in treating GAD, but other researchers disagree with these findings. As a rule, GAD
patients who have personality disorders , who are living with chronic social stress (are caring for a
parent with Alzheimer's disease , for example), or who don't trust psychotherapeutic approaches
require treatment with medications. The greatest benefit of cognitive therapy is its effectiveness in
helping patients with the disorder to learn more realistic ways to appraise their problems and to use
better problem-solving techniques.
Family therapy is recommended insofar as family members can be helpful in offering patients a
different perspective on their problems. They can also help the patient practice new approaches to
problem-solving.

Alternative and complementary therapies

Several alternative and complementary therapies have been found helpful in treating patients with
generalized anxiety disorder. These include hypnotherapy ; music therapy; Ayurvedic medicine; yoga
; religious practice; and guided imagery meditation .
Biofeedback and relaxation techniques are also recommended for GAD patients in order to lower
physiologic arousal. In addition, massage therapy, hydrotherapy, shiatsu, and acupuncture have been
reported to relieve muscle spasms or soreness associated with GAD.
One herbal remedy that has been used in clinical trials for treating GAD is passionflower ( Passiflora
incarnata ). One team of researchers found that passionflower extract was as effective as oxazepam
(Serax) in relieving anxiety symptoms in a group of 36 outpatients diagnosed with GAD according to
DSM-IV criteria. In addition, the passionflower extract did not impair the subjects' job performance as
frequently or as severely as the oxazepam.

Prognosis
Generalized anxiety disorder is generally regarded as a long-term condition that may become a lifelong
problem. Patients frequently find their symptoms resurfacing or getting worse during stressful periods
in their lives. It is rare for patients with GAD to recover spontaneously.

Prevention
As of 2002, the genetic factors involved in generalized anxiety disorder have not been fully identified.

In addition, the many stressors of modern life that raise people's anxiety levels are difficult to escape or
avoid. The best preventive strategy, given the early onset of GAD, is the modeling of realistic
assessment of stressful events by parents, and the teaching of effective coping strategies to their
children.
Read more: http://www.minddisorders.com/Flu-Inv/Generalized-anxietydisorder.html#ixzz4BsF9ZdQe

15 Serotonin Supplements to Boost Mood

Naturally
By Deane Alban
Serotonin supplements like specific amino acids, vitamins, minerals and herbs increase serotonin
levels, helping depression and other brain-related disorders.
Serotonin is a neurotransmitter that plays a large role in mood, learning, appetite control, and sleep.
Its widely believed that low serotonin is the main underlying cause of depression.

Selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Prozac, Zoloft, Celexa, and Lexapro are

used by millions to relieve symptoms of depression by increasing brain levels of serotonin.

But SSRIs can have serious side effects and dont work for everyone, possibly up to 40% of those who
try them. (1)
One meta-analysis concluded that 68% of these drugs benefits were due to the placebo effect. (2)
Several other brain-related disorders besides depression are related to low serotonin, including autism,
ADHD, bipolar disorder, sleep disorders, and schizophrenia. (3)
Many people with depression or other serotonin deficiency symptoms and conditions are searching for
better ways to increase serotonin levels naturally without the use of drugs.
If this is your situation, here are some serotonin supplements proven to help increase serotonin levels
naturally.

The Types of Supplements that Increase Serotonin Naturally

There are many kinds of nutritional supplements that increase serotonin levels amino acids,
vitamins, minerals, herbs, and more.
Before you take any serotonin supplement, its important to understand a little bit about them and
especially how they work together.
Sometimes there are vital synergistic relationships between these various serotonin boosting
substances.
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There are several cofactors required to make the most commonly used serotonin supplements do their
job.
Conversely, there are times when these supplements can react adversely with medications or other
serotonin supplements, and you need to know about those too.

Amino Acid Serotonin Supplements

Three of the most widely used serotonin supplements are the amino acids tryptophan, 5-HTP, and
SAM-e.
Note that it is not considered safe to mix any of these amino acid supplements with antidepressant
medications. (4, 5, 6)
Do so only if you are working with a knowledgeable health care professional.
Together, they can cause too large an increase in serotonin which can result in a potentially serious
condition known as serotonin syndrome.
Serotonin syndrome should be taken very seriously. Symptoms range from mild to fatal.

Tryptophan
Tryptophan might seem like a logical serotonin supplement to try first since tryptophan is a precursor
of serotonin.
Tryptophan is an amino acid commonly found in protein-rich foods like animal products.

But since protein blocks serotonin synthesis, eating a meal containing protein will actually cause both
tryptophan and serotonin levels to drop.
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However, tryptophan supplements can increase brain serotonin even though eating foods containing
tryptophan does not. (7)
Tryptophan supplements fell out of favor when a contaminated batch from Japan caused thousands to
fall ill in the 1980s.
For decades, manufacturers shied away from selling this supplement, but its now readily available and
widely known to be safe.
Related articles on Be Brain Fit
Tryptophan: A Key Factor in Mental Health
Brain Inflammation May Be the Cause of Your Depression
5-HTP Benefits for Anxiety, Depression, Sleep

5-HTP (5-hydroxytryptophan)
5-HTP could be considered as either an amino acid or herbal supplement.
It comes from Griffonia simplicifolia, an African woody shrub.
Griffonias seeds contain 20% 5-HTP. (8)

But weve put it in the amino acid category since its

so closely associated with tryptophan.
In the US, Canada, and the United Kingdom, 5-HTP is sold as an over-the-counter supplement
for ADHD, anxiety, depression, fibromyalgia, migraines, sleep disorders, and weight loss. (9)
Elsewhere in Europe, its available as a prescription drug. (10)
Unfortunately, this supplements usefulness for depression may be more hype than substance.
A review of 108 studies on 5-HTP revealed that there is still no definitive evidence that it helps
depression. (11)

Tryptophan or 5-HTP? An Ongoing Debate

Theres an ongoing discussion in the natural health community whether its better to take tryptophan or
5-HTP to increase serotonin levels.
Tryptophan more readily enters the brain, but 5-HTP requires one less step to convert into serotonin.
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We prefer tryptophan supplements not just because studies have not conclusively found that 5-HTP
helps depression, but because 5-HTP is not intended for long-term use.
While its increasing serotonin, its depleting other neurotransmitters like dopamine and
norepinephrine. (12)
Within a few months, this inevitably causes a cascade of negative side effects.

SAM-e (s-adenosyl methionine)

SAM-e naturally occurs in every cell of body and brain and fuels over 100 metabolic reactions.
SAM-e supplements are synthetically derived and sold in the US as a supplement.
In Europe, SAM-e is used as a prescription medication for depression, liver disease, and osteoarthritis.
(13)
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Several studies show that SAM-e works as well for depression as some antidepressant medications by
increasing serotonin, dopamine, acetylcholine and other important brain chemicals. (14, 15)
Its particularly helpful for Parkinsons and schizophrenia patients who also have depression. (16)
SAM-e should not be mixed with drugs that affect serotonin release such as levodopa, Demerol, or
Ultram, or the over-the-counter cough remedy Robitussin DM. (17)

Vitamins and Minerals that Increase Serotonin

According to Dr. Datis Kharrazian, author of Why Isnt My Brain Working? , numerous vitamins and
minerals are cofactors required to synthesize serotonin.
Here are a few that are integrally connected to serotonin production.
Related articles on Be Brain Fit
Balance Your Neurotransmitters to Take Control of Your Life
How Inositol Benefits These 6 Mental Health Conditions

Vitamin B6 (pyridoxine)
Vitamin B6 must be present to facilitate conversion of either 5-HTP or tryptophan into serotonin. (18)
Often 5-HTP or tryptophan supplements also contain B6 for this reason.
People suffering from major depression consistently have low blood levels of both vitamins B9 and
B12, both of which are needed for SAM-e to be utilized by the brain. (19)

Vitamin B9 (folic acid)

Folic acid deficiency will cause low serotonin levels.
It can act as an antidepressant, possibly by affecting serotonin receptors within the brain. (20)
NeuroNation Brain Training Better memory and mental performance in 10 minutes a day
One study concluded that everyone with depression should be taking folic acid since its potential
benefits are so great. (21)
Folic acid enhances the effects of both SAM-e and antidepressant medications such as Prozac. (22)

Vitamin C
Vitamin C is another serotonin cofactor that can act as a natural antidepressant. (23)
One study found that participants who were given vitamin C reported feeling happier, often within as
little as one week. (24)
Vitamin C is also required to produce dopamine, norepinephrine and epinephrine neurotransmitters
that boost physical and mental energy and feelings of reward and satisfaction.

Vitamin D

Vitamin D, the sunshine vitamin, may be the most

important missing vitamin for your brain and your mood.
Deficiency is rampant, with up to 75% of Americans not getting enough. (25)
Low levels are thought to be responsible for the depression many people feel in the winter known as
seasonal affective disorder. (26)
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Vitamin D regulates the conversion of tryptophan into serotonin. (27)
If you spend most of your time indoors or live in the northern half of the US, vitamin D
supplementation is a must.

Magnesium
Magnesium is a mineral essential in over 600 different metabolic functions including nervous system
regulation. (28)

It has a direct effect on serotonin balance. (29)

Patients treated with magnesium supplements have experienced rapid recovery from major depressive
disorder. (30)
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Besides improving mood, its also been shown to increase focus and concentration, energy,
and resilience to stress. (31)
Magnesium deficiency is a widespread issue with up to 75% of Americans being deficient. (32)

Zinc
Zinc is another essential mineral with antidepressant properties. (33)
Its normally present in high concentrations in the brain where it assists many brain functions.
It increases the uptake of serotonin in certain areas of the brain and shows potential as a treatment for
major depressive disorder. (34, 35)
Zinc deficiency is extremely common, probably affecting 2 billion people worldwide. (36)
Children, seniors, and vegetarians are most at risk for zinc deficiency.

Food-Based Natural Serotonin Boosters

There are a few serotonin boosting compounds that originate in food.
Theoretically, you could boost your serotonin level just from food, provided you consumed enough
of the right foods.

L-theanine
L-theanine is a brain boosting amino acid found almost exclusively in green tea.
It increase levels of serotonin and can make you more resilient to stress. (37)
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It has the unique ability to increase alpha brainwave activity which puts you in a similar brainwave
state achieved during meditation. (38)
You can take l-theanine supplements or get it from drinking green tea 3 cups of per day should
deliver real brain benefits. (39)
Related articles on Be Brain Fit
Serotonin Foods and Mood Disorders
The Brain Benefits of Omega-3 Fats in Your Diet
Benefits of Magnesium for Memory and Brain Health

Omega-3 essential fatty acids

Omega-3 EFAs are found mainly in cold water fatty fish like salmon and mackerel.

They are one of the most important type of nutrients for overall brain health and function.
Theyre essential for building healthy brain cells and promoting new brain cell formation. (40)
People with low serotonin levels commonly have low levels of omega-3 fats.
Two major components of omega-3s are DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid)
and both are involved with serotonin.
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DHA makes serotonin receptors more receptive, while EPA increases the release of serotonin
from neurons. (41)
DHA is generally considered the most important of the omega-3s for brain function.
Low levels of DHA are linked to depression, bipolar disorder, schizophrenia, memory loss, and
Alzheimers. (42)
You could get enough omega-3s from your diet if you ate wild salmon every day.
But there are very few people who wouldnt benefit from omega-3 supplementation in the form of
fish oil or krill oil since its estimated that 70% of the population is omega-3 deficient. (43)

Probiotics

Probiotics are good bacteria found in fermented

foods like yogurt, kefir, and unpasteurized sauerkraut.
They can help establish a normal balance between good and bad bacteria in your intestines, and that is
surprisingly relevant to the health and function of your brain.
An overabundance of bad bacteria in the gut is called dysbiosis and creates toxic byproducts called
lipopolysaccharides.
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Lipopolysaccharides have numerous negative effects on your brain including lowered serotonin
levels. (44)
Probiotic supplements can help if you dont regularly eat fermented foods.
Lifestyle factors that mess up your gut flora balance include stress, alcohol, sugar, exposure to toxins,
and taking antibiotics or birth control pills. (45)

Herbs That Increase Serotonin Levels

Theres a fine line between food based supplements and herbal remedies.
Herbal remedies are derived from plant parts seeds, berries, roots, leaves, bark, and flowers and
used medicinally.
This last group, herbal serotonin supplements, is derived from plants but not those we normally eat.
Related articles on Be Brain Fit
How to Put Post-Holiday Depression Behind You
Herbal Remedies for Depression: Viable Alternative to Antidepressants

Curcumin
Curcumin is the active ingredient in the spice turmeric which has many brain boosting properties.
This compound increases levels of both serotonin and dopamine. (46)
Curcumin supplements have proven to be as effective as Prozac for depression. (47)
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Isolated curcumin is not very bioavailable so look for a curcumin supplement that has taken measures
to enhance bioavailability.
For example, the addition of piperine, a compound found in black pepper, increases curcumin
absorption by up to 2000%. (48)

Garcinia cambogia
Garcinia cambogia is a sour tropical fruit thats used in traditional Asian cuisine.
Garcinia extract has become a wildly popular weight loss supplement that supposedly works by
decreasing appetite while increasing the bodys ability to burn fat. (49)
Studies show its minimally effective as a fat burner, but it does suppress appetite by increasing
serotonin levels. (50, 51)
It may also help with weight loss by improving mood which reduces emotional eating. (52)
If you are taking an SSRI, do not take garcinia for either increasing serotonin or weight loss as this
combination can lead to serotonin toxicity. (53)

Rhodiola rosea
Rhodiola rosea goes by many common names Arctic root, golden root, rose root, western roseroot,
Aarons rod, and kings crown to name a few. (54)
And it has almost as many uses as it has names!
Rhodiola rosea has been called an herb thats good for whatever ails you.
If you have brain fog, trouble concentrating, and low energy along with your depression, its an
excellent herb to consider.

Its been used since the ancient Greeks to boost overall physical and mental vitality.
Its a potent adaptogen that increases resistance to stress. (55)
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And its an excellent serotonin booster that also decreases the stress hormone cortisol. (56)
Rhodiola rosea helps with a wide range of brain related disorders including depression, anxiety,
seasonal affective disorder (SAD), and memory loss.
It can also help overcome the stress, brain fog, and anxiety that often accompany fibromyalgia and
chronic fatigue syndrome. (57)
It has almost no side effects and works faster to reduce depression than antidepressant medications.
(58)

How to Increase Serotonin with Supplements: The Bottom Line

Selective serotonin reuptake inhibitors (SSRIs) are usually prescribed for depression. They work by
increasing serotonin levels.
But they are not the only way to increase serotonin.
There are a wide variety of supplements that can increase serotonin levels naturally.
But there are some finer points you need to know to use serotonin supplements safely and effectively.
Its critical that you dont mix and match serotonin supplements with other substances that increase
serotonin or you put yourself at risk for potentially dangerous serotonin syndrome.
Unfortunately, just as with any antidepressant medication, there is no one serotonin supplement that
works for everyone.
It may require some trial and error to figure out the one thats right for you.