Q:I have depression that’s greatly improved by taking an anti-depressant. But one troubling problem remains: I don’t have an urge to connect with friends and family. I know it’s good for me, and some part of me wants to, but I just don’t do it. Is this a side effect of the anti-depressant, and is there any way to treat it?
A: Most anti-depressant work by raising levels of a neurotransmitter called serotonin, and some newer antidepressants also increase norepinepherine.
But there are dozens more of these chemical messengers in the brain that help to account for the vast range of moods and feelings we are familiar with. The molecular messenger that facilitates our ability to receive and respond to emotional and physical contact is oxytocin. This hormone is made in the deep structures of the brain and released by the pituitary gland just under the brain.
Oxytocin is released when we receive emotional contact. This can be in conversation with friends, looking at loved ones in photos, talking to them on the phone, being in a group where you are valued, or simply recalling the memory of someone you care about. It is also released with caring physical interactions, like hugs, massage or sexual contact.
When oxytocin is lacking, you simply don’t have the urge to seek more physical or emotional connections. You may think going out would be fun, but it simply remains as a thought, with no corresponding urge to connect. The problem is, having low oxytocin levels is a condition that tends not to self-correct; that is, it takes oxytocin to make oxytocin. Some people just never get over this hump, and never get off the couch. Other signs of deficiency are irritability, poor sexual arousal, loss of a feeling of attachment or caring when touched, flat mood, feeling overburdened, overly intellectualizing, excessive worrying, and social withdrawal.
Stress, and our response to it, is one of the main factors in decreased oxytocin levels. When we get stressed, we may respond in a way that isolates us. We may work harder, we may do more for the family, we may move faster, staying on the surface of our lives but not dropping deeper into emotional contact with the people around us. When we experience physical stress, such as pain or illness, we simply lack the vitality to connect or we are preoccupied by physical discomfort.
Fortunately, there is a way to overcome oxytocin deficiency. Safe, sublingual forms of oxytocin can be prescribed by your doctor and formulated by compounding pharmacies—pharmacies that make medicines from raw materials. For a typical adult, 10mg sublingually (dissolved under the tongue) twice daily will produce a noticeable urge to engage emotionally or physically. Once you are more engaged, you may be able to stop taking it. Though few studies on its long-term effects have been done, it appears to be safe, and nothing in either the animal or the human research points to a concern.
There can be side effects, including jealousy and emotional stickiness or clinginess. These subside quickly with discontinuation of the medicine. One important note: you must have reasonably functioning adrenal glands for the medicine to work. If you’re wiped out by stress, you won’t notice the effects of oxytocin. Work with a functional medicine practitioner to improve your adrenal function and stress response first before trying oxytocin. If you’re curious whether oxytocin would be helpful for you, ask your doctor to contact a reputable compounding pharmacist about their oxytocin preparations.
You can also promote your own production of oxytocin. Behaviors that encourage oxytocin production include all positive physical touch, including massage, hugs, kisses, holding hands and sexual caressing. Emotionally evocative music, movies, books and sharing with others, including psychotherapy, can help, as can physical exercise, warm climates, singing and eating regular meals. And once you start connecting, it’s likely that you’ll want to continue.
Nexus November/December 2012