Neurotransmitters and Mood GABA & Glutamate

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs. Register@Allce.com Counselortoolbox you hi everybody and welcome to today's presentation on GABA and glutamate. So far we've talked about serotonin, dopamine and norepinephrine and we're going to round it out with GABA and glutamate. Now, these are not the only neurotransmitters that are involved in health, wellness and happiness, but they are the Big five. You also have acetylcholine and some others that are involved. And as you've learned throughout the last presentations, it's not just the neurotransmitters that are important to focus on. Because there are certain things that can cause your neurotransmitters to get out of balance. Even if the neurotransmitter system itself is working just fine, if other things are out of whack, it might cause people to feel depressed. Think about it like a car. If you are operating a car but you have 200 pounds of dog food in the trunk, it's going to not perform as it should. Your gas mileage is going to suck. You're going to have to brake differently. The same thing is true with GABA and glutamate. With the car analogy, the brakes are just fine. There's nothing wrong with the brake system. It's the stuff in the trunk that's causing the problem with GABA and glutamate and your other neurotransmitters. Your neurotransmitter system may be operating just fine, but other systems that interact with the neurotransmitter system, like your thyroid hormones or your sex hormones, may be of whack. So it is important to look at what is causing the dysfunction, not just which neurotransmitter seems to be inadequate. In this presentation, we're going to identify the functions of GABA and glutamate, explore the interaction between these neurotransmitters and the rest of the Big five. Identify symptoms of too much of either, explore ways to reduce them, identify symptoms of deficiencies of either, and ways to increase them. And I will say again, like I've said in all the other presentations, we don't want to encourage people to start taking supplements that theoretically rapidly increase gaba or that theoretically are GABA or glutamate or serotonin or whatever, because that system is so delicate and small Changes make so much of a difference in the way our body functions that they can easily throw the system even further out of whack. So it's better again to look at what's causing the imbalances, the dysfunction. And a lot of times we're going to come back to chronic stress, hypocortisolism, trauma, lack of adequate sleep, chronic pain, a lot of, I'll call them lifestyle factors or things that we actually can address. Other times it may be thyroid dysfunction or sex hormone dysfunction. Those can be medically addressed, those are easily treatable, but it's not in, in all of those cases, it's not about giving the person a pill to add more of the neurotransmitter. It's about eliminating whatever it is that's causing them to not have enough of it. Eliminating the leak, if you will. So GABA is our body's natural anti anxiety chemical. It's our natural Valium or Xanax or whatever you want to call it. It reduces the activity of the central nervous system. One of the key points is it's made from and counterbalances glutamate. Glutamate is our main excitatory neurotransmitter, but glutamate is broken down to make gaba. So if you don't have enough glutamate, then you're not going to have enough gaba. If GABA helps us reduce anxiety, then people without enough glutamate may not produce enough GABA and may have some anxiety related symptoms. Interesting, interesting thought. So it's important to recognize that you need both, and I've used the analogy many times before of running bath. Glutamate is like your hot water and GABA is like your cold water and you want it at that perfect level of warm. GABA plays a role in the healthy functioning of the body's immune system and endocrine systems as well as in the regulation of appetite and metabolism. So it's not just a calm me down chemical. It also plays a big role in other parts of functioning. And as we have learned from the gut health presentation as well as some of the other neurotransmitters presentations, when we have stress, our gut becomes more permeable and we tend to have systemic widespread inflammation. Now it may not be huge inflammation, but a low grade inflammation which contributes to pain and depression and other things. So if the immune system is overactive or underactive, then we may have inflammation. GABA supports gut motility and controls inflammation. Well, there again if you don't have enough gaba, then you may have increased inflammation, which has been directly linked to depressive symptoms. GABA is an inhibitory transmitter in the mature brain. Okay, so once we get our brain is mature 25 plus, it's an inhibitory or a calming neurotransmitter. But in the developing brain, GABA is primarily an excitatory neurotransmitter. Who knew? So GABA changes its function over time. Once the brain stops developing, more or less, the function of GABA switches. GABA regulates the growth of embryonic and neural stem cells. So in that developing brain, GABA is regulating the development of all the connections and the synapses and all that kind of stuff. Remember, like our prefrontal cortex keeps developing until about the age of 24. So Gaba is helping make that a healthy, strong system. Once the all clear is sent out that the brain is completely developed, then GABA switches off and says, okay, I can do something different. Now think about it like a parent. When the child is growing and developing and doing all that kind of stuff, we are in parental mode. But then when the child reaches the age of maturity and decides to move out, go to college, get a job, whatever he or she decides to do, our function switches. We don't need to do that anymore. We don't need to be as parental. So we switch over to doing something else. GABA is synthesized from glutamate, which is synthesized from glutamine, which is amino acid, a protein. Glutamine is one of the most available proteins there is out there. People don't have a deficit in glutamine 99.9% of the time if they've got even moderately reasonable nutrition. Glutamine also comes in supplements if you are a workout aficionado. If you take a lot of supplements for working out, you're familiar with lysine, arginine and glutamine as some of your amino acids that you need to build muscle. Well, glutamine is in there and the body will use glutamine for energy if it needs it. Glutamine is going to be excreted any excess that you get, but it is hard on the kidneys if you're taking in too much protein. Taking in too much protein also causes the body to leach calcium from our bones and wherever else, which in and of itself is not a great thing. But if you remember back to the serotonin lecture, calcium is needed to convert tryptophan into serotonin. So if our calcium levels are low, then we, because we don't have enough glutamine, then we may start experiencing depressive symptoms because we're not able to convert the amino acid into the serotonin B6 again required for serotonin conversion and also required in the conversion of amino acids to dopamine, but also required for the synthesis of neurotransmitters in Gaba. So B6 is really important. B6 is a water soluble vitamin, which means again, you're probably not going to overdose. It's theoretically possible if you just took an ultra mega superdose, but probably not going to overdose. Your system is probably going to excrete it, but you're going to have basically really expensive urine because your body can't store B6. So it's important to get it in your diet. It's important to make sure you're getting enough. But overdoing it on B6 is not going to help matters any. If people have insufficient levels of gaba, this could be for a variety of reasons. They don't have enough glutamate, they don't have enough vitamins and necessary nutrients to break down glutamate into gaba. They have imbalances in other systems that affect the availability of gaba. There's a lot of reasons. But if we suspect someone doesn't have enough gaba, they may have anxiety, stress and depression symptoms. Now you think depression, why depression? Because GABA is an anti anxiety. You would think if they don't have enough, they're going to have, they're going to be revved up. Remember the hypocortisolism? If the body is exposed to a stressor for long enough and can't defeat it, after a certain point the body goes, you know what? I'm not throwing good energy after bad. I'm going to quit fighting this and I'm going to conserve my energy until there's a different threat that I might be able to conquer. This leads to the body pulling in, if you will, and holding on to those excitatory neurotransmitters until there's a need for it, which leads people to feel apathetic, fatigued, etc. Also, when you're anxious and stressed all the time, it is going to impact people's ability to sleep. Even if you are, you know, not experiencing hypocortisolism, if you are exhausted, if you are not sleeping, if your circadian rhythms are out of whack, you are probably going to start feeling apathetic and fatigued and having difficulty concentrating Just because you're so stressed out that you're not sleeping. So we do want to look biopsychosocially at what's going on. Insufficient GABA leads to difficulty concentrating and memory problems. When we are too anxious, we're not going to remember things as well. We're going to have more difficulty concentrating, leads to muscle pain and headaches. Well, think about it. When you get stressed, do you carry tension in your neck? Do you grind your teeth? Do you get headaches? Well, if you're stressed, if you're anxious, it can mean you don't have enough GABA for one reason or another. Insomnia and other sleep problems. When you're too stressed out, you can't sleep. Epilepsy, they've actually associated with insufficient gaba. And obviously if your patient has epilepsy, they need to talk to their doctor before they start monkeying with any supplements or anything because it's not a one to one correlation. Chronic pain and inflammation. We know that serotonin and dopamine are both involved in anti inflammatory processes. GABA is too. So if somebody has chronic pain and inflammation doesn't necessarily mean it's gaba. It could be serotonin or dopamine. But we know that insufficient GABA does contribute to chronic pain and inflammation. If you remember back to serotonin. Serotonin affects our pain perception as well. So as serotonin gets low, our pain threshold gets lower. Alcoholism is associated with insufficient gaba. Sometimes people will drink to try to calm their nerves because initially alcohol can be a system depressant. Now you remember alcohol is sort of bimodal and once you get enough in your system, it's a depressant. But then when it starts leaving the system because the body can't produce enough GABA to ease the transition, people tend to have a spike in blood pressure and a spike in anxiety. So there is a definite correlation between symptoms and GABA levels with alcoholism as well as during detox and hypertension. Too much stress can lead to hypertension. Artificially increasing GABA may trigger a depressive episode. Another reason to not just go out and find some supplement that claims it's going to increase gaba. If you start eating a relatively healthy diet, if you start getting enough sleep, then your body has the building blocks, has all the building blocks it needs to make the GABA and you're not going to overwhelm it with any particular nutrient and throw the system out of whack. People with major depressive disorder show reduced brain concentration of gaba. Interesting because when we think of major depressive disorder, what is the first thing we think of? Serotonin. Some people, that's the only thing they think of. In reality it could be serotonin, norepinephrine or GABA that is out of whack. Or all three because they all interact with one another. Here are some articles that you can look at on the symptoms of insufficient GABA if you want to do some more research. So increasing gaba, what do you do or what things increase gaba? Well, valerian and kava are herbs that are known to help with anxiety reduction. Again, we don't want to recommend or prescribe these to our clients because we are not registered dietitians or physicians. I'm just telling you what things alter GABA levels. For example, valerian theoretically is stronger than gaba, stronger than kava in its anti anxiety properties. So it can be very sedating. Valerian is also not advised for use by people with major depressive disorder because again, artificially increasing GABA can precipitate depression. It calms people down too much. Magnesium is a mineral. It's easy to get it. You can. Or a vitamin, you can get it in your multivitamin. You can get it in pretty much any enriched foods. We're going to talk about different sources of it later. But magnesium very plentiful in even the most minimally healthy diet. Theanine and arginine. Now theanine is present in things like green tea. So theanine is not one that you get through a lot of different foods, but it is an amino acid. Arginine is an amino acid that is present in a lot of the foods that you eat. Passion flower is another herb that some people take and is known for, among other things, increasing a feeling of calm and increasing GABA levels. B6, as we talked about before, is essential for the body to be able to make GABA from glutamate. So if you don't have enough B6, you're going to kind of be screwed when it comes to having enough gaba. Ginseng, green black and oolong tea, all theoretically increase GABA levels. Fermented foods like kefir, yogurt or tempeh all can increase GABA levels. Whole grains and oats. Why do they increase GABA levels? Because they have the minerals in them that you need for the body to make GABA from. Glutamate, Fava, soy, lentils and other beans. Nuts, including walnuts, almonds and sunflower seeds, tomatoes, berries, spinach, broccoli, potatoes, Dark cocoa. Dark cocoa has a lot more magnesium and a lot more antioxidants than your milk chocolate or anything. And you can get the dark cocoa powder at the store. Hershey's sells it in the baking aisle. It has no sugar in it and it has no fat in it. It's just the cocoa powder. So if you're concerned about calories and you don't want to be eating dark chocolate every night, that is one way to get some of the magnesium and other trace minerals that you need. Whey protein has been shown to increase GABA levels. If you look at a lot of the protein supplements out there, there are various types of protein. Casein protein comes from eggs, whey protein comes from milk products. Whey protein increases gaba. Now medications that also increase gaba. Thinking again that when GABA levels are artificially increased for some reason, people may. It may trigger a depressive episode in some people. And when GABA levels are too low, it may precipitate anxiety, however. So gabapentin is actually a GABA analog. It looks like GABA to the brain. So gabapentin connects to the same receptors. Benzodiazepines, your Valium, your Xanax, any of those are going to increase GABA levels. That's what they do. And your hypnotics, any of your sleep aids, like Lunesta and Ambien, those are going to increase GABA levels. We obviously want to be aware and make sure that clients are communicating with their physician. If they're taking a combination of any of these, if they're taking Valium and then they're taking Ambien at night, it's important to make sure that their doctor knows about that because basically they're supercharging their GABA system and that's probably not a good thing. And this would come if you're getting a sleep medication from your primary care and a benzo from your psychiatrist, for example, and they're not talking. But I digress. Other things that increase gaba, essential oils. Jetta Mansi is one that has been shown to really increase GABA levels. Lemon balm, valerian. Again, valerian, essential oil. All you've got to do is sniff it. You don't have to put it on yourself. Jasmine, chamomile, lavender, bergamot, all of those are good for increasing gaba. Remembering essential oils trigger reactions in the body by inhaling them. So you don't need to necessarily apply them to your body in order to get the beneficial effects. If you, if you do apply essential oils to your body, make sure to read directions on how to dilute them because you don't want to apply essential oils straight to yourself. And most places will recommend or admonish you whatever you want to say from ingesting essential oils, especially any that aren't actually labeled for ingestion. But most doctors will tell you, no, don't ingest it. There's no point. There's no benefit to that, and it can. Essential oils are so potent that they can be toxic in very, very small amounts. Excess gaba. Some people have too much. If you've got too much gaba, you may have low blood pressure, stomach distress, nausea, poor appetite, constipation, drowsiness and fatigue, muscle weakness, and at very high doses, shortness of breath. So when you look at these, I'm seeing a lot of symptoms of depression, I'm seeing a lot of symptoms of excessive slowing. GABA slows you down and you're seeing a lot of slowing down in these sorts of things and these sorts of symptoms. So how do you reduce or counteract gaba? If somebody has too much GABA for some reason, stimulants, including caffeine and nicotine may temporarily reduce GABA levels Because they are stimulants. They're going to have activate glutamate, norepinephrine, those sorts of things. Ginkgo has been shown to reduce GABA levels. So if you've got a client who has an anxiety disorder and is taking ginkgo and continues to feel anxious, it's something to consider that the ginkgo may be counteracting his or her gaba, so they're feeling more anxious. GABA A antagonists, prescription medications may be possible targets for reducing morphine reward. And I just threw that in there because it's interesting to recognize that if we antagonize gaba, if we work against it, that it actually can reduce the reward of opioid medications or opioid drugs. That is something that they're exploring in terms of harm reduction and medication assisted therapy for the opioid crisis. GABA interactions, hypertension medications. Remember, not enough gaba, too high blood pressure, too much gaba, too low blood pressure. So GABA directly affects blood pressure. If somebody is taking hypertension medications, and we know that those can be very sensitive, then also doing something that monkeys with GABA may alter the dosage of the hypertensive medications. So again, think about somebody who's taking a benzo like Xanax. I know my grandmother was on both Xanax and blood pressure Medication for many, many years. And it was a constant balancing act to help her keep her anxiety down, but not in the same time manage her blood pressure and keep it from going too low or too high. Antidepressants also affect GABA because GABA interacts with changes as the levels of the other neurotransmitters change. Serotonin increases GABA availability. SSRIs, selective serotonin reuptake inhibitors actually have been found to increase gaba. Okay, so again, we're looking at the fact that we're taking something and increasing serotonin, but by doing that, we're also increasing GABA levels. Amphetamines change the glutamate levels in the brain. Remember, glutamate is your excitatory neurotransmitter that comes out when you take stimulants, when your HPA axis is activated, all that kind of stuff. That is your power through neurochemical. In some experiments, a single dose of amphetamines led to decreased levels of glutamine, glutamate and gaba, suggesting a circulatory disturbance of the glutamine glutamate GABA circuit. Okay, so that's not what we expected, is it? When people are administered intense levels of amphetamines, instead of increasing glutamate and, you know, other things, it actually sort of through the entire system, offline, if you will, the reduction of glutamate level was hypothesized to be due to an over excitation of the glutamate system. So it got too hot, Kind of like a car engine that gets too hot and the car just shuts down. So over excitation of the glutamate system induced by the amphetamines and an excessive need for glutamate was produced. The decreased GABA level was caused by an insufficiency of glutamate. So that system that pumps out the glutamate turned off because you know that engine was running too hot. So then there wasn't enough glutamate left to break down to make GABA is the theory of what happened there. Serotonin modulates both GABA and glutamate. So serotonin's in there trying to adjust the temperature of that bathwater. GABA inhibits norepinephrine. Remember, norepinephrine is our focus and concentration chemical. Too much GABA and you're going to have difficulty focusing and concentrating. Too little GABA and you're probably going to be anxious and stressed. Out and again have difficulty concentrating. So it's about moderation. Activation of the GABA A receptors increases the release of norepinephrine and in the rat hippocampus and cortex. So that's interesting to know. When GABA is increased, norepinephrine is also increased in parts of the rat brain, which kind of goes against this whole GABA inhibits norepinephrine. So they're not really sure how GABA and norepinephrine interact, but we know that they do. Activation of GABA B receptors causes a decrease in norepinephrine. So GABA B receptors decrease norepinephrine, GABA A receptors increase it, and norepinephrine see this real circular looping in on itself system. Norepinephrine modulates the synthesis of GABA in the central nervous system. So oh my gosh, GABA can inhibit norepinephrine or increase it, but by the same same token, norepinephrine modulates the synthesis of gaba. So they're inextricably intertwined. Which is another reason when we start looking at SSRIs and SNRIs, selective norepinephrine reuptake inhibitors, we're also going to see a change in GABA levels. So we've talked about GABA because that's, you know, a lot of people's favorite neurochemical because it is our natural valium. But glutamate is another awesome neurotransmitter. And GABA is made from glutamate. Glutamate is our get up and go. It is the one that gives us our energy for fight or flee. Moderate activation of the glutamatergic neurons plays an important role in synaptic plasticity, which is closely related to cognitive learning. Alright, that was obviously technical. Garbledygook. When glutamate neurons are activated, it increases the brain's ability to form and strengthen synapses, which is what happens when we learn. So in order to learn, we need to have moderate activation of those glutamatergic neurons. Unfortunately, again, it's about balance. Because just like GABA reduces inflammation, we know that glutamate enhances inflammation. So we want a little bit of it, but not too much because then it starts causing us inflammation. They refer to the glutamate balance as the Goldilocks principle. Too little glutamate can result in difficulty concentrating or mental exhaustion. Too much glutamate can result in excitotoxicity, which, which actually damages nerve cells. So it's really important. Just like if you get that bathwater too hot, you're going to burn yourself. If you get too much glutamate in the system, then it's actually toxic to your nerve cells and can cause them to die. Dopamine receptors located in the glutamatergic terminals induce the enhancement of glutamate release. So dopamine can actually enhance glutamate in the presence of stimulants. So when people take some stimulants, not the hardcore amphetamines, when people take some stimulants, it causes dopamine to be released, which also causes glutamate to be released. Dopamine, unfortunately, further increased the excitatory neurotoxicity of glutamate. So it took less glutamate to be toxic in the brain when dopamine was also there. High levels of glutamate may act as an exotoxin and cause excitotoxin and cause cell death. It leads to acute movement disorders such as tremor and gait disturbances, parkinsonism, dyskinesias, dystonias, myoclonus, and restless legs. Restless legs. Where have we heard about that before? That was back with dopamine, now, wasn't it? If you have dopamine imbalance, you're going to see people with restless legs. If you have a glutamate imbalance, you're going to see the same thing. If you have too much glutamate, you're going to have somebody that has restless legs. Excess glutamate is also thought to contribute to cell degeneration in Huntington's disease. Now, Huntington's disease is not super common, so you may not ever have a patient with Huntington's. But if you do, be aware that excess glutamate can contribute to that disease. So their glutamate GABA system is probably dysfunctioning in some way. We want to look at that in terms of what are the mental health symptoms that we're seeing as a result of that excess glutamate? And potentially, you know, does the person remember, since GABA is made from glutamate, and if they've got excess glutamate, does that mean they have excess gaba, or does it mean that that glutamate system shutting down to keep it from overheating, if you will, and they have insufficient gaba, we need to look at that with, with clients and look at their symptoms and what might be causing it. So what works against glutamate? What calms people down barbiturates. Dextromethorphan. Now you'll remember back from serotonin that dextromethorphan also increases serotonin levels. Dextromethorphan also decreases glutamate levels. Dextromethorphan is one of those things we want to be aware of. Another point that I made about dextromethorphan in that class I'll make it again is it's also often referred to DXM and it is abused by adults and adolescents alike. Adolescents especially have unfortunately taken to using it rectally in order to increase the absorption rate and get the high from it. Unfortunately that can also lead to life threatening serotonin syndrome. It's important to be aware that dextromethorphan, although it's great for quieting coughs, can really wreak havoc on your neurotransmitter system. Alcohol works against glutamate. It initially increases the people's sedation which obviously glutamate is an excitatory neurotransmitter. Ketamine, which is basically a horse tranquilizer, has a rapid and potent antidepressant effect in treatment resistant major depressive disorder and bipolar depression. They have started experimenting with using ketamine as a treatment for people who haven't shown effective response to other medications for major depressive disorder. If you see a client on ketamine, be aware that it is a glutamate antagonist. So it will likely be extremely sedating. And what do you want to look for with that? Nitrous oxide? Laughing gas works against glutamate, which is probably one of the reasons it helps you relax in the dentist's office. And phencyclinine is another glutamate antagonist. So how do you normalize your glutamate levels? We keep talking about the fact that you don't want to just go out and start taking stuff to rapidly increase GABA or rapidly increase or decrease glutamate. So how do you normalize these levels? Vitamin B3 or niacin is used as a coenzyme in making glutamate. So making sure that you're getting a good complement of your B vitamins, that's not really hard if you eat whole grains. If you are on a gluten free, grain free diet, then you probably want to consult with a registered dietitian to make sure that you're getting enough B vitamins. Carnitine might support and protect glutamate receptors from that excitotoxic problem caused when there's too much glutamate. Carnitine is again an amino acid that we get in our diet. You really don't need to go out looking for it, especially you're an omnivore. If you are a vegetarian or a vegan, especially a vegan, you might have to look a little bit harder. Neuroadaptogens, including ginkgo, Rhodiola rosea may also protect neurons from excessive glutamate excitation. Now remember that ginkgo does affect levels of GABA and Rhodiola rosacea, again may protect neurons. But you want to go online before you start taking any supplement and look at the information that's available that tells you what it's effective for and what the potential side effects or complications are. For certain herbs that people take or can take, yes, it may do something beneficial, but it also may increase their risk of breast cancer or hormone dependent cancers or things like that. So it is really important to really know about any supplements or medications that you're taking. Part of that falls on if you're working with a registered dietitian or a physician falls on them, but part of it just falls on us to make sure that we are fully aware and informed of all of the effects of everything that we take. Neurolipid compounds like DHA, which is an omega 3, are used in cell membranes and appear to support balanced glutamate receptor signaling and function. When you look at baby formulas, DHA is often listed as an important component. We still need neurolipid compounds as we get older. Magnesium, vitamin D. Available in just about any relatively well balanced diet. Now, vitamin D. You remember some people who struggle with seasonal affective disorder don't have enough vitamin D. There's a good proportion, not a majority, but a good proportion of people in the United States who don't, who still don't have adequate vitamin D. Why is that? Well, we don't get outside. Our body is so much more able to synthesize vitamin D from the sun than we are to do anything with the oral vitamin D that we take. The percentage of vitamin D that we get out of the oral supplements that's actually useful to our body is minuscule compared to what we're actually taking, compared to what we would get with just 10 or 15 minutes outside during the non peak hours of the day. If you're living in one of those areas like Alaska or even the Northeast, where during the winter it can be dark a lot and rainy and snowy and you need to make sure that your vitamin D levels are staying balanced, because we also know that vitamin D is really. Vitamin D receptors are really present in those areas of the brain where there are also serotonin receptors. We know that vitamin D is somehow involved in regulation of mood. So it's one of those that we really want to keep track of. If you super easy to get a blood test and find out your vitamin D levels. Taurine is another amino acid. It's the one that cats have to have and that also can help normalize glutamate levels. Again, I don't recommend people going out and just taking a taurine supplement. However, if you look at a lot of the energy drinks out there, Monster and all those other. Taurine is often one of the components. Actually, most of those drinks don't have all that much caffeine, you know, when you compare it maybe to a Starbucks or something. But they have other things in there like taurine and carnitine that also increase energy levels. Ashwagandha protects against glutamate damage. So that's another one. It's an adaptogenic herb, obviously. Clear it with your doctor. Alpha lipoic acid also helps normalize glutamate levels as well as chamomile. Chamomile inhibits glutamate. So if you're willing able to drink chamomile tea, I can't stand the stuff myself. But if you can drink it, that can help normalize glutamate levels. If you're like me and you can't stand or drink it, the essential oil is great. Just sniff it. Bee pollen demonstrates ameliorating effects on the glutamate excitotoxicity and the impaired glutamine glutamate GABA circuit. So if people have a dysfunction in that glutamine GABA glutamate circuit, bee pollen has actually been shown to be effective at helping to repair it. And finally, CBD or cannabinol oil protects against glutamate. So amphetamines, depressants and opiates can all impact levels of glutamate, gaba, serotonin, dopamine and norepinephrine. Remembering that when we talk about amphetamines, and I use that term kind of generally, I should have said stimulants, probably. We're talking about everything from nicotine and caffeine to crystal meth. You know, anything that revs up the system is going to have an effect on neurotransmitters. Each of these neurotransmitters has either a potentiating or inhibiting effect on each other neurotransmitter. So, for example, you have serotonin and it's going to interact and affect the availability of dopamine, norepinephrine, glutamate, gaba. Dopamine is going to affect the availability of glutamate, gaba. You, you see what I'm saying? They all interact. As one increases, it affects the others. Changing the level of one chemical will nearly always alter the availability or functioning of all the others. All of the big five neurotransmitters are involved in some way with inflammation, immunity, mood, gastrointestinal functioning, heart rate, attention, memory, coordination, and pain. So these things that we think of as brain chemicals, as mood chemicals are really very involved in lots of other aspects and functioning of our body on a day to day basis. Effective transdiagnostic assessment is essential for helping patients help their brains recover. I used in one of the other classes an analogy about a leaky pipe. You know, you go to take a shower and there is very little water pressure in your house because there's a leak somewhere between the water main and your house. Well, what do you do? Well, you could turn up the water pressure and artificially increase the water pressure in your house temporarily. But what, what's that going to do to the leak? It's probably going to make the leak worse and you're still not solving the problem. You're just increasing the water pressure and using a whole lot more water. Or you could fix the leak. So when we're talking about neurotransmitters, you know, our brain and our mood is like the water pressure and the leak is whatever's causing not enough neurotransmitter to get through or cause the neurotransmitter neurotransmitters to be out of balance. So instead of just turning up the water pressure, instead of just throwing medications at it and trying to increase the level of this neurotransmitter and increase the level of this neurotransmitter. We need to figure out why they're out of whack in the first place. Thank you for being with me today and I will see you next time. If this podcast helps you help your clients or yourself, please support us by purchasing your ceus@allce.com or getting your agency to sponsor an episode. A direct link to the on demand ceus for this podcast is@allce.com podcastceus that's allce.com podcastce to sponsor an episode of Counselor Toolbox and reach over 50,000 clinicians per week. Go to allce.com sponsor. Thank you.