How to Feel Good Without Drugs - Book Corners

Townsend Letter for Doctors and Patients,  Oct, 2002  by Melvyn R. Werbach

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Natural Highs: Supplements, Nutrition, and Mind/Body Techniques to Help You Feel Good All the Time

By Hyla Cass, MD, and Patrick Hal ford

New York, Avery, 2002, $24.95

In her two previous books, Hyla Cass reviewed the benefits of kava and St. John's wort, two natural remedies that can help people to feel better. Now, in Natural Highs (written with Patrick Holford), she expands her subject matter to examine the numerous natural approaches to "feeling good all the time." It is a book that should be widely read.

On seeing the title, my first question was what does she mean by a "natural high?" After all, people with bipolar (manic-depressive) disorder can feel high during a manic episode -- and, when they are just hypomanic, they can seem quite normal. Is this book a guide to discovering hypomania?

The answer to my question can be found in her introduction. "Imagine living in a world where you feel happy, alert, and energetic more often than not -- a place where feeling 'high' and at one with the world is the norm, where getting high is healthy and non-addictive." In order for you to be able to maintain this pleasant state, the book provides "a range of techniques and nutrients designed to promote sensory awareness and mental flexibility, as well as to restore and maintain your energy level."

Throughout the book, Dr. Cass returns to her thesis that the 'high' that is felt by using addictive substances comes at a biochemical and emotional cost that is too expensive for the good feeling they temporarily provide. She contrasts the use of caffeine, alcohol, etc. with the use of non-addictive approaches to feeling good. When, for example, she discusses the use of stimulant drugs, she states: "We are living unnatural lifestyles that lead to excessive stress and use of stimulants. The neurotransmitter dopamine, from which we make adrenaline and noradrenaline, is released when we are stressed or use stimulants. Motivating and pleasurable, stimulants generate energy by mobilizing glucose. As a result, stimulants make us more alert, energized, cheerful, or even high.... Down-regulation quickly steps in to stop the fun. As a result, we need more and more of the stimulant to feel good and to maintain our energy levels. This leads to a vicious cycle of stimulant dependence and fatigue.... Since the stress horm ones adrenaline and cortisol lead to release of dopamine, we can become addicted to our own feel-good hormones, so we create more stress to keep the cycle going."

She astutely avoids the danger of boring her audience with a lengthy list of various beneficial substances and activities by dividing her material into several meaningful sections. The first is stress. After giving readers the opportunity to review their stress levels, she discusses the stress response and its many adverse consequences, including substance abuse. She then proceeds to tell readers how they can relax naturally with herbs, amino acids and dietary changes.

Exhaustion is her second topic. She examines how exhausted people seek relief through the use of such stimulants as sugar, caffeine and tobacco. Instead she recommends specific herbs (such as ginseng and ashwaganda) and nutrients (such as D]L-phenylalanine and coenzyme Q10) that safely improve energy.

Depression, and its treatment with mood enhancers, is examined next. She warns of the dangers of over-prescribing antidepressant drugs, noting that "there is plenty of good scientific evidence that natural products will often work just as well and without the side effects." She suggests the use of neurotransmitter precursors (such as 5-hydroxytryptophan and phenylalanine), St. John's wort, SAMe, omega-3 fatty acids and other supportive nutrients.

Fourth is a discussion of memory loss due to stress and aging. In addition to the B vitamins, her suggestions for nutrients consist of choline, DMAE, pyroglutamate, phosphatidylserine, fish oils (EPA and DHA), acetyl-L-carnitine, and glutamine. Recommended herbals are Ginkgo biloba and vinpocetine (from the periwinkle plant)

Dr. Cass' fifth topic -- and perhaps the most intriguing one -- is a discussion of our need to connect with other people, and how natural substances can improve the feeling of connectedness. "It may hit you when you're with close friends, the person you love, or wandering alone in a beautiful place: that feeling of being at one with the world. Such experiences help to shape and motivate us, and leave us feeling joyful, at peace, and part of something bigger than us -- in short, connected." She discusses the popularity of entheogens -- psychoactive drugs that awaken or generate mystical experiences -- and states that "we can get you higher without the risks, and with completely natural nutrients and herbal connectors." Her picks (again in addition to the B vitamins) are tryptophan (and 5-hydroxytryptophan), SAMe (s-adenosyl-methionine), TMG (trimethylglycine), kava, and a South African creeper named sceletium which has been used by hunter-gatherer tribes since prehistoric times.