Anxiety / Depression

Confessions of a Renegade Doctor

I felt this sensation in the pit of my stomach – it was a combination of sympathy and anger – listening to Erin tell me, through tears, about her postpartum journey into the world of depression:

“Three separate psychiatrists dismissed me when I expressed concerns about taking an addictive medication like Klonopin. It’s been two years, I can’t get off it, I’m on 4 psych meds and I feel worse than I ever did before I started this treatment.”

Erin was ushered into the promise-filled halls of psychiatry 3 months after the birth of her first baby when she began to experience racing heart, insomnia, vigilance, irritability, and a host of physical complaints including joint pain and hair loss.

No one did bloodwork.

No one asked about her diet

No one seemed to care about any of the myriad observations about her body and its changes in functioning. This was a “you’re your head-up” intervention.

I believe women deserve better.

I believe people deserve better.

Most patients who come to me for treatment of depression and anxiety do so because they want answers. They want to know WHY they are struggling.

The closest they will be offered by their prescribing psychiatrist or primary care doc is some reductionist hand waving about serotonin imbalances.

I think it is time to speak to these patients with respect, truthfulness, and to offer them more than a life-long relationship with a pill (or pills as it will inevitably become over the years). First, let’s review some basics:

Depression is Not A Serotonin Deficiency

Thanks to direct-to-consumer advertising and complicit FDA endorsement of evidence-less claims, the public has been sold an insultingly oversimplified tale about the underlying driver of depression. Here’s how we know depression is not a serotonin deficiency corrected by Zoloft:

There has never been a single study, in humans, to validate the theory of low serotonin in depression. (Low levels are found in a minority of patients).

You might wonder:

Well, then how is it that antidepressants are a billion dollar industry and I have all these friends who are so much better on them?

Some pioneering individuals have investigated the data supporting antidepressant efficacy and have made compelling arguments for what is called the “active placebo” effect. In short, the expectation of relief and subsequent change in symptoms experienced by “responders” is related to perception of side effects. This analysis suggests that antidepressants may only have 10% efficacy above and beyond the placebo effect.

But when you take into account inefficacy, long-term risks, increase in suicidality and violent behavior in patients on these medications, it is a marvel to observe the star-power of these medications.

What Is It Then?


Inflammation is a buzzword, and a 41 million+ Google hit for a reason: it appears to underlie just about every chronic disease plaguing Americans today. A contribution of genetic vulnerabilities likely determines who develops heart disease or cancer or obsessive compulsive disorder, but many researchers are convinced that depression may have a significant inflammatory component.

Just as a fever is one of your immune system’s mechanism for eradicating intruders, suppressing a fever, in no way, serves to resolve the underlying infection or to support the body’s return to balance. Similarly, suppressing symptoms of depression does not achieve rebalancing, and will likely result in the Whack-a-Mole phenomenon of shifting symptoms, and protracted resolution.

What Drives Inflammation?

What causes inflammation in the body that can affect the brain? It turns out the list is long, but these are the contributors that I see most commonly in my practice: sugar, food allergies/intolerances and autoimmunity (your body’s immune system attacking itself).

Sidenote: Beyond rampant inflammation, autoimmune disorders such as Hashimoto’s thyroiditis (morehere) also result in symptoms related to damage to tissues. Low or erratic thyroid function can cause anxiety, depression, flattened mood, cloudy thinking, metabolism changes, and fatigue. Sometimes even the presence of immune system misfiring can predict depression as was noted in this recent study where women with thyroid autoantibodies in pregnancy went on to develop postpartum depression.

Before You Go See A Psychiatrist

You see, before you can properly treat depression/anxiety, you must ask the right questions.

Chances are, your primary doctor and/or the psychiatrist they’ll refer you too, will ask the wrong questions.

To properly treat depression/anxiety, one must first ask: what is causing the problem?

And once you realize that underlying inflammation is the problem, the next question must be:

What is causing my inflammation?

A Functional Medicine Doctor, who is trained and willing to ask the right questions, will look at your condition beneath the surface, “getting to the root cause,” to figure out why you have the inflammation in your body – instead of treating the symptoms one by one with a pill(s).

Specific blood work, laboratory diagnostics, and state-of-the-art medical testing are all part of my approach here at Wilmington Functional Medicine. Once the data is in, I can determine the real CAUSE of your problem and develop a game plan, looking at diet, toxic elements in your daily life, lifestyle, and mental health.

The healthcare industry has long suffered from pseudoscience and propaganda. From an embarrassing history of pathologizing human behavior, applying crude “treatments”, and imposing beliefs about societal welfare on vulnerable populations, we haven’t come very far in the past century. Incidence of mental illness is rising, partly from changes in diagnostic criteria, commercializing mental illness, collusion between doctors and patients around the “quick fix”, and partly because our bodies and minds are crying out in protest about this toxic world we live in.

It’s time to take back control of your health by taking control of your body to heal your mind.

I help patients suffering from depression/anxiety every day do this very thing.

Combining this cutting-edge research with medical advances help me help patients just like you…

Get out of your funk.

Get back on your feet.

Get your life back.

Because there is nothing more frustrating than wanting to get well and no one is able to help you get out of the hole you’re in.

I am here to help. I have helped many frustrated patients over the years who came to me with chronic fatigue. In every case, I start with asking what is the cause of this person’s symptoms. I then works tirelessly to come up with the answers. And finally create a game plan that is designed to empower the person to get better by fixing the cause of the problem.

Call my office now. 910-444-9438.


Hilary Rutledge, DABCI

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