Natural Ways to Manage Mild-to-Moderate Depression
M]ore than 30 million Americans take antidepressant drugs…The effectiveness of … [these] drugs has been the subject
of several reviews. The results indicate that they have not been shown to work any better than a placebo in cases of mild to moderate depression, the most common reason for prescription medication … In fact, the research indicates that SSRIs and other antidepressant drugs might actually increase the likelihood of suicide in adults and children … These medications … may cause significant side effects.
~ Michael T. Murray, ND, & Joseph Pizzorno, ND, The Encyclopedia of Natural Medicine (3rd Edition 2012)
Depression, the most common type of mental illness, is the second leading cause of disability and is increasing among Americans. The effect of improved nutrition, particularly with dietary supplements, on depression may provide an alternative to standard medical treatment.
~ Lewis, et al., The effect of methylated vitamin B complex on depressive and anxiety symptoms and quality of life in adults with depression. ISRN Psychiatry. 2013 Jan 21;2013:621453
Depression ranges in degree, from occasional episodes arising as normal responses to life’s many stressors, to major depressive disorder (MDD). While scientists continue to study its causes, they are known to include preexisting chronic disease states (hypothyroidism, blood sugar imbalances, anemia, and digestive conditions, such as food allergies and systemic yeast overgrowth/candidiasis), various prescription drugs, nutrient deficiencies, sleep deprivation, and environmental toxicity. While it is always advisable to consult with a holistic practitioner and/or therapist to address depression and its underlying causes, you can begin to obtain relief from your depression through lifestyle changes and natural remedies. According to Michael Murray, ND, and Joseph Pizzorno, ND, certain “lifestyle changes, coupled with regular exercise and a healthful diet, are more than likely to produce better clinical results than antidepressant drugs, with no side effects.”
Symptoms & Brain Chemistry
Mild-to-moderate persistent depressive disorder (dysthymia, or PDD) and seasonal depression (seasonal affective disorder, or SAD), are two of the most common forms of depression that undermine the well-being of millions of Americans each year. A PDD diagnosis in adults requires daily depression during most of each day over two years, with 3 of 9 specific symptoms, including hopelessness, low self-esteem, fatigue, irritability/anger, reduced productivity, and difficulty concentrating or making decisions. SAD usually sets in during late fall/early winter when there is less sunlight. In addition to PDD symptoms, those suffering from SAD may experience: (1) disrupted sleep and oversleeping; (2) changes in appetite (especially carbohydrate cravings) or weight gain; and (3) frequent thoughts of death or suicide.
Understanding just how PDD/SAD sets in can be instructive in determining how to address it naturally. To support its many functions, the brain uses a number of neurotransmitters, chemical messengers constantly released and received by the brain’s nerve cells (neurons), to communicate with other parts of itself and the nervous system. The entire information transmission cycle occurs in seconds. Any problem that interrupts the smooth functioning of this chain of chemical events can negatively impact the brain and nervous system.
Studies have linked depression to imbalances of certain neurotransmitters, including: (1) Serotonin (take 5HTP, SAM-e; eat carbohydrates, chicken/turkey, nuts, chia seeds) – elevates mood, increases relaxation, and controls cognition, blood sugar/insulin, appetite, cardiovascular health, impulse control, and sleep; (2) Dopamine (take L-tyrosine, SAM-e; eat almonds, chocolate, avocados, pumpkin seeds, bananas) – creates a natural high, required for sexual arousal, deficiency is linked to movement disorders (e.g. Parkinsons); (3) Norepinephrine (take L-tyrosine) – involved in the fight or flight reaction to stress, arousal, and cortisol production; (4) GABA (take L-glutamine; eat salmon, nuts, eggs, legumes) – regulates communication between brain cells to inhibit the activity of neurons, and thus stabilizes mood and promotes relaxation; (5) Endogenous Opioids (endorphins, enkephalins, dynorphins) (exercise, yoga, acupuncture) – promote feelings of well-being and reduce pain; and (6) Acetylcholine – excessively high levels are believed to induce depression.
Prescription Drugs That Can Cause Depression
Medications that cause depression do so by altering brain chemicals in some way. Some commonly prescribed drugs that reportedly cause depression include: antibiotics; statins for high cholesterol; anti-anxiety, insomnia, and seizure/muscle medications; heart medications, such as beta-blockers and calcium-channel blockers; hormone replacement therapy estrogens; birth control drugs; and opioids.
Some Safe Natural Approaches to Depression
The best approach to elevating mood is holistic, one that focuses on necessary diet and lifestyle changes (ceasing smoking; high intensity interval training exercise; improved sleep) and appropriate nutritional supplements.
1. Diet Modification
As with any chronic condition, it is critical first to examine one’s daily diet when addressing depression. Though nutritional psychiatry is an emerging field, one explanation of the impact of food on mood is considered to be what is known as the gut-brain axis. It is widely accepted that: (1) the majority of the fibers of the body’s main vagus nerve, which oversees mood control, carry information from the gut to the brain; (2) since the brain requires a constant supply of healthy fuel from food, selecting the right foods determines how it functions; (3) the gut is lined with more than 100M neurons, and uses protein, vitamins, and minerals, to produce approximately 95% of the body’s serotonin; and (4) the more than 100T healthy bacteria, which comprise what is referred to as the gut microbiome, improve nutrient absorption, activate neural pathways between the gut and brain, and greatly influence gut serotonin production. Since poor nutrition directly impacts the gut microbiome, serotonin production, and the brain, an unhappy intestinal tract made dysfunctional by the wrong ingested foods can yield general unhappiness.
Many studies have shown that greatly decreasing or eliminating all sugar sources, caffeine, and alcohol, greatly supports mood enhancement. Maintaining a healthy plant-based/Mediterranean diet, low in conventional processed foods and high in water intake (generally, 64 ounces, up to half one’s weight in ounces), is also important. In addition, since scientific evidence has established for over 65 years a firm link between food
sensitivities /allergies and depression, it makes sense to use an elimination diet to test the impact of common allergens such as gluten, dairy, soy, corn, nuts, and other lectin-rich foods.
2. Anti-Depressant Nutritional Supplements
The body converts the amino acid L-tryptophan to 5-HTP, which it then converts to serotonin. Multiple double-blind studies have proven 5-HTP to be as effective as SSRIs and tricyclic antidepressants, better tolerated, associated with fewer and milder side effects (most commonly mild nausea), and much less expensive. 5-HTP works best at a dose of 150-300mg/day and with longer term use, and some may need to wait two months to see results. Traditional guidance maintains that 5-HTP should not be combined with antidepressants, and should be checked for interactions with other prescription drugs and OTCs.
Fish Oil/Omega-3 Essential Fatty Acids (O3EFAs):
Some studies and meta-analyses have linked depression with low dietary intake of O3EFAs (EPA and DHA), in part due to their anti-inflammatory properties. The link is also considered to stem from the dependence of brain function on proper cell membrane fluidity and function, both of which are compromised by EFA deficiency. Studies have proven that the physical properties of brain cell membranes directly impact neurotransmitter synthesis, uptake and function, and signal transmission. O3FAs, in combination with antidepressants, may be more effective than antidepressants alone.
Cannabidiol is a non-intoxicating constituent of Cannabis sativa. Its efficacy, and exactly how it works within the body and impacts the endocannabinoid system, is still being researched. One animal study demonstrated that CBD induces antidepressant effects comparable to those of imipramine (Tofranil®), a tricyclic antidepressant. A second mouse study concluded that “CBD could represent a novel fast antidepressant drug.”
Multivitamin & Mineral:
Scientific evidence soundly supports the negative impact of B-vitamin deficiencies on the production of brain chemicals that affect mood. In particular, the body uses vitamin B6 and B12 to produce serotonin and dopamine. Folate supports serotonin production regulation and production, and its supplementation has been shown to improve response to antidepressants. Vitamin B-5 can increase the body’s ability to synthesize norepinephrine, dopamine and serotonin. Deficiencies in magnesium, zinc and selenium have been tied to depression, and chromium helps serotonin to work properly.
Multiple studies of human subjects with mild-to-moderate depression have proven both the stigma and petals of saffron to be effective antidepressants, and even as effective as Prozac® and Tofranil®, without side effects.
Saint John’s Wort (Standardized for Hypericin):
The results of over 30 double-blind randomized clinical trials indicate that Saint John’s Wort works better than a placebo, and is as effective as antidepressants for mild-to-moderate depression, with fewer side effects. It can take 4-6 weeks for this herb to take full effect, and it can interfere with the effectiveness of certain prescription and OTC drugs (antidepressants, oral contraceptives). It is not recommended for pregnant or nursing women, children, or those with bipolar disorder, or liver or kidney disease.
The greater the vitamin D deficiency, the more effectively will supplementation improve mood. Michael Holick, MD, PhD, a renowned vitamin D researcher, maintained that animal studies have demonstrated that vitamin D will elevate mood by increasing brain serotonin levels. The normal range for vitamin D is 30-74ng/mL, with the recommended level around 50 ng/mL. Any levels below 20 ng/mL are considered serious deficiency states. Many practitioners recommend a minimum of 1,000-2,000iu of Vitamin D3 for general health, but 5,000iu is the minimum that can boost and maintain mood.
While limited space precludes full discussion of lavender, SAM-e, and ginkgo biloba extract, scientific studies fully support their efficacy as natural antidepressants in those suffering mild-to-moderate depression.
The statements in this article have not been evaluated by the Food and Drug Administration, are for educational purposes only, and are not intended to take the place of a physician’s advice.
Submitted by Erika Dworkin, Board Certified in Holistic Nutrition®, Nutrition Consultant and owner of the Manchester Parkade Health Shoppe (860.646.8178 – 378 Middle Turnpike West, Manchester, CT – www.cthealthshop.com, nutrition specialists trusted since 1956. Erika is available to speak to groups.
All statements in this article are evidence-based and references are available upon request.