The last two decades have witnessed a huge increase in depression diagnoses. At present, 1 in 10 Americans takes antidepressant medication—and many of these individuals are taking multiple pills to treat more than one psychiatric illness. Few people will even raise an eyebrow anymore upon hearing about a friend or family member being diagnosed with depression.
According to recent estimates, half of those diagnosed with depression could obtain relief simply by identifying and treating an underlying physical disease. I have discovered many conditions that cause hormone fluctuations that will manifest as depressive or anxiety-causing symptoms, including underactive thyroid, low blood sugar, cerebral allergy, a nutritionally induced or environmentally induced allergy, electromagnetic toxicity, lack of quality sleep, a nutrient deficiency, and chronic unremitting stressors. Many practitioners within the orthomolecular movement share my point of view, yet most people continue to go right off to the psychiatrist or psychologist and get absorbed into standard therapeutic models. I have a great deal of concern about this, partly because of the dangers of Prozac and other psychiatric drugs.
My recommendation? Try the least invasive approach first.
It’s been my experience that the most profound healing outcomes occur not with pharmaceutical intervention but with humanistic psychotherapy as well as whole body and mind approaches to wellness. Natural methods can not only help curb the symptoms of depression, but also address the fundamental causes of the condition. By consciously making lifestyle choices that promote physical, mental, and emotional health, we create a mind-body balance that allows us to access vital tools for preventing and reversing depression.
More recently, there have been studies of a natural derivative of folic acid called methyl folate, showing it to be as effective as the antidepressant drug to which it was compared. This supports the claim that nutritionally oriented doctors, including orthomolecular psychiatrists, have been making for many years: Folic acid prescribed in megadoses appears to be a stimulating antidepressant for some patients.
The amino acid tryptophan can be another key substance in the treatment of depression. According to William Goldwag, MD, tryptophan helps raise the levels of serotonin, a naturally occurring chemical in the brain that has been found to be abnormally low in depressed people.
“We learned about serotonin from experiments in which certain drugs that preserve it from being destroyed in the brain seem to work for some antidepressants,” explained Dr. Goldwag. “The theory is that whatever can supply or aid the serotonin factor will help depression. Some foods that contain tryptophan can act as antidepressants. It is found most abundantly in milk and turkey.”
Tryptophan is a precursor to Prozac and other drugs that similarly amplify the activity of serotonin in the brain. Tryptophan, the substance from which the brain manufactures its own serotonin, does the same kind of thing when it is taken as a supplement. In controlled studies, it was found consistently to be as effective as the antidepressant drugs that were available. Five hydroxytryptophan (5-HTP) is another compound, which is a little bit closer to serotonin. It seems to be even more effective than tryptophan.
Whereas milk and turkey, as well as kiwi fruit, figs, and dates, are good sources of tryptophan, there are plenty of foods that should be avoided if you want to boost your mood and minimize depressive symptoms.
The first step in eating a brain-healthy diet is to eliminate fast foods, simple carbohydrates, alcohol, artificial sweeteners, gluten, fried foods, white flour products, caffeine, and meat. These changes alone should improve the chemical balances in your brain.
To prevent and combat depression, your diet should contain lots of organic, non-GMO fruits and vegetables, with soybeans and soy products, brown rice, millet, legumes, and essential fatty acids. Placebo-controlled research conducted with medicated patients suggests that adding omega-3 fatty acids, particularly eicosapentaenoic acid, may ameliorate symptoms of major depressive disorders.
At all costs, you must avoid meat and fried foods, such as hamburgers and french fries. These foods are high in saturated fats that block the arteries and small blood vessels. This then interferes with blood flow, causing your blood cells to become sticky and clump together, which leads to poor cerebral circulation that is accompanied by mental sluggishness and fatigue.
Depressed people are often attracted to sugar and caffeine because of the initial lift those substances provide. Sugar does stimulate serotonin levels, which in turn temporarily improves your mood. But this initial surge of energy disappears in a matter of minutes. The reason behind the initial boost is that sugar, regardless of which form you are talking about, does not have to be digested; it passes directly into the bloodstream, where it dramatically raises the blood sugar level and overstimulates the pancreas to produce too much insulin. The excess insulin then causes the sugar level to plummet. Within half an hour of consuming a sugary snack, your blood sugar level will drop to very low levels, allowing fatigue, irritability, and anxiety to creep in. With these feelings present, the person seeks another boost from sugar, resulting in a repetition of the same, vicious cycle.
The Latest Research
An increasingly large body of evidence shows that a junk food diet can exact a heavy toll on our emotional well-being. A long-term study appearing in the journal Public Health Nutrition in 2011 observed that people who commonly ate fast food and processed baked foods were 51 percent more likely to suffer from depression than those people who rarely or never indulged in these foods. The study’s data reflect a dose-dependent relationship, meaning that the more unhealthy staples one consumes, the more at risk one is of suffering from depression. These findings are consistent with a 2009 analysis by British researchers that produced a clear link between diet and depression. Published in the British Journal of Psychiatry, the study concluded that people who ate a diet high in foods such as fried food, processed meat, refined grains, and sweets were 58 percent more likely to experience depression compared with those who consumed a diet rich in fruits, vegetables, and fish.
The millennia-old practice of t’ai chi was shown to effectively combat major depression in seniors in a recent study by scientists at UCLA. The findings, which were published in the American Journal of Geriatric Psychiatry, indicate that elderly patients diagnosed with the condition saw remarkable improvements after practicing a Westernized version of the Chinese martial art. The study compared the outcomes of two groups of seniors receiving standard depression treatment. One group engaged in two hours of t’ai chi classes weekly over the course of 10 weeks, whereas the other group spent the same amount of time attending a health education class. Both groups realized notable improvements, but the t’ai chi group experienced significantly better improvements in memory, cognition, and quality of life and had reduced levels of depression. Speaking in an interview, the study’s lead author, Helen Lavretsky, MD, remarked, “With t’ai chi, we may be able to treat these conditions without exposing [patients] to additional medications.”
Even with a diet rich in recommended vitamins and minerals, your body may not efficiently absorb and process these necessary nutrients. As you grow older, your appetite may decrease, and you may find that you are unable to consistently take in the recommended amounts of food nutrients. Furthermore, loss of appetite is a common symptom of depression. It may be that getting these nutrients in supplement form is the most efficient way for you to enhance your healthy diet. However, supplements are not intended to replace healthy food choices. Of course, before you begin any new health program, you should get a comprehensive, full-body evaluation performed by a qualified healthcare practitioner. A proper health and medical evaluation should evaluate your blood chemistry to assess your blood markers, your metabolic rate, and your blood pressure for indicators of cardiovascular, hormonal, or other imbalances or danger signs. If you are taking medications of any sort, for depression or any other condition, you need to inform your doctor of any supplements you are considering adding to your daily diet, as some may interact with prescription medications and cause adverse effects. You should always speak to your doctor before adding any of these supplements to your daily regimen.
Vitamins and Minerals
>> Folic acid levels are directly related to the severity of depression: The lower the level of folic acid in the blood, the more serious the level of depression. Low levels of folic acid have been linked to depression and bipolar disorder in a number of studies. Insufficient folic acid is one of the most common nutritional deficiencies, and one-third of all adults are low in this important vitamin. I recommend that your daily B-complex vitamin contain at least 800 micrograms of folic acid. If you are taking folic acid as a separate supplement, always combine it with 1,000 micrograms of vitamin B12.
>> Vitamin B12 deficiency may also play a part in depression. As we age, it becomes increasingly difficult for our bodies to absorb sufficient amounts of B12 from what we eat. So even if you are consuming adequate quantities of foods rich in B12, your body is not getting the full benefit. I recommend that your daily B-complex vitamin contain at least 1,000 micrograms of vitamin B12.
>> Vitamin B6 converts tryptophan into serotonin. Although extreme deficiencies in B6 are rare, minor deficiencies (which occur frequently) can lead to depression. Heavy users of alcohol are likely to have a B6 deficiency, as are women who use oral contraceptives. I recommend that your daily B-complex vitamin contain at least 75 milligrams of vitamin B6.
>> Vitamin D3 is called the sunlight vitamin because the body produces it when the sun’s ultraviolet B (UVB) rays strike the skin. It is the only vitamin the body manufactures naturally. Considered a mood elevator, vitamin D3 may be effective in dealing with seasonal depression. Although 10 to 15 minutes of sunshine a few days per week generally supplies the body with sufficient amounts of vitamin D3, the body’s ability to produce vitamin D3 declines as we age. Those who are unable to spend time outside, or who suffer the effects of the lack of sun in winter climates, may also want to supplement. For those suffering from depression, I recommend supplementing with 268 to 536 micrograms of vitamin D3 daily.
>> Inositol, also known as vitamin B8, functions closely with lecithin and choline. It is a fundamental ingredient of cell membranes and is necessary for proper brain function. The neurotransmitter serotonin depends on inositol to function properly. I recommend increasing your daily inositol supplement from 250 to 1,250 milligrams—but do not exceed 1,250 milligrams daily.
>> Magnesium deficiency is also seen in people suffering from depression. When patients recover from depression, magnesium levels in the blood rise. Magnesium supplements can be taken with calcium to lessen overreaction to stress and panic attacks. I recommend that women suffering from depression take a supplement of 320 milligrams daily; men should take a supplement of 420 milligrams daily.
>> Potassium is one of the most abundant minerals in the human body. Most of the time, supplementation with potassium is unnecessary; it is readily available in our diet in foods such as bananas, orange juice, and potatoes. Potassium is depleted from our bodies in times of stress, however, thus upsetting the delicate balance of neurotransmitter communication in our brains. For this reason, potassium supplements may positively impact depression. Potassium can interact with some drugs, so if you are taking prescription medications, consult with your doctor before taking potassium supplements. If potassium is safe for you, I recommend a daily supplement of 300 milligrams.
Smart Drugs and Nutrients
>> 5-hydroxytryptophan (5-HTP): A derivative of the amino acid tryptophan, this mood-enhancing chemical is converted into the neurotransmitter serotonin. 5-HTP should be taken with carbidopa, a decarboxylase inhibitor that prevents 5-HTP from converting to serotonin before it reaches the brain. For depression, anxiety, and panic attacks, I recommend taking 50 to 100 milligrams three times daily.
>> Adapton (garumarmoricum): This naturally occurring substance is taken from a deep-sea fish. It is widely used in Europe and Japan to help with stress, anxiety, and depression. It improves concentration, mood, and sleep. You should take four capsules as directed for 15 days; stop for one week, then continue with a maintenance dose of two capsules daily.
>> Dehydroepiandrosterone (DHEA): Youthful hormone balance is vital in maintaining health and preventing disease in individuals older than 40. One hormone that is deficient in virtually everyone in that age group is DHEA. This building block for estrogen and testosterone enhances mood and a sense of well-being in menopausal women. Not everyone, however, can take advantage of the multiple benefits of DHEA. Men and women with hormone-related cancers, for example, should not take DHEA. This supplement is available only by prescription from your doctor. If your doctor says it’s safe for you, I recommend taking a supplement of 25 to 50 milligrams daily; if your doctor thinks DHEA will help in the treatment of your depression, he or she will prescribe an appropriate increase in your dosage.
>> DL-phenylalaline (DLPA): DLPA contains two forms (“D” and “L”) of the amino acid phenylalanine. The “L” form is naturally occurring and believed to bolster mood-elevating chemicals in the brain. The “D” form is a synthetic form of a substance that has a pain-relieving effect. In one clinical trial of individuals suffering from depression, 12 of 20 depressed men and women who took 200 milligrams of DLPA daily reported being free of depression after nearly three weeks of treatment, and four reported feeling somewhat better.
You should not combine DLPA with prescription antidepressants or stimulants unless specifically directed to do so by your doctor. If you have high blood pressure, or are prone to panic attacks, DLPA may aggravate your condition. DLPA should also not be used if you are taking levodopa for treatment of Parkinson’s disease. Women who are pregnant, or individuals with melanoma, should not take DLPA. People with PKU (a rare, inherited metabolism disorder) should avoid DLPA as well.
If you are able to take DLPA, I recommend a supplement of 1,000 to 1,500 milligrams daily.
>> Dimethylaminoethanol (DMAE): This nutrient, found in sardines, is a powerful brain stimulant that increases acetylcholine levels. Acetylcholine is a neurotransmitter associated with mood and energy levels. I recommend increasing your daily supplement from 150 milligrams to 650 to 1,650 milligrams daily. Do not exceed 1,650 milligrams per day.
>> Pregnenolone: A hormone produced by the adrenal glands, pregnenolone is abundant in the brain, where it facilitates communication between neurotransmitters. Low levels of pregnenolone have been linked to depression. As we age, the amount of pregnenolone we produce declines; levels can be tested by a basic urine test. To improve your ability to handle the stress brought on by depression, I recommend increasing your daily supplement from 50 milligrams to 100 to 250 milligrams daily. Do not exceed 250 milligrams daily.
>> S-adenosylmethionine (SAMe): Pronounced “sammy,” SAMe has long been prescribed by European doctors as a treatment for depression. SAMe promotes cell growth and repair and maintains levels of glutathione, a major antioxidant that protects against free radicals and contributes to the formation of serotonin. SAMe should not be taken if you are taking MAO inhibitor antidepressants. You should consult with your doctor before taking SAMe if you suffer from severe depression or bipolar disorder. If SAMe is safe for you to use, I recommend raising the dose gradually from 200 milligrams twice a day to 400 milligrams twice a day, to 400 milligrams three times a day, to 400 milligrams four times a day, over a period of 20 days.
Exercise is an important factor in preventing depression, and equally important in overcoming the condition. The lasting effect of regular exercise is an increased energy level and a feeling of revitalization and accomplishment. Even the most moderate and mild types of exercise can be beneficial. Exercise causes the body to release endorphins, or “feel good” biochemicals that allow us to feel at ease.
When you are depressed, your energy levels are low, and it can be hard to start any kind of activity. Begin with simple movements, such as going for a walk or performing stretches while seated. Active hobbies, such as gardening, dancing, yoga, and power walking, are pleasurable ways to introduce increased exercise into your life.
As you move more, you will experience a positive effect on both your mind and your body, and it will become easier to include exercise as a regular part of your daily activities. Engaging in 45 minutes of aerobic exercise per day is recommended for depression sufferers.
The nature of depression can interfere with a person’s ability to seek assistance. Depression saps energy and self-esteem. Positive social encounters can make the difference between suffering and recovery.
Spending time with friends and family of all ages is important to remain vital and connected. Emotional support can help us weather a crisis of loss or grief. Humor lifts our moods and opens us to experiencing daily happiness. Volunteering to help others, learning new skills, and participating in engaging and pleasurable activities enhance feelings of worth at any age. Spiritual communities may offer comfort and promote positive feelings. Loving touch is a proven mood elevator: Massage, hugs, and even petting a dog can lift our mood.
Music, visual and dramatic arts, and color can all affect mood. There are therapists who specialize in using creative expression to help with mental health issues. Music, dance, and journaling help some individuals understand and process complex emotions. Our physical environment is a reflection of our emotional, spiritual, and intellectual state. Adjusting the elements in our environment can have a miraculous effect in fighting and overcoming depression.
Diet, supplements, exercise, social situations, and environment: These are all noninvasive ways to fight depression. The best part? Not only will you stave off depressive symptoms by making some lifestyle modifications, but you will also improve the rest of your health in the process.
By Gary Null, PhD