Depression – Do You Understand It?
Depression has recently been quoted in the newspapers as “the most predicted common ailment of the 21st century”. Depression is still mostly misunderstood and unfortunately the stigma associated with it remains pervasive. Women have a 25% chance of developing severe depression, however many women will not get the treatment they need to recover fully. This is because depressive illness often masquerades as something else, and it is still minimized as an illness that can wreak havoc in the quality of a person’s physical and mental health.
Undiagnozed depression exacts an enormous toll in people’s lives and the cost of undiagnozed depression has ballooned to as much as 5 billion dollars a year. These losses come from low productivity, employee absenteeism, serious accidents, marital break-up and suicide. Perhaps the greatest cost of depression is in lost time, because for depressed individuals the days pass without meaning or enjoyment.
According to the World Health Organization (WHO), someone around the globe commits suicide every 40 seconds. The World Health Organisation predicts that by the year 2020, five of the ten leading medical problems worldwide will be stress related.
Many people with depression do not seek effective help and suffer needlessly. Depression has been described under various terms from heart-break, dejection, the blues, and involutional melancholia. Today psychiatrists have called it clinical depression.
Why do we become vulnerable to depression?
- Genetic factors can make us prone to unhappiness and it is important to understand your family history. Knowing your genetic weaknesses can help you to be better prepared for everyday stresses and to arrange your life so that pressure does not build up to intolerable levels. Severe types of depression such as manic-depression and endogenous depression usually have a genetic basis. In such cases, a chemical imbalance in the brain is more important than stress in the genesis of depression.
- Personality types are important and some studies indicate that people with pessimistic thinking, low self esteem, little sense of control and prone to excess worry are more likely to become depressed. Some psychologists have argued that women have been raised to be like this, and that is why they develop depression at a higher rate than men do. They say that women are generally more passive and dependent and less able to express anger because they have been raised to think it is an unacceptable emotion. However, when anger is denied and turned inward depression is often the result.
- The past and present environment has a big influence on the emotional state. Women with a history of childhood sexual abuse are more likely to become depressed in adulthood. Psychologists have found that exposure to abuse may lead to a higher incidence of depression, due to feelings of low self worth, self blame, a sense of helplessness and social isolation. These forms of abuse are much higher in women than men. Poverty causes stresses of uncertainty, isolation and poor access to resources, which can lead to sadness.
- The loss or non-achievement of something in your life that is important to your self-esteem and self-worth. This could be the loss of a relationship, a high paying job, loss of status, financial loss, the loss of health, the loss of youth, and the loss of virility. These losses can leave a gaping hole in one’s ego, which can be difficult to replace with positive thoughts alone. Loss often leads to stress, which then leads to anxiety, and then after several weeks or months depression sets in.
- The sense of not being in control of one’s life and destiny can lead to stress and frustration. Globally, there is a trend towards large organisations and corporations and the direction of employees is often exerted by remote electronic control. Decisions are focused on pleasing directors, owners and shareholders and businesses do not appreciate the huge emotional and financial toll that depression in employees will have. Challenging pressures in the work place can be very energizing if they occur in an atmosphere of high morale. We have lost the personal touch in a corporate world that is valued in dollar numbers only.
- Hormonal imbalances can lead to depression and anxiety. Premenstrual depression can be helped with a combination of natural progesterone and nutritional supplements. Depression during the peri-menopausal years can often be dramatically improved by fine-tuning the body with a combination of natural hormones such as oestradiol, progesterone, DHEA and testosterone. Postnatal depression is a serious and relatively common illness that often lingers for years without adequate treatment. Postnatal depression will require the use of anti-depressant drugs, nutritional supplements of B vitamins, essential fatty acids, and minerals, along with natural hormones. The type of hormones required will vary, depending upon the breastfeeding & contraceptive needs of the individual woman. However, natural progesterone, either alone, or in combination with natural estrogen and testosterone, can restore the normal loving feelings towards the baby and partner of the patient.
- Lifestyle plays an important role and people who abuse drugs and alcohol have higher rates of depression. Alcohol, many recreational drugs, and some prescription medications can lead to depression. Those with poor diets and poor lifestyle habits are more likely to suffer with mood disorders.
No matter what the cause of our depression, it is true that the most stressful thing in life is often between our ears. It is in the mind that threats and emptiness are perceived. The greatest battlefield of life is usually in our own mind and when we can no longer fight alone for victory, thankfully we can turn towards modern day psychiatry and nutritional medicine.
We live in a unique age where it has become relatively easy to treat the symptom of depression with modern day anti-depressant drugs and specific nutrients, whereas it is often much harder to treat its causes. In other words, we can treat the mind but we cannot remove genetic weaknesses, stresses, losses and other external difficulties of life.
Symptoms of depression can vary a lot between individuals and depression often exists without a correct diagnosis being made. This is because depression can masquerade as many different illnesses.
Symptoms of depression
Symptoms of depression may include the following:
- Persistently depressed or dysphoric moods, overwhelming feelings of sadness, doom and gloom
- Irritability and grumpiness
- Loss of interest or pleasure in all usual activities
- Loss of motivation
- Withdrawing from friends and social activity
- An increased use of drugs, alcohol or smoking to cope
- Changes in appetite leading to weight gain or weight loss
- Bowel disturbances such as irritable bowel syndrome
- Breathlessness, tremor or racing heart
- Changes in sleep, often associated with early morning awakening
- Mental and/or physical agitation or slowness
- Slowed thinking or impaired concentration and memory
- Suicidal thoughts or thoughts of harming yourself
- Feelings of pessimism & hopelessness
- Loss of interest in sex
- Increased fatigue
- Inappropriate feelings of guilt, worthlessness and low self esteem
- Feeling out of control
- Feeling anxious and tense
- Feeling emotionally numb
- Difficulty making decisions
- Thinking excessively about the past (rumination)
- Being unusually self-critical
- Increased headaches and general aches and pains (fibromyalgia)
Manic – depressive illness
This is known as Bipolar disorder. This is a specific form of severe depression, which alternates with periods of mania. A manic episode is completely opposite to a depressive episode, comprising of extreme euphoria, irritability, sleeplessness, risk taking, grandiose delusions and unrealistic beliefs in one’s abilities and powers. Manic episodes can be very debilitating and can lead to loss of social contact, and huge bills, from wild spending sprees. A milder form of Bipolar disorder is Hypomania, in which people experience severe depressions with only mild manic episodes. Cyclothymia is a variant of bipolar disorder resulting in extremely short mood swings with only days or weeks between depression and hypomania. There is a high risk of suicide in manic depressive illness.
Medication with the drug Lithium is usually very effective and greatly reduces the risk of suicide.
Manic depression has the largest association with substance abuse and addiction than any other psychiatric disorder. Alcohol is the prime addiction as it is used as self-medication to deal with the dramatic mood changes. Supplementing with essential fatty acids, vitamin C, B- group vitamins, and magnesium is helpful in cases of manic depression.
Serotonin – the happy chemical!
When it comes to our moods and the way that we generally enjoy the pleasures of life, the most important chemical in our brain is called Serotonin.
Serotonin is a remarkable brain messenger and adequate amounts of serotonin are required for –
- Stable moods and a feeling of happiness and contentment
- Proper sleep and a healthy libido
- Regulation of appetite, usually reducing it
- Prevention of premenstrual syndrome
- Prevention of headaches
- Control of anxiety
Depressive illness is often caused or associated with abnormally low levels of serotonin in the brain.
How is serotonin made?
Serotonin is made in the brain from the amino acid tryptophan. An enzyme called hydroxylase in conjunction with vitamin B 6 and magnesium, converts tryptophan into 5-hydroxytryptophan (5HTP) which is then converted into serotonin. The other name for serotonin is 5-hydroxytryptamine.
How can serotonin levels be increased?
There are several ways:
- Anti-depressant drugs
Modern day anti-depressant drugs exert their effect because they increase the levels of various chemicals known as neuro-transmitters in the brain. The most popular anti-depressants are known as Selective Serotonin Re-uptake Inhibitors (SSRI’s) such as Cipramil, Fluoxetine and Erocap. Another modern type of anti-depressant drug called Efexor is able to increase levels of the neuro-transmitters serotonin and nor-adrenalin. For many sufferers they are remarkably effective and modern day anti-depressants are often virtually free of side effects. In some people they can have side effects such as headaches, reduced sex drive, nausea, digestive disturbances, fatigue and rashes. There is no doubt that some depressed persons will only be able to live a normal and happy life by taking antidepressant drugs. This can be difficult to accept for some, however, acceptance can be part of the healing process.
Because depression and inability to cope with stress are such common problems, the study of substances which favorably influence the brain’s biochemistry will increase enormously. Although true happiness cannot be found in a drug or supplement it is nevertheless true that these things can help human beings to cope with the difficulties of life. They can raise the threshold at which stress affects us adversely, numb the pain of rejection and failure, and enable us to be more detached and objective about our problems.
Over many years of helping patients with depression and anxiety, I have found that nutritional supplements can have a powerful therapeutic effect. This is particularly so if the correct combination of specific nutrients and herbs are used in a synergistic fashion.
The herb Hypericum, also known as St John’s Wort has been used since Ancient Greek times as a remedy for nervous complaints. The clinical success of hypericum extracts for the treatment of patients with depression has been confirmed in a large number of placebo-controlled double-blind studies. One great benefit of hypericum is that in the doses used in humans it is usually free of side effects. Allergic reactions can occur in those who are generally allergic to herbs and may manifest as photo-sensitivity rashes when exposed to sunshine.
Hypericum is thought to exert its antidepressant and mood elevating effect in a similar way to the Mono-Amine-Oxidase Inhibitor (MAOI) anti-depressant drugs. In other words, it is able to inhibit the enzymes that break down the brain chemicals noradrenalin and serotonin.
Most studies demonstrating that hypericum is an effective antidepressant have used a standardised extract of the herb, which gives a dose of 900mcg total hypericin three times daily. This is equivalent to tablets containing 300mg of a 6:1 extract of the herb. One 300mg tablet, three times daily, has been found to be the generally effective therapeutic dose, although, some people will find that they only need to take one or two tablets.
In one double blind clinical study comparing the effect of an antidepressant drug to hypericum extract, it was found that hypericum extract was more effective in improving mental function.
Another interesting benefit of hypericum is that several studies have demonstrated its pronounced inhibition of multiplication of some types of viruses, particularly retroviruses. Hypericum can be combined with vitamins and minerals in one tablet for added effect. Hypericum should not be taken with anti-depressant drugs because side effects may occur.
Mineral deficiencies can lead to impaired production of neuro-transmitters
Magnesium along with vitamin B 6 is required for the conversion of tryptophan to serotonin. Depression associated with irritability and agitation, may be part of a magnesium deficiency syndrome. Magnesium is often called the “great relaxer” as it helps to reduce muscular and nervous tension and increases energy levels. See my book called “Magnesium – The Miracle Mineral”. This book discusses magnesium as being essential for hundreds of chemical reactions that take place in the body every second, with recent findings also indicating that it offers a wide range of important health-promoting benefits. See page 9 for these benefits.
Zinc is another mineral that is commonly deficient in the Western diet. Zinc deficiency can lead to anorexia, fatigue and reduced libido, all of which are symptoms of depression, and all of which respond to zinc supplementation.
Selenium is frequently deficient in the Western diet. In a 5-week double blind cross over study, involving 50 volunteers who received a daily supplement containing either selenium or placebo, it was found that selenium was associated with improvement in mood. The lower their initial dietary selenium intake, the more the mood improved. Selenium is also important for immune function, and severe depression can lead to an impaired immune system.
The minerals manganese and zinc can also help with symptoms of dizziness and fatigue that are often part of depression and anxiety.
Many of those with depression & anxiety have disturbances of blood sugar levels, which can lead to fatigue, sugar cravings and disturbances of appetite. The mineral complex chromium picolinate is a component of glucose tolerance factor, which helps insulin to regulate blood sugar levels more efficiently. Those suffering with anxiety-depression syndromes, often have poor diets and consume large amounts of refined sugars and caffeine, which destabilise blood sugar levels. This can worsen their symptoms of nervous dysfunction. Chromium deficiency is associated with anxiety, fatigue and glucose intolerance.
B group vitamins
Many people who live and work in high stress situations that demand a high level of performance will find that supplemental doses of the B group vitamins help them to achieve their goals. I have found that best results are obtained by combining all the B group vitamins together with their synergistic co-factors, which are choline, inositol, folic acid and biotin. The nervous system has a high requirement for B vitamins and is unable to manufacture neuro-transmitters, such as serotonin and dopamine efficiently without them. Mental energy, concentration, memory and sleep patterns can all be improved with supplemental B group vitamins. Deficiencies of the B group vitamins can lead to depressive symptoms and dysfunction of the spinal cord and nerves.
Vitamin C is very important for the adrenal glands, which need to be strengthened in cases of stress-induced depression. The adrenal glands produce the “survival hormones” such as adrenaline and cortisol, which we need to cope with the stresses of life in this technological fast moving age.
A study carried out by Dr Alan Gelenberg of the Harvard Medical School showed clearly that a lack of the amino acid tyrosine resulted in a deficiency of the brain transmitters noradrenalin and norepinephrine. This deficiency occurred at certain locations in the brain, which relate specifically to mood disorders.
In those patients who find that antidepressant drugs become increasingly ineffective over time, it may be wiser to use nutritional antidepressants. This is because in such cases the drug-induced increased levels of neuro-transmitters are being broken down, after their re-uptake is inhibited. Eventually, this may lead to depletion of these vital brain transmitters with aggravation of the original depression. Tyrosine not only boosts neuro-transmitter levels, it also has a boosting effect upon the production of thyroid hormone which can help metabolism. This makes tyrosine an excellent antidepressant for those with sluggish metabolism and weight excess.
The combination of hypericum with the vitamins and minerals above, addresses the imbalance in serotonin levels in the brain, which occurs in patients with depression and related mood disorders. It also helps to boost stamina. In many people with anxiety-depression there are deficiencies of essential vitamins and minerals, which must be corrected. Imbalances in blood sugar levels are common and need to be addressed in those with depression and weight problems. This combination of nutrients is designed to help stabilise blood sugar levels and stop cravings for sugary foods and alcohol.
If you think that you may be depressed, talk to your local doctor. Your own GP may be very good at counselling and prescribing anti-depressants. Alternatively, seek the help of a good psychiatrist. Psychiatrists are fully qualified medical doctors, who have completed post-graduate study in the field of mental and emotional problems.
If you want to feel more relaxed, confidant and “up-beat” turn towards nutritional medicine. Find mental equanimity naturally!
Recommended supplements for depression
- Magnesium Tablets or Magnesium Powder
Take 1 teaspoon daily or 2 – 4 tablets daily – to assist with mild depression, anxiety and muscular tension.
- Blues Free (Depression Free)
Take 1 to 2 capsules daily – assisting with moods, feelings, confidence, mental energy, appetite and sleep associated with depression.
- Adrenal Plus Support
Take 2 tablets daily. Many people with depression are suffering with adrenal gland exhaustion. This is a common consequence of long term stress or anxiety and it worsens depression symptoms.
- Vitamin D
Take one capsule daily with food. Research has shown that vitamin D deficiency is a common contributor to depression.
- Fish Oil
Take 4 capsules daily before meals. Fish oil is an excellent source of omega 3 fats, which help to support a healthy mood and cognitive abilities.
The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.
The Amino Revolution, Dr Robert Erdman & Meiron Jones
H. Schulz & M Jobert, Effects of Hypericum extract on the Sleep EEG in Older Volunteers. J. Geriatric Psychiatry Neurol. 1994, Suppl. S39-S43
B Staffeldt. et al., Pharmacokinetics of Hypericin after oral intake of the hypericum perforatum extract LI 160 in healthy volunteers, J Geriatric Psychiatry Neurol. 1994; suppl 1, S 47-S53
Suzuki O et al, Inhibition of monoamone oxidase by hypericum. Planta Med 1984;3;272-274
Inhibition of MAO & COMT by Hypericum Extracts & Hypericin, J. Geriatric Psychiatry Neurol. 1994; 7, suppl 1, S54-S56
Hall RCW, Joffe JR. “Hypomagnesemia ; physical & psychiatric symptoms” JAMA 224 (13);1749-51, 1973
Benton D, Cook R. “The Impact of selenium supplementation on mood” Biol. Psychiatry 29(11);1092-8, 1991
Maes M, et al, “Hypozincemia in Depression” J. Affective Disorders 31(2);135-40, 1994
Werbach MR, Nutritional Influences on Mental Illness, Tarzana, California, Third Line Press Inc. 1991