Approximately one in nine Americans report taking an antidepressant medication in the past month, according to national survey data released by the Centers for Disease Control and Prevention (CDC). Thirty years ago less than 1 in 50 people were taking antidepressant medications. There are many reasons other than depression that people are put on antidepressants. Those reasons include anxiety, sleep issues, pain and fatigue. There are additional underlying issues that can contribute to depression including nutrient deficiencies, hormone changes and chronic stress. Our environment and the time of the year can affect mood too. In the Northwest with the sky frequently filled with pregnant clouds threatening to drizzle all day long, we occasionally see seasonal depression that is unnecessarily treated year-round. There are times when antidepressants are needed to treat depression, but at times natural therapies can be an effective treatment choice. Some Naturopathic treatments are safe to use in conjunction with antidepressants to improve health and happiness. In many cases natural medicines treat the underlying cause of illness.
In my clinical experience, naturopathically addressing the cause of depression usually means working on diet, replacing critical nutrients and improving gut health. The seasonal depression due to lack of daylight can sometimes be addressed with well-timed vacations to sunny locations and full spectrum light bulbs. Low vitamin D levels are also a critical component to seasonal depression and are lowest in the winter due to the absence of sunshine.
Diet incalculably affects the brain's behavior. The levels of brain chemicals known as neurotransmitters, which regulate our behavior and are closely linked to mood, are controlled by what we eat. Our "feel good" neurotransmitters are dopamine, serotonin and norepinephrine. Imbalances of these neurotransmitters cause mental and emotional illnesses that are classified as depression, anxiety and pain. Serotonin plays a role in mood, sleep, relaxation and appetite and is one of the major pathways that many antidepressant medications target. Adequate protein consumption and absorption (requiring proper digestion) are essential to have enough protein building blocks to synthesize neurotransmitters. Neurotransmitter production also requires nutrients such as fatty acids like DHA and EPA, vitamin B3, folate, vitamin B6, copper, calcium, magnesium, iron, carnitine, among many other nutrients. At times it may be appropriate to use a high-quality supplement to replace deficient nutrients when diet is not enough.
Part of supporting healthy mood is to address supporting the digestion and absorption of the food you eat. Identifying and eliminating food intolerances through a blood test, testing for infections and analyzing the gut microbiome can be helpful tools for evaluating gut health. Healing the GI tract is a key step in addressing depression because over 80% of the serotonin in our body is produced in the GI track where it regulates healthy bowel functions. Removing foods that cause inflammation such as heavily processed prepackaged foods and adding in supplements that heal the digestive tract can be important steps toward improving mood. It's difficult to understand how the digestion and mood are connected, but your brain and your GI tract talk to each other. If you have ever had a highly stressful event and had then gotten diarrhea, had "butterflies in your stomach" before an interview, or caught a tummy bug and felt sad or even depressed then you have experienced the gut-brain connection. Hidden in the walls of in intestines is a "second brain" that communicates with the brain in your head (central nervous system or CNS) and is known as the enteric nervous system (ENS). These two systems are constantly talking to each other, hence when there is something like strong emotion going on with the CNS or an infection or irritation in the ENS the other one known and reacts.
Mood support requires an integrative approach. Finding the cause of depression may include running labs such as vitamin D, micronutrient testing, neurotransmitter testing and food sensitivity testing. Spectracell Micronutrient Test is a functional medicine blood test that looks at 37 different markers including amino acids, vitamins and antioxidants. Multiple nutrient deficiencies have been linked to depression. This functional test tracks nutrient deficiencies over a multiple month period Some of the supplements I fine useful for my patients are:
- Fish oil with sufficient amounts of EPA and DHA has been found to be low in patients with mild to moderate depression. Finest Pure Fish Oil by Pharmax and Pure Omega by Integrative Therapeutics are two of my favorite fish oils on the market as they are high in these specific omega-3s.
- Low levels of B vitamins have been shown to cause depression, specifically methylfolate, methylcobalamin, biotin, B6 and B2 which are building blocks for our "happiness" neurotransmitters. Some people have challenges converting inactive forms of B vitamins to active forms of B vitamins which makes it hard to have enough to makes our feel good neurotransmitters. B Complex by Vital Nutrients is one of my favorite B complexes for depression. This product has a great blend of b vitamins which are important building blocks for our feel good neurotransmitters serotonin, dopamine and epinephrine.
If you or a loved one is suffering from depression there may be more you can do improve your mood, schedule an appointment with a doctor at NaturoMedica where we believe that good health is by design not luck.