By Dr. Peter Bongiorno, ND, LAc
Depression can take away a person’s sense of self and also severely impair the quality of life of the people around them.
Affecting about one out of every 10 people, the World Health Organization ranks it as the second most burdensome disease in the world, meaning that it will cause more problems with sickness, time off from work and costs, as well as being a burden to society.
More than 160 million antidepressant drugs are prescribed every year. Studies show these drugs are no more effective than placebos (sugar pills) for mild and moderate depression, the greatest reasons these drugs are prescribed. The drugs do have an advantage in the minority of severe depression cases, and should be considered for these.
Even more, the research shows incredible side-effect profiles for these drugs. Sexual problems including low libido, as well as problems like diabetes and weight gain, blood pressure issues, death from heart problems, fertility problems, defects in the unborn and even increased rates of suicide have all been shown to increase with the use of these drugs.
How Can Natural Medicine Help Depression?
Natural medicine practitioners look at the body as a part of nature, and nature knows how to heal itself when given the right input. Natural medicine care may be the best overall choice to treat depression because modern psychiatry spends its time using drugs to chase after neurotransmitters. Neurotransmitters are the molecules responsible for feeling content, joyful, excited and calm. While these are certainly a piece of the puzzle, the truth is there are many, many other factors that contribute to a good mood and contribute to the production and balance of neurotransmitters. Modern psychiatry has all but ignored these.
There is an old joke about a man who walked drunkenly out of a saloon and is looking for the keys he dropped in the parking lot, which has one lit lamppost. He spends about two hours looking under the lamppost, when finally a police officer comes up to him and says, “Mister, why are you looking only under this light, when there’s a whole lot to look through?” The drunk man answers, “Well, maybe my keys are out there, but the light is so much better here.”
While conventional psychiatry is looking under the neurotransmitter lamppost, natural medicine practitioners know we need to shine the light on the whole lot to find the answers. In that spirit, it is important to consider a number of different factors which affect mood. We will briefly discuss these below.
Depression: Underlying Factors
Getting enough sleep (and good quality sleep) is imperative to best mood. People with depression are known to typically have challenged sleep, which will make their mood much worse. Poor sleep increases both anxiety and depression. Seven to eight hours of sleep a night is best. In my clinic, this is the first step to a better brain and mood. Working on rituals to help fall and stay asleep (such as shutting off computers, cell phones and TVs at least one half hour before bed) and using supplements like valerian, melatonin and tryptophan can aid the process and restore disturbed sleeps.
A well-exercised body creates a healthy brain. Hippocrates knew this 2,500 years ago, and it remains true today. Good exercise will help create balanced neurotransmitters, keep the digestive tract healthy, and help detox the body — all things we need for a good mood. Exercise also increases feel-good endorphin molecules, and will lower inflammation in the brain and body to keep you feeling your best.
Healthy Digestion and Quality Food
Your digestive tract is known as the “second brain.” This is because it has a complex web of nerves and hormonal glands that play as strong a role in our mood as our brain does — and many experts believe even more so. The majority of neurotransmitters in your body are made in your digestive tract — so it is no wonder healthy digestion will help a healthy mood. Also, new research shows that a healthy digestive tract will promote balanced flora (good germs) in our intestines, which are known to have a calming and mood-elevating influence.
Keeping our digestion healthy includes slowing down to eat and eating healthy foods. Good digestion will lower the inflammation in our bodies, which lowers brain inflammation and supports the best mood. One diet that is an excellent mood lifter is the Mediterranean diet, which has helped treat people with anxiety and depression, as well as prevent it. High in vegetables, lean protein, olive oil, fish, nuts and seeds, it provides mood-satisfying phytonutrients, protein and healthy fats, while avoiding highly processed carbohydrates, unhealthy trans fats and chemicals known to foul up the brain and nervous system.
Blood Tests and Nutrient Repletion
While there is no known diagnostic blood test for depression, we can learn a great deal about how to support someone with depression by looking at a variety of blood tests. The ones I often recommend include many that most conventional psychiatrists rarely consider. These include serum iron and storage iron levels, testosterone and DHEA, thyroid hormones and estrogen/progesterone for women. Inadequate levels of iron and hormones will greatly predispose someone to mood issues. Some vitamins are also worth checking: B vitamins, folic acid, vitamin D and zinc are some mood-regulating nutrients. I also check serum carnitine, which is an amino acid that helps the body create proper energy levels and protects the nervous system as well. Finally, people with a defect in the methyl-tetrahydrofolate (MTHF) gene may be more predisposed to depression and can benefit from B vitamins and supplementation with a specific form of folic acid called methyl folate.
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While stress is a normal part of everyone’s life, for people prone to depression, stress will overactivate brain areas, causing burnout which leads to depression. An area in the middle of the brain called the hypothalamus regulates communications among the nervous, immune and hormonal systems. When a person has too much stress input, the system called the hypothalamic pituitary adrenal (HPA) axis will get thrown way off and create imbalances in stress hormones like cortisol, which contribute changes in the brain resulting in depression. Meditation is an effective way to calm and rebalance this system and get it back to normal. Psychotherapy, yoga, gentle exercise and calming supplements like theanine and gamma amino butyric acid (GABA) can also aid to calm and rebalance the hypothalamus and the stress effect on the body and brain. Acupuncture is another fantastic way to rebalance the HPA when other methods are not as effective, or if the person has a hard time calming him or herself down.
Every day, industry and consumer activity pours countless chemicals into the air, water and our food. As a result, the world is becoming a more toxic place. We are inundated with pesticides, heavy metals, plastics, phthalates and numerous other molecules known to disrupt healthy brain and body physiology. Research shows an association between exposures to environmental chemicals and rates of depression. Similarly, anxiety, neurodegenerative diseases like Alzheimer’s and Parkinson’s Disease and other mood disorders can be encouraged with increased toxin exposure. Heavy metals have been shown to make it difficult for the brain to clear glutamate, a naturally occurring toxin that in high levels can contribute to depressive illness. Plastics and phthalates (like perfumes) block healthy hormonal and blood sugar function. Learning to avoid sources of toxins is the first step. One example is to eat organic food. Having quality water and air filters and avoiding use of cleaners and lotions with these chemicals can also help. Working with a doctor who uses methods of detoxification and chelation therapies (clearing metals from the body), along with the right foods and supplement regimens, may help the patient with depression, improve even more.
Supplements for Mood
Lastly, certain supplements can improve mood directly by helping balance neurotransmitters and supporting some physiology that may be unbalanced. Oftentimes, supplements can have positive effects without the side effects that their drug counterparts typically have.
Some of my favorites include S- adenosyl-l-Methionine (SAMe), which helps increase neurotransmitter balance, 5-hydroxytriptophan (5-HTP) an amino that provides the building blocks needed to raise the calming feel-good hormone serotonin. The amino acid, tyrosine, is a precursor to epinephrine and dopamine, two neurotransmitters needed for energy and motivation. The mood-balancing herb rhodiola can help with both anxiety and depression. St. John’s wort is the most studied herb of all time, and can help digestion while lifting low mood and calming anxiety at the same time.
Certain nutrients like folic acid in form methyl-tetra-hydrofolate (MTHF), as well as zinc and vitamin B12 may help drugs work better for patients who do not respond to medications. And ginkgo has been shown in some studies to stop the sexual side effects that often come with antidepressant medication.
It is important to remember that supplements always be included in a more comprehensive plan which also works with sleep, exercise, diet, stress, environment and lifestyle changes at the same time for best long-term healing.
While conventional psychiatry spends its time focusing on neurotransmitters and medications that share limited benefit with strong side effect profiles, there are a number of well-researched, holistically-minded choices from the natural medicine toolbox to help balance both the body and mind to heal depression. These can both help someone with depression feel better, and help the body heal the underlying causes at the same time.
About Dr. Peter Bongiorno
A naturopathic doctor and acupuncturist, Dr. Peter Bongiorno is co-director of InnerSource Natural Health and Acupuncture of New York City and Huntington, Long Island.
Dr. Bongornio researched in neuro-endocrinology at the National Institutes of Health and Yale University, then attended Bastyr University for his naturopathic doctorate and acupuncture degrees. He teaches holistic medicine electives at the Mount Sinai School of Medicine, NYU, and serves as VP of the New York Association of Naturopathic Physicians.
Dr. Bongiorno’s newest book is “How Come They’re Happy and I’m Not?: The Complete Natural Program to Healing Depression for Good” (Red Wheel 2012). Dr. Bongiorno can be reached through www.InnerSourceHealth.com and www.drpeterbongiorno.com.
Written By: Updated: March 19,2014