What is depression?
Like many other chronic illnesses, depression can be caused by a wide variety of factors and is characterized by several out of a long list of symptoms. It affects people of all ages, races, and nationalities and according to the World Health Organization (WHO) is the most costly of all diseases largely because it disables people who would otherwise be productive. It is estimated that 10 percent of the US population experiences depression severe enough to require medical attention with women twice as likely as men to develop depression.
Normal vs. Clinical Depression
Although it is often normal and healthy to experience sad moods in response to a trauma such as the loss of a loved one, a major depressive episode is characterized by inappropriate sadness that persists, or is out of proportion with its apparent cause. Clinical depression can further be categorized into Unipolar depression, marked by recurring episodes of sadness, and bipolar depression, in which the sadness alternates with periods of elation and mania. Unipolar depression is by far the more common of the two. Both kinds of clinical depression can be caused by number of factors, including constant tension and unresolved stress, genetics, chemical or hormonal imbalances, chronic illness, poor diet, food allergies, nutritional deficiencies, and even inadequate sunlight.
If your depression is clearly reactive to stresses or events in your life, many of the therapies below may ease some of your discomfort and help you work your way through the source of your sadness. Professional counseling is also a good idea. If you suspect that you are clinically depressed, first consult a doctor to rule out any underlying illness (such as a thyroid problem) and then see a psychologist or psychiatrist for a diagnosis and appropriate treatment. Obviously it is best to work with a doctor who embraces natural therapies and will work with you to find the cause of your depression. The suggestions here will support your therapy and will also point you to toward possible causes or aggravating factors of your disorder.
- Chronic Illness or Pain
- Food Allergies
- Heavy Metal Toxicity
- Lack of Sunlight
- Neurotransmitter Imbalance
- Nutritional Deficiencies
- Poor Diet
- Recreational Drug Use
- Sleep disturbances
- Unresolved Emotional Issues
A depressed person will usually have several of the following symptoms
- Appetite disturbances
- Avoiding Social Situations
- Decreased Sex Drive
- Difficulty concentrating or making decisions
- Digestive Problems
- Feelings of Guilt
- Feelings of Helplessness
- Feelings of Hopelessness
- Feelings of worthlessness
- Inability to enjoy things
- Increased Anxiety
- Mood Swings
- Recurrent thoughts of death or suicide
- Sleep problems
- Neurotransmitter balance – urine test
- Hormone testing (thyroid, DHEA, cortisol, testosterone, IGF-1, estrogen, progesterone) – saliva, blood, or urine tests
- Vitamin and Mineral Analysis – blood test (especially test magnesium, B12, folic acid B6, B1)
- Anemia – blood test (CBC, iron, ferritin, % saturation)
- Food and environmental allergies/sensitivities – blood, electrodermal tests
- Blood sugar balance – blood test
- Toxic metals – urine or hair analysis
Diet and Lifestyle
One of the most important dietary considerations to prevent or improve depression is the balance of fats. The American diet has an overabundance of saturated fats (as found in red meat and dairy products) and omega 6 fatty acids (polyunsaturated fatty acids) as found in vegetable cooking oils such as soy and corn oils. The brain is primarily composed of fatty acids and requires a constant dietary supply of omega 3 fatty acids. While omega 3 fatty acids are most recognized for their cardiovascular benefit they are quite important for normal mood. Various studies, including a recent one in Psychosomatic Medicine have demonstrated that a relative imbalance between omega 6 and omega 3 fatty acids is associated with symptoms of depression. (Conklin SM, Manuck SB, Yao JK, Flory JD, Hibbeln JR, Muldoon MF. High omega-6 and low omega-3 fatty acids are associated with depressive symptoms and neuroticism. Psychosom Med. 2007 Dec;69(9):932-4. Epub 2007 Nov 8. ) Omega 3 fatty acids can be consumed through cold water fish such as ocean salmon, sardines, and low mercury content tuna. Almonds, walnuts, pumpkin seeds, flaxseeds are also healthy sources.
It is also important to reduce simple sugars in the diet which may worsen depression. Do eat regular meals so that blood sugar swings do not affect your mood. Avoid artificial sweeteners which may aggravate depression in susceptible users.
Various studies have demonstrated that exercise is comparable in its benefit to that of depression drugs. Routine exercise (3 hours a week) can profoundly reduce depression. (Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM,Barbour KA, Herman S, Craighead WE, Brosse AL, Waugh R, Hinderliter A, Sherwood A.Psychosom Med. 2007 Sep-Oct;69(7):587-96. Epub 2007 Sep 10 )
Studies on Fish Oil & Depression
The brain is composed of fats such as docosahexaenoic acid (DHA) that are required for normal function. As discussed in the Diet and Lifestyle Changes, omega 3 fatty acids are important for the prevention and treatment of depression. Since many people do not eat adequate amounts of omega 3 fatty acids supplements as fish oil are desirable. Low blood levels of omega 3 fatty acids are associated with depression. (Maes M, Christophe A, Delanghe J, et al. Lowered omega3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res 1999;85:275-91.Tiemeier H, van Tuijl HR, Hofman A, et al. P Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr 2003;78:40-6.
A study published in the Archives of General Psychiatry 70 patients with persistent depression despite ongoing treatment with an adequate dose of a standard antidepressant. Patients were randomized on a double-blind basis to placebo or fish oil at dosages of 1, 2, or 4 grams daily for 12 weeks in addition to unchanged medications. Researchers found patients who took the lowest dose of fish oil at 1-gram daily showed significant improvements on all major measures of depression compared with those who took a placebo. More specifically, 69% of the patients who took the 1-gram dose had a 50% reduction in their symptoms, compared with only 25% of those who took a placebo. (Peet M, Horrobin DF.
A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry. 2002 Oct;59(10):913-9. )
Effect of Vitamin B12 and Folic Acid Deficiencies
Deficiencies of these nutrients may cause symptoms of depression. Deficiencies of these nutrients are more common in vegetarians and seniors. A multivitamin may be sufficient to provide these nutrients and help depression. Researchers from the University of Sheffield assigned 225 older hospitalized patients (average age 75) to receive daily multivitamin and mineral supplements or a placebo along with the normal hospital diet. After six months, there was a significant increase in the number of patients with no symptoms of depression in the supplement group (from 67% to 76%) compared to the placebo group and a decrease in patients with symptoms of mild (25% to 21%) or severe (8% to 3%) depression. Levels of folate and vitamin B12 increased significantly in those taking supplements and decreased in the placebo group. (S. Gariballa, S. Forster, Clinical Nutrition, July 25, 2007)