Depression
- Posted on
- By Gabriela Mancilla Valdez, CHN, RA
- Posted in Blood Sugar, Depression, Methylation, Thyroid
In this blog post, we dive into some major underlying causes of depression. Dietary, supplement, and lifestyle recommendations are discussed to address the underlying causes.
Depression is a prevalent disease in our society today, particularly in the US where about 1 in 6 adults will experience depression at some point in their lifetime, which equates to about 16 million people each year. Symptoms of depression include a persistant depressed mood, loss of interest and pleasure, change in appetite or body weight, over or under-sleeping, slowness or agitation, fatigue, inability to concentrate or make decisions, and thoughts of death or suicide.
There are many underlying causes to depression, including deficiency in certain neurotransmitters, thyroid disorders, blood sugar imbalances, and nutrient deficiencies just to name a few. In this blog, we will dive into a few of the main causes of depression related to things that can be fixed through dietary changes, supplementation, and lifestyle modification.
One of the main causes of depression is a serotonin deficiency. Serotonin is the “feel-good” hormone and it is the primary defense against depression and anxiety. Some of the ways that people can become deficient in serotonin include not eating serotonin foods like protein or healthy fat, eating antiserotonin foods like caffeinated sodas, coffee, or diet sweetened drinks or foods, and intaking serotonin’s “enemies” including stimulants like caffeine and nutrasweet that stimulate rather than relax.
Stress can also deplete serotonin because stress forces the brain to use up its serotonin supplies that it normally uses to keep you calm and centered. Another cause of low serotonin could be genetic such as those who inherit false mood brain programming. Additionally, gender and sex hormones can also lead to deficiencies in serotonin. Females produce as much as a third less serotonin than males; a deficiency of estrogen and testosterone could also lead to low serotonin levels because estrogen blocks the breakdown of serotonin and testosterone has a similar effect in men.
A deficient exposure to light or in evening or winter when there’s not enough bright light to signal your brain to make serotonin can result in a deficiency, as well as a lack of exercise because physical activity has a serotonin boosting effect. Fast foods and skipping meals can lead to serotonin deficiency because they deplete people of vitamins and minerals that assist in the conversion of tryptophan to 5-HTP to serotonin; without calcium, magnesium, Vitamin D, and B vitamins, neurotransmitters cannot be made consistently.
Some physical symptoms that indicate low levels of serotonin include gut and heart problems, sleep problems, fibromyalgia and other pain conditions, and cravings for carbohydrates, alcohol, and certain drugs. Gut problems can indicate low serotonin because surprisingly 90% of serotonin is in the gut, not the brain. Serotonin can help prevent fibromyalgia and other pain conditions because it has a powerful muscle relaxing effect and powerfully stimulates our natural pain killers, known as endorphins. Cravings for carbohydrates are common with serotonin deficiency because carbohydrates trigger a release of insulin that takes up the other amino acids that normally compete with tryptophan to get into the brain; thus, they allow tryptophan to enter the brain when the other amino acids are taken into the other tissues.
The next cause of depression is a catecholamine deficiency. Catecholamines include dopamine, norepinephrine, and adrenaline; dopamine produces the other two and is the most prolific in the brain. Catecholamines are the neurotransmitters that give people motivation and drive, so without them a person is left with the sense of apathy and withdrawal that is typical of depression.
Tyrosine is the amino acid that is used to make all three of the catecholamines. There are a few reasons that people can become deficient in catecholamines. Stress can deplete catecholamine stores because if a person exceeds the limit of how many catecholamines their brain and adrenal glands can produce at one time, it depletes their stores. A low calorie or high carbohydrate diet can cause catecholamine deficiency because these diets are low in protein that provides the amino acids the body needs to produce catecholamines. Carbohydrates also cause a release of insulin that sweeps amino acids out of the bloodstream and into the muscles before they reach the brain even if the person is eating an adequate amount of protein.
Additionally, vegetarians can be at risk for catecholamine deficiency because protein rich animal derived foods are high in tyrosine while vegetable protein is not; additionally, soy tends to inhibit the conversion of tyrosine into catecholamines. Lack of exercise can also cause a low amount of catecholamines because physical activity can raise catecholamines. Finally, low levels of sex hormones including testosterone and estrogen can fail to stimulate catecholamines in the brain.
The next possible cause of depression is low thyroid conditions. If someone is depressed and the methods for raising their serotonin and catecholamine levels are not effective, it can be helpful to check for low thyroid function. Check for symptoms such as low energy, fatigue, lethargy, trouble getting up in the morning, depression, feeling cold, and weight gain. Low thyroid can cause low levels of neurotransmitters because without adequate T3 produced by the thyroid, the brain cells cannot produce enough of the catecholamines and tyrosine cannot be transformed into the catecholamines or produce enough serotonin or other mood neurotransmitters.
Some reasons for low thyroid function include genetic programming, eating a low calorie diet, not eating enough thyroid nutrients such as iodine, tyrosine, B12, iron, selenium, zinc, folic acid, and B vitamins, eating anti-thyroid foods (goitrogens) such as wheat, rye, barley, oats, soy, cruciferous vegetables, and millet, chronic stress or physical trauma, intaking fluoride or chlorine, or taking medication such as estrogen and lithium, antidepressant, sulfa drugs, or antidiabetic drugs, which are thyroid-inhibiting drugs.
Some other causes that can affect mood and lead to depression include blood sugar imbalances, deficiencies of nutrients including Vitamins B6, B12, folic acid, Vitamin C, zinc, magnesium, chromium, and essential fatty acids, deficiencies of tryptophan and tyrosine, and allergies and sensitivities. Additionally, the fast pace of life and need for adaptation leads to the production of more and more adrenalin and serotonin in response to our too frequent up and downs, stresses and strains; thus, our need for the building blocks, namely the nutrients that mood enhancing neurotransmitters (serotonin, adrenalin, noradrenalin) are made from, are higher because of a low intake and a higher need for those nutrients.
A few other root causes of depression include a homocysteine level that is too high, a deficiency in essential fats, and inflammation. Individuals with depression tend to have higher levels of immune cells and immune activation, C-reactive protein, and inflammatory cytokines.
There are dietary interventions that can be made to support depression. First, the “good mood” foods to support a positive mood will be discussed. The first food to favor for depression is protein. The goal should be to eat 20-30 grams per meal, 3 times a day because the neurotransmitters that send out positive feelings can only be made from the amino acids, which come from protein. Some examples of protein sources include fish, poultry, eggs, beef, lamb, pork, venison, buffalo, and dairy.
The second food to favor is food with omega-3. The body has a ratio of omega-3: omega-6 fatty acids; the more omega 3, the better your mood; the more omega-6, the worse your mood. The rate of depression among individuals correlates with the ratio of omega-3 to omega-6 fatty acids in the brain. Additionally, omega-3 raises dopamine by 40 percent, which increases mental and physical alertness, focus, and excitement. Studies have shown that even severe depression can be helped with omega-3 fatty acids. Sources of omega-3 include fish such as wild salmon, sardines, herring, anchovies, mackerel, grass-fed beef, and eggs with higher omega-3 content. Fish should be eaten at least 3 times a week; the Japanese eat 2.5 pounds per week and their depression rates are historically low. To view our options for omega-3/fish oil click here.
The other fatty foods to favor are saturated fats because they support the function of omega-3 in the brain and reduce the negative effects of excess omega-6. Some examples of saturated fats are coconut oil, butter, and full fat yogurt. Omega-9 is another fat to favor because it supports the omega-3s and helps to promote serotonin’s antidepressant activities in the brain. Omega-9 is found in olive oil, cashews, and macadamia nuts.
The next food to favor is vegetables. There should be 4-5 cups of vegetables in the diet everyday. Dark leafy green vegetables especially should be included in the diet because they are loaded with B vitamins to support mood and stress and they are high in magnesium. If it is hard for you to get your vegetables in everyday, you can supplement with Phytomulti Superfoods Metagenics, Nanogreens Biopharma, or Nourish Greens Apex.
Another group of foods to favor are “good-mood” carbohydrates, which include fruits, vegetables, legumes, and grains. These carbohydrates supply the brain with glucose without spiking blood sugar that can further contribute to depression and mood issues. Apart from the kinds of food to eat, one should also focus on eating regularly. Eating small, regular meals of natural, unprocessed foods including fiber and protein can help balance blood sugar and keep blood sugar levels even.
Hydration is also important and should consist of eight or more 8 ounce portions of filtered water, herbal tea, or vegetable juice. Since tryptophan is an important amino acid for depression because it can help boost serotonin levels, foods rich in tryptophan such as eggs, baked potato, dairy, chicken, and salmon should be consumed at each meal.
Finally, since inflammation can contribute to depression and mood disorders, it is important to favor anti-inflammatory nutrients such as turmeric, ginger, green tea, blueberries, olive oil, chia seeds, fatty fish, walnuts, spinach, broccoli, avocado, tomatoes, beetroot, garlic, onions, apples, tart cherries, flax seeds, dark chocolate, mushrooms, and bone broth. If you would like to supplement with anti-inflammatory es in addition to diet, click here to view our selection of anti-inflammatory nutrients.
In addition to favoring good-mood foods, one should also try to avoid bad-mood foods to further support depression. The first foods to avoid are sweets and white-flour starches. These foods are similar to drugs regarding their effect on the body; they remove nutrients and can force a release of your brain’s natural feel-good neurotransmitters, serotonin and endorphin, which leads to a need for more and more to get the same “boost”. Additionally, an increase in sweets and intake of refined starchy carbohydrates is the primary cause of the fastest growing disease in the world, diabetes, which has a doubled incidence of depression. Another food to avoid is gluten. Depression is a common symptom of gluten intolerance, and people with gluten intolerance have low levels of the antidepressant brain chemical serotonin.
The next foods to avoid are bad-mood fats including corn oil, soy oil, canola oil, safflower oil, sunflower oil, peanut oil, sesame oil, wheatgerm oil, cottonseed oil, and walnut oil. These oils are very unstable and are oxidized quickly and are high in omega-6 fatty acids; when someone does not get enough omega-3 fatty acids that are supposed to make up the brain’s cell walls, omega-6 oils fill in because it is similar in form and the brain cells quit sending and receiving signals properly, which is seen in depression where depression rates are rising along with consumption of omega-6 fatty acids. Trans fats should also be avoided because they prevent the brain from using the protective omega-3 fatty acids, and contribute to the takeover of omega-6 fatty acids, which leads to depression and mood disruption.
Other dietary things to avoid to support depression include avoiding fat. Low fat diets are firmly associated with depression and irritability. Low fat diets almost always mean high carbohydrate and low blood sugar leading to mood swings, hypoglycemia, and diabetes. Low protein diets should also be avoided because they contribute to low energy and low mood since the brain and the body are low in the amino acids needed to make natural antidepressants and stimulants, serotonin and norepinephrine, and naturally relaxing GABA.
Caffeine should also be avoided or at least limited because studies show that individuals who drink the most coffee often suffer depression as well. Studies have also shown that caffeine plays a major role in depression. MSG should also be avoided because of its ability to trigger depression.
Finally, figuring out if any of the major allergy foods need to be avoided because they may be contributing to depression should be part of a dietary approach to depression. The top offending allergy foods that could be contributing to bad moods include wheat, cow’s milk, soy, nightshades, chocolate, peanuts, eggs, and corn.
Next, there are many supplements and nutrients that can be taken to support depression. One nutrient recommendation is tryptophan because it converts to serotonin, a good-mood neurotransmitter in the body. Foods high in tryptophan include turkey, beef, pork, dairy products, chicken, and eggs. Studies have shown that removing tryptophan from the diet lowers serotonin and increases depression, while adding it as a supplement can raise serotonin 200 percent. Tryptophan taken with antidepressant medications has been shown to drop depressive symptoms more than 50 percent and when combined with Prozac; Tryptophan increased the speed of antidepressant effects and eliminated sleep disturbances caused by Prozac. Our option for Tryptophan is L-Tryptophan Montiff.
5-HTP is another supplement that is highly recommended for depression because it is one step closer to serotonin from tryptophan since tryptophan converts to 5-HTP before becoming serotonin. Studies comparing 5-HTP to other antidepressant drugs have shown that serotonin activity increased from 150 percent on Prozac to 615 percent with the addition of 5-HTP. 5-HTP had an improved percent of depression patients than on Luvox with 68 percent compared to 62 percent and 5-HTP had an 11 percent lower failure rate than Luvox. 5-HTP eliminated anxiety symptoms in 58 percent of patients as opposed to 48 percent on Luvox. SSRIs cause sexual dysfunction in 50-75 percent of users, while 5-HTP has shown no sexual dysfunction and few other side effects. Our recommendations for 5-HTP include 5-HTP Thorne, 5-HTP 50mg Pure, 5-HTP 100mg Pure.
St. John’s Wort is another supplement that can be helpful in depression. In a study comparing St. John’s Wort to Prozac, they both showed a 48 percent improvement in depression symptoms. However, St. John’s Wort has fewer side effects than tricyclic antidepressants. According to Julia Ross (Author of the Mood Cure) and the studies in her practice, St. John’s Worr tends to help raise serotonin levels when amino acids somehow do not; it typically works when thyroid function is sluggish and thus 5-HTP and tryptophan do not work. For St.James Wort try St.John’s Wort MediHerb.
SAM-e is another nutrient that can support depression. SAM-e plays a role in methylation, which is essential for the production of neurotransmitters including serotonin and three other mood-regulating neurotransmitters in the brain. SAM-e is recommended especially if one has a high homocysteine level and thus faulty methylation contributing to their depression. It is also recommended by Julia Ross in her practice if the amino acids and St. John’s Wort do not completely relieve depressive symptoms, particularly in people over forty or where alcohol, cocaine, or other stimulants have been a problem or if arthritis or liver function is a problem. For SAM-e try SAMe 200 Jarrow or SAMe 400 Jarrow.
When taking the supplements mentioned above, which all work to raise serotonin levels, it is important to take them middle to late afternoon and 9-10pm unless symptoms trouble a person in the mornings. It is also important to watch for “serotonin syndrome”, which is when a person takes serotonin at first when they are deficient and they feel better, but later if they get too much serotonin then the symptoms that result are the same as those they had when they were deficient. Symptoms to look out for are getting relaxed or sleepy during the day or getting a mild headache after a dose. Additionally, if one is eating plenty of tryptophan-containing protein foods, they can take their supplements on an as-needed basis.
Next are the nutrients and supplements that help support the catecholamines, another potential cause of depression.Tyrosine is the amino acid that fuels the brain to make the three antidepressant catecholamines and is the basic ingredient used by the adrenals to produce fight or flight chemicals. It is also the primary component of enkephalins, which are the “cousins” of endorphins that are the most powerful pleasure promoting chemicals. Tyrosine is also needed to produce thyroid hormones, which stimulate every cell in the body, including the brain cells that produce catecholamines. If one relies on caffeine in the morning as a pick-me-up, they should take tyrosine and eat tyrosine-rich protein foods in the morning instead. For a tyrosine supplement, try L-Tyrosine Pure.
Another nutrient that can support catecholamine production is phenylalanine, which is the precursor to tyrosine. Some people may do better on either tyrosine or phenylalanine or with a combination of both. For a combination of tyrosine and phenylalanine, try DopaFlo Apex. For just phenylalanine, try DL- Phenylalanine Pure. Vitamin D can be helpful as well in addition to tyrosine and/or phenylalanine because it directs the conversion of tyrosine to catecholamines in the brain and the adrenal glands. For more information on vitamin D and for supplement options check out our vitamin D monograph part one and part two.
Another supplement to take in addition to eating foods high in omega-3 is omega-3 fish oil. Fish oil can raise catecholamines by 40 percent. Additionally, the higher the blood levels of omega-3 fats, the higher the levels of serotonin are likely to be because omega-3 fats help build receptor sites and improve reception of serotonin in the brain. To view our options for omega-3 fish oil click here. Some of our top recommendations for fish oil include Omega 900 TG Active Factors and Pro-Omega Nordic Naturals. For a non-fish option for omega-3 try Vegan Omega Deva or UltraPure Vegan Omega Vital Nutrients.
If the thyroid is the issue underlying depression, nutrients can be taken to support thyroid function. These nutrients include glandulars that can support the thyroid, homeopathic preparations of thyroid, thyroid supporting nutrients, and glandular or synthetic prescription thyroid medications. For thyroid supporting nutrients, you can try Thyrocsin Thorne, Thyroxal Apex and Thyro-Zyme Apex. The Thyrozyme and Thyroxal contain thyroid glandular.
If high homocysteine seems to be a causative factor of depression, there are specific supplements that can support depression. High levels of homocysteine are strongly associated with depression. When histamine levels are high, a person is more likely to be depressed, compulsive, and have abnormal thinking. B vitamins are essential to correct faulty methylation, and TMG and SAMe can also boost methylation to lower homocysteine levels and keep the brain in balance by adding methyl groups when needed.
These nutrients are especially needed for histadelics, which are people that are genetically preprogrammed to overproduce histamine. Dr. Pfeiffer is a doctor that studied histadelics; he concluded that a substantial number of depressed patients are histadelics. For histadelics, he recommends a diet low in protein, high in complex carbohydrates, and an emphasis on fruit and veggies. He also recommends they supplement 2 grams of vitamin C a day, zinc, manganese, B5, folic acid combined with other homocysteine lowering nutrients: B2, B6, B12, and TMG.
For B vitamins to support healthy methylation, check out Basic B Thorne, B Activ Xymogen, or Methyl B Complex. For further homocysteine support you can add TMG Allergy Research Group and SAM-e Jarrow 200 or 400. For combination products that support homocysteine levels check out Methyl Protect Xymogen, Methyl Guard Plus Thorne, Homocysteine Plus Allergy Research Group, or Cardio B Ortho Molecular.
The basic supplement recommendations that are recommended for all causes of depression and for general mood support include a multivitamin, magnesium, calcium, Vitamin D, a B Complex, Vitamin C with bioflavonoids, Vitamin E, and fish oil. For our selection of multivitamins, click here. For more information on magnesium and for supplement recommendations, check out our Magnesium monograph. For calcium, check out Reacted Calcium Ortho Molecular and Calcium Citrate Arcana. For more information and supplement recommendations for Vitamin C, check out our Vitamin C monograph. For vitamin E, check out Vitamin E Mixed Tocopherols Metagenics or Vitamin E Arcana. For fish oil and B complex, reference the recommendations discussed above.
B vitamins are essential to correct faulty methylation, which is indicated by a high level of homocysteine and is strongly associated with depression. Additionally, B6, B12, and folic acid are needed to support methylation, which is critical for balancing the neurotransmitters dopamine and adrenalin. B6 and Zinc should be supplemented to correct a common biochemical imbalance that can promote low moods known as pyroluria, which is where the body loses B6 and zinc due to excess pyrolles binding to B6 and zinc and excreting them in the urine. Vitamin C in large amounts has been proven to enhance recovery for depression.
Chromium is a helpful nutrient for atypical depression, which is a type of depression where people are gaining weight, feeling tired all the time, craving carbohydrates, and can sleep forever. In Holford’s practice, he has seen that most have instant relief by taking 400-600mcg of chromium a day because of the blood sugar link to depression. Finally, magnesium is another supplement to consider for supporting depression. Studies have shown that people with depression recovered rapidly with supplemental magnesium at each meal and at bedtime. For chromium and other blood sugar support supplements, check out Chromium Pure , Berberine Thorne, Diabenil Thorne, and Diaxinol Ortho Molecular.
The final topic in this discussion on depression support is lifestyle modifications. Lifestyle modifications for depression include getting light exposure, exercise, lowering stress, getting enough sleep, meditation, and other alternative therapies that may support depression.
People with depression should spend 30-60 minutes a day under a lamp without glasses or contacts, preferably before 3 pm so as not to suppress sleep by bright light. This practice should be done if one does not have enough light where they live or if it is winter and they do not get light exposure. There are special light units that can be bought and used at home that provide 2500-10,000 lux at a distance of 30-60cm that patients can sit in front of for 30-60 minutes a day as well. In patients who go to sleep late at night and rise late in the morning, light therapy is most effective in the morning, sometimes supplemented with 5-10 minutes more of exposure between 3-7PM.
Another lifestyle modification is to increase the amount of exercise. Exercise causes other amino acids to go to the muscles in need, but allows tryptophan to get through the blood brain barrier and into the brain so one can make serotonin. Exercise also increases the intake of oxygen, which is critical to the formation of serotonin from amino acids. Exercise cannot just be done once and fix depression, one has to keep exercising to get the mood benefits. Exercise should be done moderately for at least thirty minutes, outdoors if possible, during the day 3-4 times a week if one is able.
Stress can contribute to mood disorders and depression, so it is important to try and manage stress as much as possible, This can be done using exercise, aromatherapy, meditation, prayer, spending time with loved ones, trying to limit the amount of things done in the day, having time to wind down at the end of the day, and getting adequate sleep. Meditation techniques, such as mindfulness meditation can be useful for stress management and for depression support.
Other alternative therapies that can be incorporated into lifestyle to support depression include cognitive behavioral therapy and interpersonal therapy. These types of therapies are effective in patients with major depressive disorder, both to treat acute symptoms and to decrease the likelihood of relapse. Other therapies include neurostimulation techniques such as electroconvulsive therapy, vagus nerve stimulation, repetitive transcranial magnetic stimulation, and ablative neurosurgery.
In this blog, we have discussed some major underlying causes of suppression as well as ways to support depression through diet, supplementation, and lifestyle modifications. The mind and body are intricately connected so it is important to support our physical health to support our mental health.
References
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