By Pina LoGiudice ND, LAc and Peter Bongiorno ND, LAc Directors of Inner Source Health
While everyone experiences “the blues” from time to time, depression is a kind of low mood that can affect a person’s ability to effectively live and enjoy life.
Depression impacts about 120 million people worldwide, with about 6% of men and 9.5% of women experiencing this condition. The World Health Organization predicts depression to become the second most burdensome disease by 2020, which means it will cost society, in terms of medical care, sickness and days lost from work, more than every other condition except heart disease.
“My Depression Drug Is Not Working and It’s Making Me Fat.”
If you feel your medication is not really helping, and is causing unwanted problems like weight gain and low sex drive, you are not alone.
As one of the most well prescribed types of drug of all time, over 160 million antidepressant prescriptions are written annually, despite the fact that a 2010 study in the Journal of the American Medical Association revealed antidepressants to be no more effective than placebos (sugar pills) in most cases of depression. Anti-depressants are shown to be helpful in the minority of very severely depressed cases, and should be used when needed for these cases.
Studies also show that antidepressants can cause a laundry list of side effects, including sexual side effects, fertility problems, increased weight gain and diabetes risk, blood-pressure problems, increased heart attack risk, heart defects in unborn children – even increased desire to commit suicide.
The Naturopathic Advantage for Depression
The reason why antidepressants do not work in most cases of depression is because these drugs target only one aspect of this complex condition: neurotransmitters, the brain's "mood molecules." When “feel-good” neurotransmitters like dopamine, epinephrine and serotonin are low, artificially raising the levels with the drugs can sometimes help in the minority of the most severe cases.
Unfortunately, depression is a multi-factorial issue. While conventional medicine focuses only on neurotransmitters, naturopathic and holistic medicines are at an advantage to treat the many factors that contribute to depression:
- sleep and lifestyle issues
- lack of exercise
- poor diet choices and poor digestion
- inflammation in the body and the brain
- hormonal imbalances
- stress and spiritual issues
- nutrient and healthy oil deficiencies
- environmental toxicity
Case Study: Lenore
For example, one very depressed and anxious 48-year-old patient we will call “Lenore” came to our office after she had tried five different antidepressants over a three-year period. After listening carefully to her story and asking for some testing, we learned her thyroid was working sub-optimally, her vitamin D, B12 and iron was low, and her early life experiences produced negative thought patterns that did not allow her have a more positive outlook.
To help, we gave her some essential fatty acids, vitamin D, B12 and iron, as well as thyroid support. We worked on her digestion in order to allow better nutrient absorption. We also prescribed 100mg of 5-HTP twice a day (more on this later), recommended acupuncture, and she also started to work on her negative thought patterns. Her depression lifted in about one month after starting treatment, and she no longer needed medication. For Lenore, no one recommendation might have worked, but all of them together did the job.
A naturopathic physician, or other well-trained holistically minded doctor, will work with all these factors to truly create an individualized solution to the menace that is depression.
Nutrients and Herbs for Depression?
There are many wonderful and safe nutrients and botanical medicines (herbs) that can help with low mood. For this article, we are going to focus on a few nutrients that we have seen to be very useful, and sometimes miraculous to help our patients who are suffering from depression. Of course, it is very important to remember that if you are not looking into the many factors listed earlier to address the underlying causes of depression, these nutrients or herbs alone may not do the trick.
Also, if you are taking antidepressant medications, you should always check with your prescribing doctor before changing your medication dosage, or using these supplements along with your medications.
St. John’s Wort for Low-Level Depression
St. John’s wort is the most studied herb of all time. It’s Latin name Hypericum perforatum means “above a ghost” and the plant was originally gathered as a way to ward off evil spirits. Rigorous studies have shown St. John’s wort to be quite useful in treating depression illness. While early researchers thought St. John’s wort worked like a weak version of an antidepressant drug, current research suggests that St. John’s wort has many effects on both the brain and the body. St. John’s wort is known to help digestion, act as an antiviral, has anti-inflammatory properties and supports thyroid function. It also gently balances the neurotransmitters GABA, norepinephrine, serotonin and dopamine.
In our practice, we find depression sufferers who have a long-term chronic type of depression called dysthymia often do the best with this herb. If you can get out of bed and function at a job, but are just generally still low in mood, self-esteem and zest for life, this may be a good herb for you.
You can take St. John’s wort in capsule, as a tea, or as a liquid extract, which is a concentrated form of the herb. It is usually dosed in capsule form at 900 mg to 1800 mg a day in divided doses.
Please note St. John’s wort can affect the effectiveness of other medications. Two studies show it can help the drug Plavix work better in people for whom it did not initially work. Other studies show it can lower the effects of birth control pills and immune suppressants. So, if you are taking medications, check with your doctor or pharmacist before using St. John’s wort.
Saffron: Spice Up Depression and Help Digestion
Saffron is a well-known Persian spice used for its ability to help the digestive system heal. Because most neurotransmitters are made in the digestive tract, this might be the reason saffron has been shown in studies to elevate low mood. As the most expensive spice, it is high in carotenoids and B vitamins. In studies, saffron has been compared to both Prozac and Imipramine, and found to work at least as well, or better, with less side effects.
While the petal is the expensive part of the herb, you can also take capsules of the stigma part of the plant, which is less expensive, but still contains the powerful mood-enhancing ingredients. Studies use a dose of 15 mg twice a day. No toxicity has been shown when taking saffron in therapeutic amounts or in cooking.
5-HTP for Depression With Anxiety
5-hyrdroxytryptophan (5-HTP) is an amino acid found in low amounts in foods like turkey and bananas. 5-HTP is the molecule the body uses to make serotonin, a molecule that helps elevate mood. While many antidepressants artificially stop the production of enzymes that breakdown serotonin, 5-HTP gives the body more of the raw materials it needs to make more serotonin. 5-HTP is very good at crossing the blood brain barrier, which means it is a molecule that can get into the brain to help achieve a needed change in brain chemistry.
5-HTP is best used with someone who has both depression and anxiety. It is also an effective choice for people who have insomnia and cannot stay asleep. Finally, there is some research that suggests it has benefit with weight loss.
While there are no known toxicities of 5-HTP, some people can get a little nausea when taking 5-HTP, so it helps to take it with some carbohydrate, like a slice of apple, which will also help its absorption. We often dose it at 100 mg twice a day, up to 200 mg three times a day.
SAMe for Depression With Aging and Pain
SAMe stands for S-adenosylmethionine, and is a naturally occurring chemical in the body based on the amino acid methionine; it helps boost a number of neurotransmitters. SAMe also helps with healthy nerve conduction as well. It also has been shown to be helpful with patients who have arthritis and joint pain.
We love SAMe as it tends to work quickly, often lifting mood within days rather than weeks, whereas most other supplements and drugs take longer.
It has been shown to be very useful for Parkinson’s Disease patients with depression, and some studies suggest it may be most beneficial in the senior population. Other studies show it to be safe for children too, and preliminary research shows it may be safe in pregnancy, though more research is needed.
Dosing for SAMe starts slowly. Usually, we recommend a dosage of 200 mg twice daily, for the first day, then increase to 400 mg twice daily on day three, then to 400mg three times daily on day 10, and finally to the full dose of 400 mg four times daily.
There are many natural options for depression from the natural medicine world. Addressing underlying lifestyle, diet, digestive and psychological causes is very important for long-term results. Using St. John’s wort, saffron, 5-HTP or SAMe can be a healthful and effective part of healing from depression.
Reference Source: Dr. Peter Bongiorno’sHealing Depression: Integrated Naturopathic and Conventional Treatments. CCNM Press. Toronto, Canada. 2010.