Depression is so taboo in our present culture that it’s almost regarded as an infection disease. Don’t get too close, you might catch it too! In general no one wants to hear about it or discuss it. Unfortunately many believe it is something that someone can ‘just snap out’ of, or exercise and it’ll be gone, or that it is a lack of positive thinking. However, the real story behind depression is very often a deficiency in some key nutrients. Mood, behavior, and mental performance all depend on the balance of neurotransmitters, the brain’s chemical messengers.
Antidepressants are one of the most commonly prescribed medications in the United States to address this chemical imbalance. They have a significant effect on the body, especially in the gut and the brain. Unfortunately antidepressants come with many side effects and dangerous warnings. How can we avoid these or enhance their action in the body and decrease side effects?
What is depression?
There are a variety of types of depression. However, I will focus on the most common types of depression: major depression, also known as clinical depression, and chronic depression, also known as dysthymia. These types are the result of a chemical imbalance in the body, and last longer than a few days.
Signs and symptoms of depression include:
- Ongoing sad, anxious, or empty feelings
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details, and making decisions
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating, or appetite loss
- Thoughts of suicide, suicide attempts
- Aches or pains, headaches, cramps, or digestive problems
Causes of depression
Depression is generally diagnosed as a disorder of the brain, where important neurotransmitters—chemicals that brain cells use to communicate—are out of balance. Neurotransmitters travel around the brain and nervous system and help determine how a person feels. There are hundreds of different kinds of neurotransmitters, the key neurotransmitters, however, in the brain-mood connection are GABA (gamma-aminobutyric acid), works to calm and relax; Epinephrine (aka adrenaline), which is made by the adrenal glands and is the motivator, mostly to stimulate a response to stress; Dopamine and norepinephrine are the ‘feel good’ neurotransmitters, which aid in feeling energized and ‘in control’; endorphins promote a feeling or sense of euphoria (also involved in the ‘runner’s high’); Acetylcholine addresses memory and concentration; Serotonin works both to make happy and calming feelings, improving mood and sleep; and Melatonin helps with circadian rhythms, helping with sleep.
Seeing the action of each of these neurotransmitters in the brain can show how any one being out of balance can create feelings of depression, sadness, anxiety, sleeplessness, irritability, lack of motivation, concentration, and/or interest. Depression can set in with there’s a state of good neurotransmitter starvation. Loss of neurotransmitter production can occur in a number of ways, primarily by not getting the correct nutrients to feed production of these neurotransmitters. Other factors and risks involved are eating a poor diet (high in sugar, caffeine, processed foods, low protein, low fat), chronic stress (saps nutrients), not getting enough exercise, genetics (base-line brain chemistry can be inherited), not enough light in the evenings or winter, gender (women are twice as likely to get depression than men), age (elderly are more likely), triggers such as traumatic events, health conditions (cancer, heart disease, thyroid, chronic pain, diabetes), drugs (medications, alcohol, birth control pills, etc.).
There is yet another source of depression, and that source is in the gut. Often the gut is forgotten in mood disorders. Alcohol is an example of a direct brain-gut connection, in which the gut aspect is often forgotten or dismissed. Alcohol is widely understood to have effects on the brain and nervous system, and its connection is very simple: it is ingested into – dramatic pause – the gut. If the gut is unwell, it will affect the rest of the body. Leaky gut, for example, is a common gut dysfunction that can affect the brain and, for example, show up as depression.
What is leaky gut? Leaky gut syndrome is a problem with intestinal permeability. Food particles, toxins, and bacteria are able to get past the intestinal wall cells, causing an increased immune response. This enhanced immune response is may lead to chronic inflammation ultimately increasing the risk for a number of illnesses—including depression. In addition, some of the toxins produced by bacteria and yeast are very toxic, especially to the nervous system (lipopolysaccharide). Antidepressants have the potential to further exacerbate the gut dysfunction.
Conventional treatments for depression generally include antidepressant medications, psychotherapy, electric shock treatments, and cognitive behavior therapy. The most popular kind of antidepressant, the serotonin reuptake inhibitor (SSRI), acts by increasing the action of serotonin in the brain.
Side effects. There are a myriad of warnings that come with these medications and many unknowns about taking long term. Because the majority of the serotonin in our bodies is produced in the gut (approximately 80%), any medication affecting the action of serotonin is going to have an effect on the gut. Common side effects of SSRIs include diarrhea, sinus infections, upset stomach, vomiting, flattening of emotion, loss of libido and inability to perform sexually and/or attain orgasm, suppressed rapid eye movement (REM) sleep (the rejuvenating sleep, needed for a well-functioning endocrine and nervous systems), headache, nausea, stomach upset, loss of appetite, agitation, insomnia. In rare cases SSRIs they have shown to cause suicidal and violent thinking and behavior.
Antidepressants affect the brain and the digestive system; again, because of the gut-brain connection. Deliberately altering serotonin levels can cause a wide range of unwanted effects, especially in the gut with many digestive side effects (diarrhea, constipation, stomach ache, dry mouth, nausea). There haven’t been enough studies to show long term use side effects, but some have reported growing evidence of long-term use in adults being linked to bleeding in the gut and increased risk of stroke.
Alternative protocols for depression generally include supplements, addressing gut dysfunction, whole-foods diet, and lifestyle changes.
- A healthy intestinal environment: address gut dysfunction.
- Avoid nutrient robbing foods and substances.
- Eat the right nutrients for good brain chemistry.
- Identify and reduce causes of stress in the body.
Nutrition can have a significant impact on the neurotransmitters. Protein, especially, is needed for proper neurotransmitter function. The protein consumed is broken down into amino acids, specifically for brain function, are: tryptophan, tyrosine, GABA, glutamine, taurine. These amino acids are turned into the important neurotransmitters, with some help from cofactors vitamins B3, B6, folate, B12, and C, and minerals zinc and magnesium. Essential fatty acids and glucose are also key components to make this all happen.
Tryptophan has an uphill battle to fight to get to the brain to make these feel good neurotransmitters. First, there needs to be enough in the diet. Second, it has to get through the amino acid-selective gateway of the blood brain barrier (BBB). Third, it is a relatively small amino acid, so it has a harder time than other amino acids getting through the BBB, and needs help. There are many supplements that can help, such as 5-HTP, which is derived from tryptophan, which is converted (with vitamin B6) into serotonin.
Glucose is fuel for the brain. Complex carbohydrates are the best option for assisting tryptophan through the blood brain barrier. Complex carbohydrates are also a brilliant nutrient-dense package of important phytonutrients and fiber—helping to stabilize blood sugars in addition to providing needed nutrients. Refined sugars, grains, processed foods offer quick sugars, which the brain will quickly gobble up. However, the sugar highs from these quickly dissipate (sugar lows) and the brain wants more, which can quickly lead to blood sugar imbalance and mood swings. A deficiency of amino acids, especially, can elevate sugar cravings.
Lifestyle & the gut: We live in a very fast paced world and are constantly subjecting our bodies to an excess amount of stress (which stimulates our fight or flight nervous system—and cortisol—not allowing our digestive nervous systems to work) that it’s not equipped to handle. Cortisol and serotonin have an inverse relationship. The higher the stress and cortisol output, the lower the serotonin levels will be. Anything from a mountain lion attacking, to emotional stress to eating too many carbs/sugar causing blood sugar imbalances to going to bed late can cause this stress reaction. Stress is cumulative, as is its effect on the body. Find ways to reduce stress and breathe (breathing helps release stress and lowers blood pH, literally riding our body of acid): meditation, yoga, quiet walks, massage, exercise. Yoga specifically, has a three-fold approach toward mind-body balance: it involves meditation with physical postures, breathing techniques, and relaxation. Exercise is also an important element in healing depression. Different types of exercise (walking, running, dancing; cardiovascular and strength training) can lower stress, help relax, help reduce symptoms of depression, and increase serotonin naturally in the brain.
Nutrients to help depression
Nutritional therapy can work better than most anti-depressants for a number of reasons. However, antidepressants should never be quit cold-turkey, there can be serious side effects to abruptly ceasing these meds. Working with a physician to decrease the dosage and adding in nutritional therapy can be the most effective means to get off the medications and restore balance.
Supplementing is two-fold, one part making sure there’s a good foundation and the other part is addressing deficiencies that generally accompanying mood conditions. Because there are a lot of supplements to take, a daily chart to keep track of supplements and when to take them is advised.
- Tryptophan rich foods: 20-30g of protein per meal from sources such as turkey, beef, pork, dairy products, chicken, salmon, halibut, cod, and eggs. Vegetarian sources: nutritional yeast, pumpkin seeds, nuts, and seeds
- Complex carbohydrates: potatoes, yams, beans, quinoa, lentils, broccoli, squashes, root vegetables.
- Probiotics will help restore a healthy gut, and concurrently stronger immune system: kefir, kombucha, fermented vegetables.
- Eat regularly, don’t skip meals, this will help keep blood sugar levels balanced and provide a reliable and even amount of nutrients to feed the brain.
- Breakfast really is the most important meal of the day. It sets up the body’s metabolism for the day and gives the brain a jump start on producing healthy neurotransmitters.
- Eat a carbohydrate vegetable with proteins at every meal to help the tryptophan through the blood brain barrier.
Avoid the following as they will deplete nutrients needed for the brain and a healthy gut.
- Refined sugar, syrups, powders. Sugar will perpetuate low serotonin levels and systemic inflammation.
- Bad fats, aka highly processed fats: hydrogenated, synthetic, or highly altered fats (trans fats), vegetable oils, margarine, corn oil, soy bean oil. These fats harm the body and brain, by creating carcinogens that oxidize LDL cholesterol, damaging cells.
- Processed foods (nutrient void) and food additives: artificial flavorings, dyes, artificial sweeteners, MSG, caffeine, diet sodas, chocolate. These can contribute to irritability and mood instability. They also deplete melatonin, B vitamins, vitamin C, potassium, calcium, and zinc.
Depression is a difficult topic to discuss for many, taboo even, making solutions even harder to find. It is very easy to walk into a doctor’s office and get prescription for antidepressants. Nutritional protocols can offer alternatives to antidepressants and a much healthier way to bring the brain back to balance from depression. It is a tough road, but there is hope of getting off or avoiding antidepressants for good. Healing the gut, addressing stressors, nutrient deficiencies, and increasing good brain-chemical nutrients are keys to bring about balance. Time, patience, and persistence can be invaluable tools in concert with this nutritional protocol to bring about balance.