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Relaxing in a chairWe all have times when we feel sad or down, but when symptoms of hopelessness, indifference, insomnia, anxiety, fatigue, weight changes, headaches and muscle pain become persistent (usually defined as greater than 3 months), a person could be suffering from a medical illness known as depression. If you think that you may be depressed, it is time to take a closer look at what you are putting into your body, because symptoms can be exacerbated by medications such as anti-hypertensives, estrogens found in birth control pills, steroids, and antianxiety drugs. Dietary factors that affect depression include food sensitivities, vitamin deficiencies, alcohol, caffeine, the artificial sweetener aspartame, and foods with simple sugars. It is important to realize that depression is caused by more than just one etiology, and that addressing this illness early with your medical provider ensures the most success for treatment. 

Depression affects approximately 14 million Americans per year, and it is estimated that by 2020, depression will be the leading cause of disability worldwide. This medical condition affects women twice as much as men, and two thirds of people who have had depression before will have at least a second episode in their lifetime. What is interesting to know is that about 30 percent of patients who suffer from depression do not benefit from, or cannot tolerate antidepressant medication due to unpleasant side effects such as weight gain, lack of libido, and waves of anger or anxiety. Alternative treatments include supplements, adding or eliminating certain foods, acupuncture,Transcranial Magnetic Stimulation,and stress reduction techniques.

Deficiencies that are linked to depression include B complex vitamins (especially B6 and B12), Vitamin C, Vitamin D and folate. A study involving food sensitivities also showed that by-products from incomplete digestion of dairy products, cereal grain proteins, and other dietary factors lowers the brain chemicals serotonin, dopamine, and norepinephrine that are all involved with stabilizing mood. With this in mind, there are foods and supplements to consider.

Increase these foods:
1. Foods that are high in DHA and EPA, the omega-3 fatty acids found in fish such as salmon, sardines and seafood. The omega-3’s have been shown to help improve depression by affecting cell membranes in the brain and improving blood flow.
2. Saffron – a study showed than men with depression took 30 mg per day and had similar benefits as taking prozac.
3. Folate-rich foods such as bananas, lentils, chili peppers, tempeh, liver, turkey, and tuna.
4. Foods rich in Vitamin D such as herring, tuna, salmon, mackerel and eggs.
5. Taking a balanced multivitamin/mineral supplement can help combat symptoms of depression. Important minerals such as calcium and magnesium help to improve relaxation and sleep. Supplemental zinc, manganese and L-amino acids also aid in increasing energy levels, and iodine supports healthy thyroid function.

Supplements for Depression: (These are not intended for treating bipolar disorder)
1. 5HTP- This is a precursor to serotonin and can help with symptoms of depression, as well as improve insomnia. It has also been shown to reduce migraines and help with carbohydrate cravings. Do not take this supplement if you are already taking an SSRI (selective serotonin reuptake inhibitor), are pregnant or nursing, or have significant cardiovascular disease. Do not take this supplement if you are already taking St. John’s Wart.
2. St. John’s Wart- Hypericum is the active ingredient in this supplement and has shown encouraging benefits in treating depression. In a study conducted by top homeopathic researchers in Germany, hypericum was as effective as a single antidepressant, and 1.5 times as effective as combination antidepressants. Hypericum also had fewer side effects compared to the most commonly prescribed antidepressants.
3. SAM-e (S-Adenosinemethionine)- This supplement is still being studied as a beneficial treatment for depression. SAM is a substance that is required by the adrenal glands to produce epinephrine. A study conducted at a hospital in Boston showed improvement of depression symptoms, but it caused side effects such as diarrhea and anxiety.
Other supplements taken address specific aspect of depression, such as valerian and hops to improve insomnia, kava kava to treat anxiety, ginseng to help with energy, and Siberian ginseng to cope with stress. Make sure to talk with your medical provider before starting an over the counter supplement in order to avoid medication interactions or contraindications.

Lifestyle changes for depression:
1. Correct vitamin deficiencies and address food sensitivities
2. Talk with your medical provider about medications you are taking, and if they could be contributing to depression.
3. Avoid or minimize the ingestion of caffeine, alcohol, aspartame, and simple sugars
4. An exercise program that will help reduce stress, improve sleep, and will be fun in order to stay motivated!
5. Address sleep disorders
6. Cognitive therapy
7. Counseling
8. Acupuncture
9. Massage as well as relaxation therapies such as Meditation or Yoga

Medication-free treatment:
In October of 2008 the FDA approved a new treatment called NeuroStart TMS Therapy (Transcranial Magnetic Stimulation). It is prescribed/administered by a psychiatrist, and involves the delivery of MRI strength magnetic pulses to the areas of the brain that control mood. It allows the patient to be awake during the procedure, does not cause seizures, and it is an outpatient treatment. The typical duration of treatment is approximately 40 minutes 5 times per week over a 4-6 week period.
Keep in mind that in addition to medications and diet contributing to symptoms of depression, this illness has many etiologies. These include genetics, illness, thyroid disorders, external stressors such as employment, finances, family responsibilities, the death of a loved one, and even daylight savings! Having a comprehensive plan with your medical provider to treat depression at the earliest time of onset will help you achieve a quicker recovery and prevent relapses.
A good website to learn more about depression, its symptoms, types, and resources is www.depressionatoz.com .


Written by Dr. Allison Helms, GreenLite Medicine Physician

References:
1. “Staying Healthy with Nutrition” by Elson M. Hass M.D.
2. “Chef M.D.’s Big Book of Culinary Medicine” by John La Puma, M.D.
3. www.Medicalnewstoday.com
4. www.about.com
5. www.everydayhealth.com

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