Depression is not a Prozac Deficiency: Underlying Chemistry and Specific NutrientsHyla Cass
As a nation, we are overfed and undernourished. Diets high in refined foods, sugars and unhealthy fats can actually interfere with normal brain chemistry, making modern eating habits a factor in anxiety, depression, ADD/ADHD, and more. Nutritional deficiencies can contribute to chemical imbalances, like anemia and hypothyroidism, which in turn can lead to anxiety, insomnia and depression. People with depression are commonly found to have low levels of, for example, zinc, magnesium, B vitamins, essential fatty acids and amino acids. Indeed, we have seen many studies showing that specific nutrients can successfully treat depression, along with anxiety, attention deficit hyperactivity disorder (ADHD), schizophrenia and even, bipolar illness. A groundbreaking study from Harvard, found that omega-3 fatty acids in conjunction with medication worked so powerfully on bipolar (manic-depressive) illness that the study was interrupted so all the subjects could take them. (Stoll et al, Arch Gen Psychiatry. 1999;56:407-412)
To maintain adequate levels of natural antidepressant chemicals in the brain, I recommend eating plenty of organic vegetables and fruits, whole grains, adequate healthy fats (fatty fish, avocado) and lean protein. Drink lots of purified water, get adequate sleep, and exercise regularly. Research shows that exercise can work as well as medication for mild to moderate depression. Instead of side effects with all of these solutions, there are side benefits!
By no means a comprehensive list of healing nutrients, here are some highlights:
B vitamins Many people, particularly over 65, have vitamin B-12 deficiencies and respond dramatically to injections of the vitamin, which is not well-absorbed as we age. Even sublingual delivery is better than oral ingestion for absorption through the oral mucosa. B vitamins can boost mood by facilitating neurotransmitter production. Other pluses: B vitamins are essential for preventing such conditions as heart disease, cancer, and Alzheimer’s disease. Dosage: Take at least 800 micrograms of folate, 1,000 mcg of B-12, and 25 to 50 milligrams of B-6. A B-complex vitamin should do the trick, and if you’re depressed, take more. Take them in combination to maintain a balance.
Essential Fatty Acids Their benefits are among the best documented. They are part of every cell membrane, and if those membranes aren’t functioning well, then neither is your brain. Dosage: For depression, take at least 2,000 to 4,000 mg of fish oil a day. It should be purified or distilled so it’s free of heavy metals. Since it can oxidize in your body, take it along with other antioxidants, like natural vitamin E (400 IUs a day).
Amino acids as needed: These are the building blocks of neurotransmitters, derived from protein, and include 5-HTP, tyrosine, tryptophan, glutamine, theanine, and SAMe. It’s best to take a questionnaire which when scored, let’s you know what neurotransmitters and thus what amino acids and co-factors you’re lacking. My preferred questionnaire can be found on the nutrition4recovery.com website. Although it’s geared to addiction recovery, in fact it is just as useful for such issues as anxiety, depression and ADD/ADHD, to name a few.
5-HTP (5-hydroxytryptophan) raises levels of the neurotransmitter, serotonin, elevating mood in cases of depression, anxiety, and panic attacks, and relieving insomnia.
Dosage: Start with a low dose, 50 mg once or twice daily. You can quickly increase to 100 mg twice daily and observe.
Cautions: Mild nausea or diarrhea (uncommon)
If you’re taking an antidepressant that also raises serotonin (SSRI, SNRI) take them at least 6 hours apart. While the combination can theoretically produce an overload of serotonin, I have yet to see the syndrome using that time space, and prescribe 5-HTP to ease the withdrawal for those coming off antidepressants.
Tyrosine This amino acid is a building block of dopamine, the neurotransmitter that gives us mental energy, focus, and motivation. Lack of dopamine can lead to a variety of conditions, from depression and ADD to addiction. Dosage: Start with a low dose, 500-1000 mg daily before breakfast. Can be repeated in mid-afternoon, no later than 3 PM or so, since it’s activating.
Cautions: Hypertension in those susceptible. Also, it should not be taken by those with phenylketonuria or melanoma.
St. John’s Wort Best for mild to moderate depression, well -researched with a long, safe history. Dosage: Start on a dose of 300 mg (standardized to 0.3 percent hypericin extract) two to three times a day, depending on severity of depression. It can take three weeks to show benefits.
Cautions: It may interfere with certain prescription and over-the-counter drugs.
SAMe, pronounced “sammy” (S-adenosylmethionine) is an amino acid molecule produced in the body, but can also be taken as a supplement. With many positive findings in European studies, it enhances the production of neurotransmitters and has few side effects or drug interactions. Dosage: Can range from 400 to 1,200 mg a day, though high doses can cause jitteriness or insomnia. Take in the morning on an empty stomach. Cautions: People with bipolar disorder shouldn’t use it without supervision because it can trigger mania.
GABA: Gamma-amino-butyric acid is a calming amino acid, as well as a neurotransmitter, and counteracts the more activating neurotransmitters and stress hormones. Dosage: 250-500 mg twice daily preferably away from food
Cautions: can cause nausea in high doses. Other calming aminos include theanine, taurine, and glycine and are excellent alternatives. You can experiment to see which works best for you.
Rhodiola and other adaptogens: Stress that accompanies such losses as the breakup of a relationship or a job loss can also drain you of important nutrients that support mood and energy– and may produce symptoms of depression. Adrenal support supplements called adaptogens can increase your resistance to a variety of stressors, and enhance overall energy. Useful for mild to moderate depression. Dosage: Take 100 to 200 mg three times a day, standardized to 3 percent rosavin. Cautions: More than 1,500 mg a day can cause irritability or insomnia.
CBD (cannabidiol): More recently on the scene is CBD which acts on the regulatory endocannabinoid system to balance neurotransmitters and is useful for treating stress, anxiety, pain , low mood, hormone imbalance and more. For more information, click here.
This approach requires that the individual be a full partner in their care,
You must be motivated to make what may be pretty daunting lifestyle changes, including shopping for organic food, preparing meals without using a lot of additives, preservatives, sugar, and unhealthy fats, and taking a variety of supplements. This is opposed to the standard of care, taking a daily prescription pill (or more), but we know what the downsides there are.
Even small lifestyle changes, like cutting out processed foods, or adding daily fish oil capsules, can make a big difference. And once started, the process can develop its own momentum. When people start eating better or taking a few supplements, they often feel better. Without much effort, they find themselves dropping sugar, caffeine, alcohol, or whatever they were using for mood control. A balanced brain is a happy, non-craving one!
Those that give the natural approach a chance find that it is ultimately more complete and satisfying, and with more lasting results. A common comment is, “I feel myself again!” Or from a family member, “I have my (son, daughter, spouse) back!”
For more information on using diet and targeted nutrients for a variety of conditions, including but not limited to addiction recovery, see www.nutrition4recovery.com.
For natural approaches to brain and mood imbalances, as well as scientific references on the use of individual nutrients, see the following books:
- Natural Highs by Hyla Cass & Patrick Holford (Avery-Penguin Putnam 2002)
- 8 Weeks to Vibrant Health (Mind Publishing, 2014) by Hyla Cass & Kathleen Barnes
- The UltraMind Solution by Mark Hyman (Scribner, Reprinted 2010)
- Optimum Nutrition for the Mind by Patrick Holford (Basic Health Pub, 2009)