Non-Pharmacological Approaches to Treatment for Depression
Depression is a common condition characterized by depressed mood, fatigue, insomnia, or excessive sleeping, feelings of worthlessness, difficulty concentrating and in some cases suicidal ideation or suicide attempts.
The cause of depression is not fully understood, but it appears to involve psychosocial stressors, genetics and biochemical factors. The biochemical abnormalities include deficiency or decreased activity of serotonin, norepinephrine, and possibly other neurotransmitters.
Conventional therapy for depression include psychotherapy and antidepressant medications.
Natural Treatments for Depression
Nutritional, hormonal and herbal treatments have been found to be effective in treatment for depression. In many cases, the results may be equal or better than those achieved with conventional drug therapy, while causing few adverse effects. In some cases however, antidepressant medications are clearly more effective than natural treatments.
Diet: Elderly are at high risk of suboptimal nutrition especially those with various illnesses. For example certain amino acids are essential for the production of certain neurotransmitters like serotonin. One study of elderly hospitalized patients given a protein drink with micronutrients improved in their symptoms of depression.
Reactive Hypoglycemia: Once discovered, individuals with this condition can improve dramatically with a diet designed to stabilize blood glucose levels. Prior to diagnosis, patients with reactive hypoglycemia typically experience worsening of their depressive symptoms in the late morning or late afternoon (before mealtimes), and an improvement after eating. They tend to crave sweets and report a transient improvement with sugar ingestion, followed by an exacerbation of symptoms.
Food Allergy: A number of investigators have reported that allergic reaction to foods can cause depression in susceptible individuals. They usually demonstrate other manifestations of allergy like eczema, migraines, asthma or runny nose.
Fructose and Lactose Malabsorption: An association has been observed between malabsorption of fructose and or lactose and the presence of depressive symptoms.
It has been suggested that malabsorption of sugars form complexes with tryptophan in the GI tract, potentially inhibiting its absorption, and thereby decreasing the availability of tryptophan for serotonin (the happy hormone) synthesis. Studies have shown that patients with depression related to malabsorption of fructose or lactose, GI symptoms and depression improved on a diet free of lactose and fructose.
Caffeine: An observational study of 83 adults in a psychiatric hospital who consumed large amounts of caffeine (750mg/day) had higher depression scores than those who consumed less. More research on this subject is needed however.
Alcohol: Excessive alcohol consumption is frequently associated with depression. It may cause depression through a direct toxic effect or indirectly by promoting the development of nutritional deficiencies.
Aspartame: the artificial sugar sweetener aspartame has been reported several times to be a cause of depression. Animal studies suggest that the mechanism may be by the inhibition by aspartame of glucose-stimulated uptake of tryptophan into the brain. Aspartame is present in most diet sodas.
MSG: monosodium glutamate. A single case report of MSG ingestion was the cause of recurrent episodes of severe depression.
Nutritional Supplements: Multiple studies demonstrate the efficacy of supplements like l-tryptophan and omega three fatty acids to name a few.
Hormones: Thyroid hormone deficiency can commonly present with depression. Treatment with thyroid hormone frequently relieves the depression (please see my section on thyroid hormone). Often patients demonstrate normal levels of thyroid hormone on blood tests, but treatment with the hormone relieves the depression. DHEA is an adrenal hormone. Several studies have found that lower circulating levels of DHEA-Sulfate (DHEA-S) were associated with an increase in frequency or severity of depression.
Melatonin: is a hormone produced while asleep. Levels decline with age. In double-blind trials, administration of 3mg/day of melatonin at bedtime for 6 months improved symptoms of morning depression. It may also improve menopause-related depression possibly by increasing thyroid hormone levels and enhancing ovarian function.
Candidiasis: If the patient usually female has recurrent yeast infections along with depression, a trial of a candida elimination program is in order. Some practitioners have reported that a chronic candida infection can cause depression.
Environmental Factors: several practitioners have reported environmental exposures as a cause of depression, i.e., natural gas and combustion products of gas, oil, and coal. Today outgassing of plastics and other newer petrochemical byproducts should also be viewed as potential contributing factors. Heavy metal burden like lead and mercury (though no research to support this), may also be a strong environmental factor. In my clinic testing and treating for heavy metals can sometimes be useful in depression.
At my clinic:
The patient with depression gets a full work up including history and testing for hormones like thyroid, dhea-s, nutrient analysis like tryptophan, iron, B-vitamin levels, food allergy testing. A trial of elimination diet is also in order. In doing so, the patient can discover if certain foods or drinks (like alcohol, caffeine, sugar, fructose, lactose, msg) are culprits. Testing for hypoglycemia, candida and heavy metals if the history is suggestive. Empirical treatment with the Meyer’s cocktail (IV vitamin push) can offer impressive improvements with some patients, and similarly the vitamin-B12 shot.