Depression is NOT Prozac Deficiency
By Sarah Axtell, ND • December 30, 2013
The World Health Organization (WHO) estimated that by the year 2020, depression will be the second largest cause of suffering (second to heart disease).
As a naturopathic doctor, my role is to identify and address the underlying cause of one’s illness. In the case of depression, anti-depressant medications can be a band-aid approach. There are many possible biochemical and functional underlying causes. Dietary interventions along with healing the gut and nutrient supplementation have proven to be effective in cases of depression.
Low mood, Low cholesterol
Our brains are the fattest organ in the body. In fact, it is made up of 60% fat. We need to obtain 30% of that fat from our diets. A low fat diet high in inflammatory carbohydrates is linked not only to depression but also to autism, ADHD, tic disorders, migraines, and schizophrenia.
Statin medications too commonly prescribed for high cholesterol increases one’s risk of depression, dementia and Alzheimer’s. Studies show a connection between low cholesterol and depression, suicide and violence.
For optimal brain health and a stable mood, eat plenty of healthy fats, such as eggs, olives, coconut, avocados, nuts, seeds, fish, and grass-fed meat. Avoid trans fats, margarine, and vegetable oils, such as canola oil, safflower oil, and sunflower oil. Vegetable oils are highly processed and create inflammation in the body.
Gluten’s Effects on the Brain
There is a significant overlap between celiac disease and depression. In fact, 1/3 of all patients with celiac disease also have depression. You do not have to have celiac disease to experience this. Patients with gluten sensitivity often tell me they get the “gluten blues” or a depressive state after eating gluten. Gluten sensitivity is just as much a neurological disease as it is a gastrointestinal disease. There is a physiological explanation for such an effect on the brain.
In a gluten sensitive individual, the body reacts to the gluten protein as if it were a foreign invader. This ignites the immune system in an attempt to get rid of the protein or reduce its effect. But the protein to which those with gluten sensitivity are reacting is very similar to other proteins found in the body, including those in the brain. The body then becomes confused, and the immune system attacks the brain and nervous system. This results in inflammation and irritation that, in turn, causes depression and anxiety. This immune system attack to gluten also causes inflammation in the gut, which precludes the absorption of essential mood-boosting nutrients.
The Role of Nutritional Supplementation in the Treatment of Depression
Several nutrient deficiencies are implicated as a causal factor in depression:
- Amino acids (AAs): AAs are the building blocks of neurotransmitters. AA availability for neurotransmitter synthesis is dependent upon digestive enzymes and their activation of HCl in the stomach. So if there is inadequate HCl in the stomach, your body is not able to produce these important building blocks. Supplementation with free form AAs is more effective because they are already broken down and thus easily absorbed.
- Amino acid precursors, such as tryptophan and 5HTP have the following effects on the brain: positive mood; relaxation and calming; and healthy eating behavior.
- B vitamins, most notably B12: B12 deficiency has a profound impact on the brain, resulting in irritability, apathy, personality changes, depression, memory loss, dementia, and violent behavior. If you ask your doctor to test you for B12 deficiency, he/she will likely order a serum B12, which is an inaccurate representation of actual B12 status. Intracellular micronutrient testing (Spectracell labs, available at Lakeside Natural Medicine) is a more sensitive evaluation of your B vitamin status.
- Zinc: Low Zinc levels have been linked to major depression, and Zinc treatment has been shown to have an antidepressant effect.
- Folate: Inadequate intake of folate-containing foods, malabsorption, genetic defects (MTHFR) and medications (birth control pill) are all to blame for folate deficiency. Patients with an MTHFR defect reduce efficiency of folic acid metabolism. Patients with this all-too-common genetic defect have a 1.36 times greater chance of developing depression. Ask your Naturopathic Doctor to test you for this MTHFR defect. With supplementation of the proper form of folate, depression can successfully be reversed.
- Essential Fats: Every aspect of neurotransmitters and brain health involved adequate functioning of omega 3s. Inflammation research studies suggest that levels of omega-3 fatty acids may directly influence the magnitude of the inflammatory response to stress and depression. Aim for at least 3 grams of total omega-3 fatty acids daily.
Supporting Your Second Brain In Addressing Depression
Your gut is often termed your second brain. The nerve cells in your gut produce 90% of your body’s serotonin (your “feel good” neurotransmitter). If your gut is inflamed from poor food choices and/or food sensitivities (most commonly gluten), your production of serotonin will be compromised.
My 4R Approach to Gut Healing includes:
1. Remove– Remove the following highly inflammatory foods:
These foods can create inflammation in your gut lining, causing loose junctions in between cells of the GI tract. This is characteristic of leaky gut syndrome. Remove these foods for a minimum of 4 weeks, and then re-introduce one food group at a time and monitor symptoms. Alternatively, there is food sensitivity testing available that identifies your individual sensitivity. When multiple foods come up as reactive on a food sensitivity panel, the gut is likely leaky.
2. Reinoculate the gut with a high quality probiotic.
3. Replace- Once the gut has been cleaned up, we want it to stay that way. Supplement HCl or Apple Cider Vinegar. Consider digestive enzymes. Liver and gallbladder support (especially if gallbladder has been removed) is also important.
4. Repair– Repairing leaky gut is a long road that requires patience and persistence.
Licorice, L-glutamine, flavonoids, aloe, slippery elm, and marshmallow root are all soothing herbs and nutrients that repair the lining of the GI tract.
Weaning off Anti-depressants
Talk to your naturopathic doctor about some of these possible underlying causes of your depression. Dr. Axtell is happy to collaborate with your prescribing physician to create a plan for you to safely and effectively taper off your medication.
Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.