Vitamin D for Depression

I typically place depressed patients on a starting dose of 2000 IU’s of vitamin D, check their calcium and vitamin D levels and then decide if the dose should go up or down from there. I have seen great response to vitamin D especially in those that are low. Most people that live in the northern lattitudes like Seattle will be low on vitamin D.

Out of the hundreds of patients I have checked, I have only found one person in Seattle that had a normal vitamin D level. Repleting deficiency is imperative, as this vitamin that is now considered a “pro-hormone” may have more of a role in the physiology of the body than we are currently aware. Overdosing on vitamin D can result in a life threatening case of hypercalcemia as vitamin D and calcium absorption are interrelated.

Do NOT take more than 1000 IU of vitamin D without being monitored by your doctor. Although the active form of vitamin D in the body is 1, 25 cholecalciferol the best test for vitamin D levels is 25-D-OH, ask your doctor to do a basic metabolic panel and check your vitamin D, pre-treatment, a month out, 3 months out and so forth. If you are deficient in vitamin D and start a 2000 IU daily dose it will take about 1 week to raise your vitamin D levels 1 point.

So if your level is 16 and you need to get to 60, it will take about 44 weeks to get you back to the normal range. You are better off doing this gradually in my opinion as we do not want to cause atherosclerosis (hardening of the arteries) by hypercalcemia from taking large doses of vitamin D at once. Other naturopaths may be willing to dose you up really high, but I am completely against it, until we have more research supporting the safety of this fat soluble vitamin that stores in the body. Be sure to use vitamin D3 (cholecalciferol) in an emulsion form, because vitamin D2 is just crap, and not worth your time taking.

SAMe and Depression

S-adenosyl-Methionine (SAMe)- A natural amino acid anti-depressant that is part of the homocysteine metabolism pathway and serves the role of “methylating” neurotransmitters. As
A very great natural anti-depressant is SAMe. This should NOT be used by those with bi-polar as it has been shown to cause manic outbreaks.

How does SAMe work?

SAMe converts to S-adenosyl-homocysteine it donates “methyl” groups (CH3) to the nervous system so that it can effectively produce neurotransmitters such as serotonin, dopamine, and catecholamines that make us feel GOOD and HAPPY. This natural anti-depressant is also a great detoxifying agent for the body as it activates phase II detoxification pathways in the body.

SAMe for Detox

If you are recovering from alcoholism or drug abuse this may be the better choice of natural anti-depressants, however it should not be used by those that suffer from bipolar because of it’s ability to increase catecholamines and may trigger a manic episode. I would stick with St. John’s wort or 5-HTP for those susceptible to manic or hypomanic episodes. Do NOT combine with prescription drugs. Typical dose of SAMe is 50 mg once to twice daily. Always take SAMe with magnesium for optimal methylation of neurotransmitters, and a multi-vitamin as the B-vitamins folic acid, B-6, and B-12 are necessary for preventing homocysteinemia, a potential consequence of consuming elevated levels of SAMe. Homocysteine is correlated with cardiovascular damage and B-vitamins will ensure it’s conversion to an inert substance.

A natural amino acid anti-depressant that is part of the homocysteine metabolism pathway and serves the role of “methylating” neurotransmitters. As SAMe converts to S-adenosyl-homocysteine it donates “methyl” groups (CH3) to the nervous system so that it can effectively produce neurotransmitters such as serotonin, dopamine, and catecholamines that make us feel GOOD and HAPPY. This natural anti-depressant is also a great detoxifying agent for the body as it activates phase II detoxification pathways in the body.

If you are recovering from alcoholism or drug abuse this may be the better choice of natural anti-depressants, however it should not be used by those that suffer from bipolar because of it’s ability to increase catecholamines and may trigger a manic episode. I would stick with St. John’s wort or 5-HTP for those susceptible to manic or hypomanic episodes. Do NOT combine with prescription drugs. Typical dose of SAMe is 50 mg once to twice daily. Always take SAMe with magnesium for optimal methylation of neurotransmitters, and a multi-vitamin as the B-vitamins folic acid, B-6, and B-12 are necessary for preventing homocysteinemia, a potential consequence of consuming elevated levels of SAMe. Homocysteine is correlated with cardiovascular damage and B-vitamins will ensure it’s conversion to an inert substance.

5-HTP and Depression

Now most studies have been done on tryptophan, but because of past contamination issues it is tough to get your hands on tryptophan except through diet. 5-Hydroxy Tryptophan is just the new and improved tryptophan, and is a better therapeutic agent in my opinion because it is a biochemical step ahead of tryptophan in the production of serotonin, passing the “rate limiting step” that tryptophan fails to do. This means that 5-HTP can only feed forward in to serotonin and not go backwards in to something else.

With that being said this medicine can be a bit expensive, but is certainly worth a try! Do NOT combine this natural anti-depressant with prescription anti-depressants. I typically prescribe about 250 mg of 5-HTP on an empty stomach once or twice daily. This is pretty mega considering that most capsules start at 50mg, but the 200mg to 300mg range is what appears to work best.

5-HTP is also beneficial for insomnia, pain syndromes, schizophrenia, anorexia and bulimia, PMS, and migraine headaches. Excess tryptophan in the body is converted to serotonin (makes us happy) and melatonin (makes us sleepy). So if you have depression with insomnia this should work well for you.

Snacks for Depression

The recipe for success with depression is to pair light proteins such as vegetable proteins, turkey, nuts, or white cheeses with a high fiber friend such as a fruit, vegetable, or a whole grain choice.

These foods also are typically rich in calcium and magnesium, minerals that serve to relax the nervous system and alleviate muscle tension.

Think of cottage cheese as your "drug of choice" for boosting these amino acids. Be sure to always combine light proteins with high fiber foods to stabilize your blood sugar as I have discussed in the The Low Glycemic Index Diet.

Some simple snack ideas:

• Cottage cheese and fruit.
• A string cheese and a few whole grain crackers.
• A small serving of salmon and brown rice.
• A bowl of oatmeal with almonds.
• Yogurt, fruit, and wheat germ.
• Granola and yogurt.
• Peanut butter on whole grain toast.
• One egg and a piece of whole grain toast.
• A fruit smoothie with protein powder.
• A small bowl of high fiber cereal and milk.
• A handful of raw cashews, peanuts, or other nuts.
• Half an avocado and whole grain chips.
• Half a turkey sandwich on whole grain bread.
• 3 tablespoons of hummus and veggies or a few whole grain chips.
• 2 tablespoons of cashew butter and celery decorated with raisins.
• Rice cakes and cashew or peanut butter.
• Almonds and apple slices.
• 3-6 tablespoons of freshly ground flax seeds mixed with applesauce or yogurt.

Resource: http://KitchenTableMedicine.com

Recommended Reading: Sleep, Stress, The Low Glycemic Index Diet, Hypoglycemia, Fiber, Amino Acids and Mood Disorders, Anxiety

Omega 3 Fatty Acids for Depression

Fish oil is likely more efficacious than flax oil, I would experiment with the oil that works best for you. You can read my article on “Fish oil vs Flax oil”.

A concentrate of 9.6 grams per day was shown to be effective compared to a placebo in a small pilot trial. Patients on the study were not taken off their current medications. This is one natural therapy you can safely add as an adjunctive to most treatment plans unless you are taking blood thinning medications.

I typically prescribe one tablespoon of Carlson lemon flavored cod liver right before a meal, and yes you can take it in capsules if the thought of drinking fish oil makes you gag.

Calcium and Magnesiusm for Depression

Calcium/Magnesium- Also dirt cheap are a simple quick fix for reducing the stress, muscle tension, and insomnia associated with depression. Most people on the Standard American Diet (SAD) are deficient in magnesium, and some are likely deficient in calcium. A 500mg calcium citrate with a 250 mg magnesium an hour before bed will help replete this likely deficiency while improving quality of sleep at night. Cal/mag is most likely safe to combine with most prescription medications, but always check with your doctor before starting anything new!

Magnesium helps SAMe donate methyl groups to form neurotransmitters, and is also needed for muscle relaxation as well as over 400 enzymatic processes in our body including detoxification pathways and is also beneficial for constipation, muscle cramping, torticollis, acute angina after myocardial infarction, stroke, asthma, kidney stone prevention, dysmenorrhea, premenstrual syndrome, acute gastrointestinal spasms or cramping, eclampisa, heart disease especially cardiomyopathy, diabetes mellitus, nocturnal muscle cramping, mitral valve prolapse, toxemia of pregnancy, fibromyalgia, migraine headaches, lead toxicity, and fatigue.

Calcium is of course necessary for bone and muscle health, optimal functioning of our nervous system and is shown in the research to benefit hypercholesterolemia, hypertension, blood clotting, periodontal disease, insomnia, smooth and skeletal muscle relaxation, anxiety, hyperactivity, lead toxicity, prevention of calcium oxalate stones, prevention of colon cancer, and leg cramps.

B-Vitamins and Depression

Now I never prescribe B-vitamins alone without prescribing the WHOLE family. The family works synergistically together on the Kreb’s cycle to produce energy in the form of ATP as well as serves as very important coenzymes for a ton of other important biochemical pathways.

B-12, cyanocobalmin, for instance is needed for the production of the myelin conductive sheath that insulates the neurons of our nervous system, adequate B-12 is thus critical to a healthy nervous system. B-6, pyridoxine, is imperative for women suffering from PMS, and folic acid has research supporting it’s ability to improve the efficacy of fluoxetine (prozac) in a clinical trial.

Folic acid comes from “foliage” so be sure to eat your green leafies too! All depressed people need green vegetables. Be sure you are taking 800mcg of folic acid in your supplement.

B-vitamins are dirt cheap and can be like water on a wilting plant for a depressed person. A good quality multi-vitamin is typically what I prescribe to my depressed patients for B-vitamins. A multi-vitamin is a great insurance policy that nutritional deficiency is not contributing to depression. B-vitamins and standard multi-vitamin doses are most likely safe to take with anti-depressants and most medications.

Research on Depression

If you like to read research articles here are the articles I have referenced so far:

• PMID: 11552767; A systematic review and meta-analysis of Hypericum perforatum ion depression: a comprehensive clinical review. Int Clin Psychopharmacol. 2001 Sep;16)5):239-52.
• PMID: 11939866; Effect of Hypericum perforatum (St. John’s wort) in major depressive disorder: a randomized controlled trial. JAMA. 2002 Apr 10;287(14):1807-14.
• PMID: 11308434; Effectiveness of St. John’s wort in major depression: a randomized controlled trial. JAMA 2001 Apr 18;285(15):1978-86.
• PMID: 12053635; St John’s wort or sertraline? Randomized controlled trial in primary care. Can Fam Physician. 2002 May;48 :905-12.
• PMID: 16160619; A Double-blind randomized trial of St. John’s wort, fluoxetine, and placebo in major depressive disorder. J Clin Psychopharmacol. 2005 Oct; 25(5):441-7.
• PMID: 9539254; Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl). 1998 Feb;135(4):319-23
• PMID: 386715; Symptom reduction in depression after treatment
• PMID: 11679026; Passionflower in the treatment of generalized anxiety: a pilot double blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001 Oct; 26(5): 363-7.
• PMID: 12888186; Omega 3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur neuropsycholparmacol. 2003 Aug;13(4):267-71.
• PMID: 12365878; A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry. 2002 Oct;59(10);913-9.
• PMID: 10967371; Enhancement of the antidepressant action of fluoxetine by folic acid; a randomized, placebo controlled trial. J Affect Disord. 2000 Nov; 60(2):121-30.

Passionflower for Depression

Passionflower- I have yet to meet a depressed person that does not have some degree of anxiety, so I am including this gentle nervine relaxant herb on my list so that if you are depressed because you are anxious, you can use Passiflora incarnata to help calm down a bit. From my observations anxiety typically feeds depression forward.

Watch your depression patterns, and if you tend to get REALLY stressed out, and then just crash and burn in to a depressive state, an herb like passionflower might help you more than an anti-depressant herb, or both can also simply be used. Implementing stress management tools are key, such as “Square Breathing” or “Five Minutes to Zen”. Passion flower extract at 45 drops daily (tincture) was shown to be as effective as oxazepam (similar to valium).

Schisandra for Depression

“Chinese Prozac” is the perfect herb for depressed people that are stressed out. The berries of Schisandra chinensis improve mood, break up anxiety, support the adrenal glands through their “adaptogen” properties, enhance libido, and aid the liver’s detoxification.

I would say if you are a stressed out stay at home mom with a low libido and feeling frazzled then this herb is most likely created just for you! Standard capsule dose is two 500mg capsules taken twice daily. Take in the morning and at lunch. Because of the adaptogen properties, do not take this herb in the evening as we want it to support the adrenal glands when they are the most active. Adrenal gland support is imperative for people “running on empty” and under chronic stress, as the adrenal glands create the “fight or flight” response in the form of cortisol and catecholamines that eventually become burnt out and dysfunctional from chronic stress.

St. Johns Wort for Depression

The bright yellow flowers of the St. John’s wort plant are full of an oily red substance called hypericin.

If you have St. John’s Wort growing nearby you can see the little red spots in the plant (hence the perforations in the name Hypericum perfoliatum), now roll the flowers between your fingers to release the red oils and see the medicine first hand! The red oily hypericin is the active constituent of Hypericum perfoliatum.

This herb has been highly studied in many double blind research trials and shown to have significant effects similar to prescription anti-depressants. St. John’s Wort has also been shown to have a lower risk of side effects than conventional anti-depressants.

THIS HERB SHOULD NOT BE COMBINED WITH OTHER MEDICATIONS! The reason for this, is that it activates the liver’s cytochrome p450 detoxification pathway and will metabolize drugs at a faster rate, thus moving them out of your system before they likely can have their therapeutic effect. This is why we don’t combine St. John’s wort and birth control pills. I find it interesting that St. John’s Wort works so well for depression and is also such a great detoxifying agent. According to Chinese Medicine most depressed people have “sluggish livers” and thus the liver/bowel meridians are typically treated. St. John’s wort should NOT be used with prescription anti-depressants as it has a weak MAOI and SSRI effect similar to the standard activity of anti-depressants and thus may cause adverse effects. Standard dose of St. John’s Wort for those not on any other medications, is 300 mg THREE times daily of the 0.3% standardized extract.

Recommended Reading for Depression

1. Ten Ways to Better Cope with Depression
2. The Depression Diet
3. The Low Glycemic Index Diet
4. Fish Oil vs Flax Oil
5. Depression
6. Anxiety
7. Square Breathing
8. Five Minutes to Zen
9. The 3 Day Depression Walk
10. ? Please add your own useful links in the comments!
    

Getting Started with Natural Depression Treatments

If you are currently on anti-depressants, I would add only vitamins, minerals, and omega 3’s in for the time being and see if your mood can be improved enough to consider titrating off of them, work on implementing the Depression Diet gradually. NEVER ever ever… discontinue your prescription medicines without following the advice of the doctor that prescribed them.

I would start a depressed patient on either St. John’s Wort, 5-HTP, OR SAMe in conjunction with a multivitamin, vitamin D, omega 3’s, and cal/mag. If stress and anxiety is a problem, I would then add in schisandra or passion flower. Following the Depression Diet guidelines to ensure adequate amino acids in the nervous system, and counseling are integral to a comprehensive mind/body/spirit approach to the management of depression. Try the St. John’s wort, 5-HTP, or SAMe at least a month if not three before swapping out for a new treatment.

Be cautious when using combinations of the three together as “Serotonin Syndrome” which results in too much serotonin causing anxiety, profuse sweating, irritability and agitation may occur.

Natural Remedies and Anti-depressants

I strictly advise AGAINST combining herbs or natural therapies (aside from vitamins, minerals, or fish oil) with any form of anti-depressants. Although it is occasionally done, most naturopathic physicians, MD’s, and psychiatrists agree that until we have research demonstrating efficacy and safety herbs and natural anti-depressants with similar mechanisms to prescription drugs should not be simultaneously used.

Also, although these medicines are “natural” they are still medicines. Please do not choose to discontinue your natural medicines without the advice of your physician, someone should be overseeing your care.

Depression is complicated to sort out. Please do not try to do it alone. Someone needs to be documenting your mood fluctuations as well as when you start and stop specific therapies.

Walking for Depression

The other day I was talking to a friend on the phone that was suicidally depressed.

After a long conversation I asked… “Can you go out and go for a nice long healthy walk tomorrow? The fresh air and exercise will do you good.”

She responded, “Doc, I am too depressed to walk right now, can you just walk for me?”

This got us laughing about how maybe we should start a “3 Day Depression Walk”, you know like what we do in honor of those that have survived breast cancer?

“I would walk for you, if I actually thought it would do some good”, I replied.

Believe it or not, if you struggle with suicidal depression, you are a survivor. When you consider the rates of suicide, and number of people that die in reckless activities each year associated with depressed or manic behaviors, you will soon realize that if you are safe and sound at home right now, regardless if you are feeling happy, or if you are feeling suicidal, you are still a survivor. For that you should be proud.

Depression is a difficult disease for those loved ones that do not suffer from it to understand, it does not physically disfigure a person, it does not create many physical symptoms, or anything too tangible to grasp on to. People that were born naturally happy just don’t really seem to understand the torture that lies under the surface of someone that suffers from major depression.

Victims of depression are simply prisoners of their own bodies, trapped in a world of physical and mental pain that can be at an excruciating level that most people may never have to endure until their own death. We then beat ourselves up about how we can’t seem to control our negative thinking and depressive behavior which only serves to potentiate the pattern.

I have had several patients describe to me that the pain from depression was so bad that “all I could do was cut myself and watch myself bleed to distract me from the pain raging inside my blood.” If you have lost a loved one to suicide, you know first-hand what a devastating disease depression is for family and friends.

Surviving the fear in our own minds, the anxiety associated with severe depression and learning to overcome it is one of the most challenging obstacles a person can overcome. Depression survivors are some of the bravest people that I know.

Most people are ashamed to tell their friends and family that they struggle with depression. They are expected to “not be so negative and just shift their thinking and be more positive” which is about as practical as applying a fresh coat of bright paint to a rotting house.

Alternative medicine is great for treating depression long-term; some people will still need to stay on their natural or prescription anti-depressants while they address the root cause of their depression via naturopathic medicine, therapy, counseling, craniosacral, energy healing, reiki, acupuncture, life coaching, or even prayer.

Changing diet, adding exercise, using herbs and other natural medicines are also extremely effective. Regardless of how you choose to treat your depression, never give up hope. There are endless options available. Remember that it is all about “progress and not perfection”.

I believe disease is our teacher, and that if we are good students and present for our life lessons we will grow and become stronger individuals.

Which is precisely why we should all put an END to the vernacular “struggling with depression” and replace it with “challenged by depression”.


Our teachers often show up at the oddest of times, not just when we are struggling with hardships, but also during those supposed happy times such as birthdays, weddings, anniversaries, brand new babies, new exciting jobs, vacation, retirement and other occasions in which we are supposed to feel happy. Sometimes we just feel agitated, which is a commonly under-reported sign of depression in men.

If you are depressed, I would encourage you to find a doctor to work with that is willing to look at your depression from a mind/body/spirit perspective. Put together a support team of counselors, teachers, doctors, friends, and family so that you are sure to be safe when severe depression or suicidal thinking strikes. Read my “Top Ten Tips For Those Struggling With Depression”. Also try to follow the Depression Diet so you can learn to eat the foods that will naturally raise your neurotransmitters. Stay tuned for future discussions on herbs and other alternative medicines that may be helpful as well.

With that being said, I would like to take a moment to encourage everyone with depression to start walking. Exercise in my opinion is more efficacious than most anti-depressants. The obvious obstacle is to get a depressed person out walking though. If you have a friend or family member that is depressed, make them move every single day. Insist they go walking, running, swimming or biking with you. Sign them up for salsa dancing. Play tennis. Organize a kickball game. Tell them you are picking them up for a hike at 8am. If you really want to help them, start the exercise routine for them, force them to do it, they will thank you eventually. An object in motion stays in motion. Exercise is a simple and free way to naturally boost our neurotransmitter levels.

If you are depressed and relatively inactive, work up to a new fitness program gradually and commit to moving your body every single day. My guess after three days of walking you will notice a notable improvement. Take a day off when you really need it, otherwise please just whatever you do, keep on moving, keep on walking in honor of your depression. You are a survivor, you are extremely brave, and for that you should be proud.

Hold your head up high when you walk. Never look down.

Fish Oil for Depression

People of Northern European descent especially seem to have a problem converting the omega-3 fats found in plants like flax and walnut as the diet of their ancestors was heavily reliant on cold water fish. Many people are also deficient in magnesium and B vitamins that along with zinc play a key role in the biochemical process of converting plant oils like flax to the form the body can use. Fish oil conveniently comes already converted to DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) the key players in brain function, inflammation, and disease prevention.

Signs of omega-3 deficiency are memory loss, ADHD behavior, depression, dry skin, calluses on the heels, tendency to produce excess ear wax, rashes, arthritis and inflammation. Omega-3’s also appear to decrease the incidence of cancer and cardiovascular disease as well as reduce the severity of psoriasis, rheumatoid arthritis and diabetic complications. Substantial evidence also supports the use of fish oil for reduction of blood pressure, clotting, arrhythmias as well as hardening of the arteries. These oils are especially fundamental to the nervous system as they “insulate” each nerve fiber and speed it’s conductive ability. Electrical signals cannot travel rapidly in our bodies without the myelin sheath formed from these good fats.

A nervous system deficient in omega-3’s is as about as effective as a lamp with a frayed cord.

Omega 3 Fatty acids- although fish oil is likely more efficacious than flax oil, I would experiment with the oil that works best for you. You can read my article on “Fish oil vs Flax oil”. A concentrate of 9.6 grams per day was shown to be effective compared to a placebo in a small pilot trial. Patients on the study were not taken off their current medications. This is one natural therapy you can safely add as an adjunctive to most treatment plans unless you are taking blood thinning medications. I typically prescribe one tablespoon of Carlson lemon flavored cod liver right before a meal, and yes you can take it in capsules if the thought of drinking fish oil makes you gag.

Ten Ways to Cope with Depression

The challenges of depression can be extremely isolating and overwhelming, please keep in mind that some of the advice here is for PREVENTING depression, and some is for TREATING depression. Implement that which works for you, and don’t worry about anything else.

1. Have an emergency plan in place for when severe depression strikes, and be sure that you can easily activate your support group if necessary. A support group should include your physician, crisis/suicide hotline numbers, and friends and family that are familiar with your condition.

2. As often as possible eliminate or drastically reduce the use of alcohol and other simple sugars such as what is found in refined and processed foods. Alcohol is a depressant, and although it may temporarily “help” someone with depressed mood, the long term consequences of overuse are dangerous and it thus should be avoided whenever possible.

3. Get outside!!!Sunlight increases our bodies stores of Serotonin the neurotransmitter known to make us happy.On a blue sky sunny day we need 15 minutes of exposure outside in order to achieve the estimated 10,000 lux of light equivalent most people need in order to feel happy.On an overcast day one must spend an entire hour outside in order to achieve the same light exposure. If you live in a low light area and experience worsening depression in the winter months you may want to consider purchasing a light box. Light boxes should be used in the morning and never after 4pm.

4. Spend less time in your head and more time in your body. Energetically most patients with depression and anxiety are “all up in their heads” having body work done such as massage or craniosacral therapy, as well as exercise can be fundamental for getting out of your head and more in to your body. Meditation as well is important for stopping redundant thoughts. I ask all my patients struggling with this energetic imbalance to massage their feet for 5 minutes at night with a lavender oil to pull the energy down to their feet and help them feel more rooted and grounded overall. You can also imagine that you have two “brains” one in your head, and one in your legs. The two brains are mutually dependant on each other. When the brain in your head is overwhelmed you need to give it a break by spending some time with the brain in your legs. Giving the brain in your legs a solid work out will give you a break from the brain in your head for a while.

5. Seriously make a commitment to quit feeling sorry for yourself when at all able. Consider how much of your time each day you want to spend with your depressive thinking. Keep a gratitude journal. A study recently demonstrated that people that listed the Three Positives of each day had improvement in mood. I think focusing on the positive, regardless of how incidental it may seem really helps improve the overall attitude.

6. Be sure to sleep at least 8 hours each night. Some people actually need 9 hours of sleep at night. Although oversleeping has it’s detriments especially in the severely depressed, most people error on the side of averaging about 6 hours of sleep per night which lowers serotonin and growth hormone levels which then in turn increases carbohydrate cravings which then in turn feeds back in to the overuse of refined carbohydrates and simple sugars which increase anxiety and lower mood in the big picture.

7. In all reality does the word “depression” most accurately describe how you feel? Instead are you sad, lonely, angry, irritated, overwhelmed, or stressed? The key to awakening from depression is to understand what the root cause of your depressed feelings actually are. Working with a counselor is fundamental for this process. If you have tried counseling before and did not have good results, or stop making progress with a counselor you are currently working with you may want to consider experimenting with a different style of counseling.

8. Learn to manage your stress more appropriately. Many patients with depression also struggle with anxiety, and in my opinion the anxiety is actually the root cause of the depression. Our society promotes stressful living and attitudes, my goal as a doctor is to help make modern day living more enjoyable by teaching my patients helpful stress management techniques. A simple breathing exercise called “Square Breathing” can be done by sitting quietly breathing in slowly to the count of five, hold for five, breath out to the count of five, and hold again to the count of five. Repeat this five times, or for as long as needed to check in with yourself, remove stress, and feel more grounded and centered. Focusing your attention on your breath will not only relax you but will take your attention away from unhealthy negative repetitive thoughts.

9. Consider seeing an alternative medicine practitioner such as a Naturopathic Physician, Acupuncurist, or Craniosacral Therapist if traditional modalities have failed you, if you are looking for a fresh perspective to your depression, if you are interested in weaning off your medication, if you cannot withstand the side effects of anti-depressants, or if medications simply are not helpful to you. Naturopathic Physicians can prescribe nutriceuticals and herbal medicines that may improve your mood, while investigating the root cause of your depression.

You can find a reputable Naturopathic Physician in your area at the AANP website.

10. Last but not least, get out and volunteer. Focusing on people with much worse problems than your own may help you have a better attitude about life in general. I also think that our society promotes depression as everyone is so disconnected these days. We have babies in day cares, and old folks in nursing homes, and young people that need guidance and advice stashed away in apartments feeling alone and confused. Find people in your community to reach out to, listen to old people talk, play with some young children, depression is an extremely isolating condition and keeping yourself connected to others is an important long term goal to prevent devastating episodic reoccurrences. Helping someone else out is a great way to temporarily take the focus off your own problems.

Diet and Lifestyle Changes for Depression

Making changes can be tough, especially when you are already depressed! Be gentle with yourself.

Work on things gradually one at a time. Pick the improvements that you can easily make and start with those first. Inform your friends and family that you are trying to eat differently so that you will feel better.

Ask for their support while making these changes. Depression is a serious condition that requires support from a physician, counselor, or other qualified therapist. Be sure to check with your health care provider before making any changes to your health care routine to ensure that you get the best care possible.

Teas for Depression

Happy Days Tea: 1 part borage leaves, 1 part calendula blossoms, 1 part nettle leaves, 1 part oatstraw, 1 part basil leaves. Blend all herbs in a pot, 1 Tablespoon per cup boiling water. Cover and steep 15-20 minutes. Drink as desired.

Mood Lifting Tea: 2-1/2 cups cold water, 4 black peppercorns, 4 green cardamom pods, 1 cinnamon stick, 4 cloves, a few slices of fresh gingerroot. Place the water and spices in a pan and heat to nearly boiling (never boil). Cover and simmer for one hour over low heat. Strain and serve with soy milk, rice milk or nut milk and sweeten with stevia.
Note: In addition to dietary interventions, adequate daily exercise, sleep, full-spectrum lighting and counseling or other mental/emotional support are important factors in reversing depression and are prescribed in conjunction with supplements, botanicals and homeopathy.

Diet Tips for Depression

The term depression has several meanings: (1) As a human affect, it arises from the disruption of life’s normal balance, usually following a loss, conflict or trauma (2) It can be a symptom of an underlying medical condition or the side effect of a medication (3) It’s also a clinical syndrome of varying severity, based on brain chemical (neurotransmitter) disturbances and (4) Finally, depression can result from any combination of all three processes. The causes are not fully understood, but are many and varied.

Depression affects the entire body. In addition to the more noticeable affects on the nervous system, moods, thoughts and behavior, numerous studies in a field of research known as psychoneuroimmunology have shown that depression affects the functioning of every type of body cell. Immune functioning, allergies, bone density, cardiac and vascular functioning, endocrine balance, digestion, fertility, ageing and longevity—any and all aspects of our physiology are inextricably tied to our mental, emotional and spiritual health (or lack of).

People from all walks of life and of all ages suffer from depression and its prevalence seems to be increasing. It’s estimated that 5-12% of men and 10-20% of women in the U.S. will suffer from a major depressive episode at some time in their life. The percentage of teenagers diagnosed with clinical depression has increased five-fold over the past forty years.

Symptoms of depression typically include chronic fatigue, sleep disturbances, changes in appetite, headaches, backaches, digestive problems, irritability, loss of interest or pleasure in everything in general and feelings of worthlessness or inadequacy. Commonly there can be a preoccupation with death that sometimes results in suicidal ideation and/or attempts. Treatment options vary widely, though any given treatment does not necessarily work for everyone.

The Role of Diet in Depression
Diet greatly influences the brain’s behavior. The levels of brain chemicals known as neurotransmitters, which regulate our behavior and are closely linked to mood, are controlled by what we eat. The neurotransmitters most commonly associated with mood are dopamine, serotonin and norepinephrine. Deficiencies, excesses or imbalances of these cause mental and emotional disturbances and affect our perception of pain and pleasure. Neurotransmitters carry electrochemical impulses between cells. Serotonin plays a role in mood, sleep, relaxation and appetite. Dopamine and norepinephrine play a role in hunger, thirst, digestion, blood pressure regulation, heart rate, respiration, thermoregulation, aggression and sexuality.

Adequate protein consumption and absorption (requiring proper digestion) is essential in order to have enough precursor amino acid building blocks in order to synthesize any neurotransmitters. Their production also requires nutrients such as fatty acids, Vitamin B3, iron, folate, Vitamin B6, copper, calcium, magnesium and lecithin, among others. The absorption of precursor amino acids depends on the consumption of adequate complex carbohydrates.

Note: The dietary recommendations and guidelines below include foods to which some individuals may have allergies, intolerances and sensitivities. In those cases, those foods should be avoided. Persons taking medications should not consume any of the herbal teas described without first consulting your physician/clinician regarding potential interactions. Dietary choices should be modified to meet your personal dietary needs. Consult your physician/clinician for further information regarding nutrition and your individual medical condition.

Dietary Recommendations and Guidelines

• Avoid sugar and both artificial and natural sweeteners of all types, even honey, molasses and fruit juice. Stevia is an acceptable “sweetener”.
• Avoid alcohol, caffeine and soft drinks.
• Avoid junk food, processed and refined foods, foods high in saturated fats or hydrogenated (trans) fats. Healthy fat choices include polyunsaturated and monounsaturated fats and oils that are organic and cold-pressed.
• Identify and eliminate food allergies, intolerances and sensitivities. Gluten found in some grains has been linked to depressive disorders. Gluten-containing grains include wheat, spelt, rye, triticale, oats, barley and kamut.
• Eat adequate lean sources of protein (0.8 g/kg body weight daily). Emphasize wild, cold-water fish (salmon, halibut, mackerel, etc.), legumes, nuts and seeds. Organically raised poultry and eggs are also good protein sources. Fermented dairy products are also acceptable (yogurt, kefir, cheeses, etc.)
• Every meal and snack should be balanced, containing some protein, fat and complex carbohydrates.
• Food choices should be whole foods (unprocessed and unrefined), organic whenever possible, including at least five servings daily of vegetables and fruits. Grains should be whole and unrefined, especially rice, corn, quinoa, millet and amaranth. Fresh food is always preferable to frozen and frozen is always preferable to canned.

Recipe for Depression:

Don't worry, this won't give you depression, this should help alleviate it. Try a meal or snack with fiber-rich complex carbohydrates and low-fat protein!

Tofu Salad with Cajun Spice Dressing

6 tablespoons Cajun Spice seasoning blend
1 pound firm- style tofu or Tempeh*
1/2 cup vinaigrette dressing
4 cups organic salad greens including:
dandelion greens, watercress, arugula, baby kale, romaine, spinach
1/2 cup organic shredded carrot
1/3 cup thinly sliced fennel
1/4 cup thinly sliced red onion
1 - 2 tablespoons canola oil

1. Drain tofu, cut into 1/2-inch thick slices, press briefly with paper towel to absorb excess water. If using tempeh, simply slice tempeh into 1/2-include slices.
2. Measure 5 tablespoons of spice mixture into shallow bowl; dip tofu/tempeh in spice mixture to evenly coat; transfer to a dry plate. Cover and chill 30 minutes.
3. Combine remaining spice mixture with vinaigrette dressing. Blend well; let stand 15 minutes before serving.
4. Preheat heavy iron skillet. Lightly coat skillet with vegetable oil. Pan fry tofu/tempeh for 4 - 5 minutes on each side or until lightly browned.
5. arrange salad greens on serving plates. Arrange tofu/tempeh evenly over greens. Garnish each salad with carrot, fennel, and red onion. Top each with two tablespoons dressing.

*Tofu and tempeh are good sources of magnesium. Deficiencies in magnesium have been linked to depression, irritability and confusion.

Foods to Avoid for Depression

Avoid

• Tobacco, alcohol, caffeine, artificial sweeteners
• Refined sugar and processed foods
• Be aware of your specific food sensitivities

Diet for Depression

Depression is a complex illness that must be diagnosed by a qualified health care practitioner. Often, however, the dietary component of mental illness is overlooked. Food sensitivities, or vitamin and mineral deficiencies may worsen the symptoms of depression. Following a few dietary guidelines, in combination with other prescribed treatments, may help to relieve symptoms of depression.

Dietary guidelines that may help to relieve depression:

• Follow a diet plan that prevents hypoglycemia (e.g. eliminate refined sugar, alcohol, caffeine and tobacco; eat 4 - 6 small meals throughout the day; eat plenty of dietary fiber
• An elimination or rotation diet will help to decide whether or not you have sensitivities to particular foods

Foods for Depression

Helpful Foods for Depression:

• Foods high in omega-3 fatty acids for growth and repair of nervous tissue: nut, seed, cold water fish (salmon, halibut, mackerel) and vegetable oils (safflower, walnut, sunflower, flax seed), evening primrose oil (500 mg/3 times per day)
• Foods rich in vitamin B6 - needed for normal brain function: Brewer’s yeast, bok choy, spinach, banana, potato, whole grains
• Foods rich in tryptophan - precursor to neurotransmitter serotonin: white turkey meat, milk, nuts, eggs, fish
• Liver cleansing foods - proper liver function helps to regulate blood sugar: garlic, onions, broccoli, cauliflower, cabbage, brussel sprouts, beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root
• Magnesium rich foods - important for nerve conduction: seeds, legumes, dark green leafy vegetables, soy products, almonds, pecans, cashews, wheat bran, meats

Amino Acids for Depression

Recently more patients like you have been looking for alternatives to traditional antidepressant and anti-psychotic drugs. These drugs have may annoying side effects such as: dizziness, fainting, dry mouth, constipation, sluggishness, nausea, tremors and inability to read or concentrate. Maybe you want to eliminate these effects, reduce them or simply feel better while maintaining your drug therapy. One of your goals might be to taper off and eventually stop your current antidepressant. These ideas should be discussed with your clinicians and physician during your treatment here. Our goal is to help inform you of options that are available so that you can make the best choice for yourself.

It has been known for many years that the brain requires certain nutrients, including the amino acids, to function at its optimum. There are twenty two common amino acids that are the building blocks of proteins. Eight of the twenty two are called “essential” amino acids because the body cannot make them.

Certain deficiencies of amino acids can worsen the condition of schizophrenic patients. Often deficiencies in folic acid, ascorbic acid, manganese, zinc, niacin, magnesium and the omega-6 fatty acids can accompany the amino acid imbalance. Also many bipolar depressive patients and schizophrenics have a tendency toward food sensitivities, especially to wheat and milk.

Tryptophan, an amino acid, is metabolized into a brain chemical called serotonin. The amount of serotonin present in the brain is proportional to the amount of tryptophan in your diet. When your intake of tryptophan is low you may experience sleep disturbances, more sensitivity to pain and depression. If this deficiency occurs over several months you may experience: suicidal or aggressive impulses, short attention span in children, alcoholism, eating disorders and chronic pain. To enhance the uptake of tryptophan over other amino acids in protein sources, you should take in carbohydrates with the tryptophan source. Now that supplements of tryptophan are not available, the best dietary sources are soy-based protein powders, milk, eggs, and turkey.

It has been proposed by many researchers that defect in the metabolism of tryptophan may be present in persons with schizophrenia. Some researchers say that changing the tryptophan levels in the person’s diet will not correct the defect, while others say that supplementation may be beneficial. Patients that were treated experimentally with tryptophan experienced reduced hostility and aggressive moods, less “acting out” on hospital wards and less depression.

Tyrosine is an amino acid formed from the ingestion of the essential amino acid phenylalanine. Tyrosine has also shown beneficial effects in the treatment of depression. When tyrosine is metabolized completely it gets converted into adrenalin. Reduced amounts of adrenalin (also known as norepinephrine) also result in depressed mood. With adequate amounts of adrenalin you feel a sense of purpose, pleasure and gratification. This chemical works in your brain to promote memory, drive, ambition and alert mental functioning.

Methionine is an essential amino acid required for growth in infants and proper nitrogen balance in adults. If methionine levels are low in the diet you may experience: seizures, spasticity, Parkinsonism, hereditary forms of depression and some forms of osteoporosis. Additionally, methionine is a part of a large pain-killing protein called Met-enkephalin. This is a naturally occurring chemical that is secreted by the adrenal glands. It functions to increase immunity, enhance mood, improve outlook and assist in the weight gain of depressed patients. Methionine-enkephalin has been found to improve the conditions of patients with AIDS or ARC. Methionine as a dietary supplement, has been effective in the treatment of bipolar depressive disorder.

These treatments work by making adequate nutrients available so that the nervous system can create the quantities of brain chemicals it needs. A balance is obtained and this results in improved functioning of your central nervous system. The goal of this therapy is to increase the amount of brain chemicals called neurotransmitters. Tryptophan, tyrosine and methionine are all considered precursors to the neurotransmitters and are one of the safest and best methods of increasing brain amine levels. One theory on how they work is by increasing both serotonin and epinephrine together instead of only just one type of neurotransmitter.

Since traditional antidepressants promote the presence of only one type of neurotransmitter they may not work in certain cases of schizophrenia or depression. The toxic and hazardous side effects of traditional anti-psychotic treatments are their most unfortunate disadvantage.

Presently, what seems to help the brain most is a close chemical match from NATURE. Combining this therapy with supportive vitamins, and other individualized care may be suitable choice for you. Our purpose is to correct a deficiency or imbalance, avoid toxic side effects, and help you feel better.

Depression Symptoms

Symptoms of Depression Include:

*Sadness, feeling low or blue, irritability

*Feelings of hopelessness, helplessness, worthlessness

*Difficulty concentrating

*Changes in appetite including overeating or under eating

*Difficulty sleeping

*Feelings of fatigue

*Persistent physical symptoms such as headaches, digestive difficulties, chronic pain

*Thought of death or suicide

*Suicidal attempts

Statistical information reported on this page was obtained from The National Institute of Mental Health: http://www.nimh.nih.gov

If you think you may be suffering with any of these symptoms, or would just like to talk with a professional in a caring and completely confidential way, you can visit Dr. KC at www.DOCintheBiz.com where you will be able to email her for private and confidential help from your own home! You will never be made to leave your house or comfort zone.

Depression is NOT:

What Depression IS NOT:

*A condition to be taken lightly.

*A sign of personal weakness.

*The fault of the person suffering.

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What is Depression?

Did you know that depression is:

*The leading cause of substance abuse (either drugs or alcohol) as well as suicide.

*A mental condition that can strike anyone of any age, race, gender, or ethnicity.

*A very treatable condition given the proper therapeutic intervention and/or medication.

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