One in four Americans experiences some degree of clinical depression or mood disorder during their lifetime. One in eight of us will, at some time in our lives, experience depression serious enough to affect our personal relationships and job performance. Clinically diagnosed depression currently affects 17 million Americans, and more than 28 million of those, including teens and children, are currently on antidepressant drugs or anxiety medications.

When is depression a normal experience?
Depression following significant loss is a normal, healing part of the grieving process. The death of a loved one, a divorce, an accident that permanently changes one’s physical abilities, the loss of a job, even the recognition that our youth is not without end - all may trigger depression. Feelings of sadness in response to loss are normal and healthy. Grief is a purging, healing emotion that should be respected, even valued for the lessons offered.

Think back to some difficult time in your past. Chances are you emerged from this trial with more compassion, stronger in spirit, more aware of and grateful for the blessings in your life. No one’s saying it was easy, but, let’s face it, the hard times force us to look deeper, to reevaluate our priorities, to grow.

What causes depression?
Depression may also be caused by numerous biochemical and physiological factors. If you are depressed for no apparent reason, or if depression following a loss does not begin to improve after a few weeks, you should seek medical attention.

A state-licensed N.D. (naturopathic physician) or an M.D. who practices orthomolecular or functional medicine can help you verify that none of the following factors - any of which can negatively affect brain chemistry - is contributing to your depression. For more information on locating a qualified physician in your area, contact the American Association of Naturopathic Physicians. Physicians who practice orthomolecular and functional medicine can be located via www.healthcomm.com and www.drwhitaker.com.

It’s not all in your head
Any of the following can cause biochemical imbalances in brain chemistry that can result in depression:

• A nutritionally poor diet. Refined foods; pesticides, chemicals, additives in foods; excess sugar and caffeine consumption. A diet largely composed of refined foods does not provide the nutrients necessary for proper functioning of numerous bodily systems, including the brain and nervous system. In susceptible individuals, pesticide residues and food additives can be neurotoxic. Just one example - the chemical, aspartame (trade name, NutraSweet) has been shown to alter brain chemistry in sensitive individuals to the point of causing epileptic seizures.
• Foods to which you are allergic or intolerant. For example, wheat protein has been shown to alter brain chemistry in sensitive individuals, inducing brain fog and/or depression.
• Hormonal imbalances. Normal functioning of endocrine can be disrupted by stress, environmental toxins, diet, excessive exercise. For example, women are at much higher risk for depression at certain reproductive points, such as menstruation, menopause and immediately after giving birth.
• Stress. Excessive flight or fight responses, the Type A personality, free-floating hostility — all result in the frequent secretion of stress hormones. Stress not only suppresses the immune system, but can affect brain chemistry in susceptible individuals, disrupting normal serotonin signaling and leading to depression.
• Excessive or insufficient sleep. Most people need eight hours each night. Consistently getting several hours more or less than your optimal sleep needs can disrupt circadian rhythms, leaving you feeling groggy, foggy, depressed. Bright light — lights from street lamps, rooms adjoining your bedroom, even light from a digital alarm clock that shines in your face — can disrupt melatonin production leading to sleep disturbances and depression.
• Lack of exercise. Non-exercisers are three times more likely to experience depression than regular exercisers. Exercise increases not only dopamine but endorphins — neurotransmitters that create a sense of well-being.
• Environmental toxins. Solvents and heavy metals such as aluminum, cadmium, mercury and lead are neurotoxins. Example: “Silver” dental amalgams contain mercury and may be neurotoxic in susceptible individuals.
• Intestinal parasites. Parasitic infection can cause mental/emotional symptoms including brain fog, feelings of impending doom and depression.
• Candidiasis - an overgrowth of yeast in the gut. Excessive consumption of sugar or refined carbohydrates can stimulate overgrowth of candida. The yeast’s metabolic byproducts can affect brain chemistry.
• Hypothyroidism. Thyroid hormones regulate metabolism in every cell of the body. Low levels of thyroid hormone can cause exhaustion and depression. Other signs of an underactive thyroid include hair loss, obesity, edema, infertility, irregular menstrual bleeding, fibrocystic disease, chronic fatigue and reduced immune function.
• SAD (Seasonal Affective Disorder) - depression caused by lack of exposure to sunlight in susceptible individuals. SAD typically occurs in winter in northern latitudes, especially in frequently overcast locations, e.g., Seattle. If daily exposure to at least 15 minutes of natural sunlight is not an option in your area, consider using full-spectrum lights in rooms where you spend the most time.
• Hypoglycemia. Low blood sugar deprives the brain, one of your most fuel-hungry organs, of glucose. Usually due to inappropriate diet.
• Drugs - Prescription drugs, such as antihistamines, anti-hypertensives, anti-inflammatory agents, birth control pills, corticosteriods, tranquilizers, sedatives and antidepressants, have all been found to cause depression in susceptible individuals. In terms of legal drugs, alcohol is a brain depressant, increases adrenal hormone output, interferes with many brain processes, and disrupts normal sleep cycles. Nicotine stimulates adrenal hormone secretion, including cortisol. Caffeine causes anxiety, panic disorders, depression, nervousness, palpitations, irritability and recurrent headache in sensitive individuals.
• Imbalances in the levels of neurotransmitters. When the level of serotonin, the brain’s mood-elevating and tranquilizing neurotransmitter, is too low, depression results. This is the biochemical derangement that antidepressant drugs try to control, but these drugs should be your last resort for numerous reasons. Antidepressant drugs take over a normal function of the body. They do nothing to correct the real underlying cause of the problem. The real question is: “WHY are serotonin levels too low?” An imbalance in neurotransmitters may be caused by any of the above biochemical and physiological causes of depression. An imbalance in neurotransmitters is NOT due to a Prozac deficiency! Antidepressant drugs have serious, sometimes deadly, side-effects. Safe, effective natural alternatives are available that help the body re-establish normal neurotransmitter balance.

The perils of prozac
Prozac, Luvox, Zoloft, Paxil — all belong to a class of drugs called SSRIs (selective serotonin reuptake inhibitors). SSRIs block the removal of serotonin by nerve cells in the brain, thus leaving more serotonin to bind to brain receptor sites. While too little serotonin is believed to cause depression, too much serotonin makes people anxious, obsessive, violent and unable to feel empathy. In addition, drug reactions to synthetic antidepressants cause 31 deaths per 1 million prescriptions.

In one out of every 25 children taking it, Luvox causes mania. One out of every 12 patients admitted to mental hospitals for psychosis is taking an SSRI. The clinical trials submitted by Eli Lilly to the FDA for approval of Prozac were inadequate. Less than 300 people were involved in these clinical trials, and of this small group, one out of seven dropped out of the study because of side effects of the drug. Many children under the age of three have been given Prozac, the second most commonly prescribed drug in the U.S., which will soon be made in flavored form for children.

If you are currently taking an SSRI, DO NOT go off the drug cold turkey. SSRIs MUST be tapered off very slowly under the supervision of a physician.

Natural depression busters
If your symptoms are severe, consult a health professional — preferably a state-licensed N.D. or a physician practicing orthomolecular or functional medicine.

A health-promoting diet and lifestyle will go a long way toward restoring optimal serotonin levels and permanently healing mild to moderate depression, but the normalizing of bodily systems takes time — typically at least six to eight weeks. In the interim, the following natural agents can provide the necessary serotonin boost to support making the health-promoting changes needed for long-term health.

St. John's wort
St. John’s wort (extract standardized to contain 0.3 percent hypericin content) is the most thoroughly researched of the natural antidepressants. Over 1,500 patients have been studied in 25 double-blind controlled studies. In 15 studies, St. John’s wort was compared to placebo, and in 10 studies, to an antidepressant drug.

Better overall results were seen in patients taking St. John's wort than those taking antidepressant drugs. St John’s wort consistently alleviated depression, anxiety, apathy, sleep disturbances, insomnia, anorexia and feelings of worthlessness. Plus, it had virtually no side effects (mild short-lived stomach irritation in only a few patients).

Dosage: standardized for 0.3% hypericin, 300mg three times per day.

Ginkgo biloba
Persons over the age of 50 who are depressed may actually be suffering from cerebrovascular insufficiency, a lack of blood flow to the brain. Insufficient blow flow to the brain results in impaired delivery of oxygen and nutrients, plus impaired removal of wastes.

Ginkgo biloba significantly improves blood flow to the brain. Patients with cerebrovascular insufficiency often experience improvement in mood as well as relief of other symptoms when given ginkgo. Recent double-blind placebo-controlled studies have found that gingko biloba significantly enhances the effectiveness of antidepressants in patients over 50.

Ginkgo biloba significantly increases the number of serotonin binding sites in the brain. As we age, the number of serotonin receptor sites on brain cells drops significantly. We become more susceptible to depression, impaired mental function, insomnia and sleep disturbances. Ginkgo may be taken along with St. John's wort or 5-HTP.

Dosage: standardized to contain 24% gingko flavonglycosides, 80mg three times per day.

5-HTP - The manufacture of serotonin in the brain depends on how much of the amino acid, tryptophan, is delivered to the brain where it is eventually converted to serotonin.

The following dietary and lifestyle factors reduce serotonin levels by impairing tryptophan delivery and conversion, such as cigarette smoking, alcohol abuse or blood sugar imbalances.

In addition to correcting the above serotonin inhibitors, supplementing with 5-HTP (5-Hydroxytryptophan) will also help raise serotonin levels. When tryptophan reaches the brain, it is first converted to 5-HTP, which is then converted to serotonin. 5-HTP also causes an increase in levels of endorphin and other neurotransmitters that are often decreased in depression. 5-HTP has been compared in numerous double-blind studies to antidepressant drugs, including Prozac, Paxil and Zoloft (SSRIs), and imipramine and desipraine (tricyclic antidepressants) and has consistently been found to be equally effective, less expensive and better tolerated.

In addition, 5-HTP improves sleep quality, while antidepressant drugs typically disrupt normal sleep processes. It also has much, much milder side effects in significantly fewer patients. About a third of patients experience mild nausea, heartburn or gas which typically resolves after four to six weeks. More than half of patients receiving antidepressant drugs experience side effects of moderate to severe intensity, so severe that many discontinue the drug.

Dosage: Begin with 50 mg three times per day. If the response is inadequate, gradually increase over a period of two weeks to 100-200mg three times per day.

SAM-e
SAMe is the most active of all methyl donor molecules, SAMe is a crucial component of a process called methylation, which occurs billions of times every second throughout the body. Methylation makes dozens of essential bodily processes happen in cells, including the production and activity of neurotransmitters. In addition to boosting production and action of mood-enhancing neurotransmitters, SAMe promotes the methylation of phospholipids. Phospholipids, fats which provide structural support to cellular membranes, are especially abundant in brain cells. Phospholipid methylation is essential in maintaining the fluidity and responsiveness of nerve cell membranes.

Numerous clinical trials involving almost 1,400 patients have confirmed the beneficial effects of SAMe on depression. A 1994 review of all the clinical trials carried out between 1973 and 1992, some of patients with severe depression, found SAMe consistently effective. Fourteen of these studies compared SAMe to prescription antidepressants, and every one found SAMe to be as effective as the drugs.

Dosage for mild to moderate depression: WARNING: Individuals with bipolar (manic) depression should not take SAMe. Because SAMe may initially cause nausea in some people, gradually increase the dosage until mood improves, then maintain your lowest effective dosage. For the first two days, take 200mg twice daily on an empty stomach (at least 30 minutes before, or two hours after eating). On Day 3, increase to 400mg twice daily. On Day 10, take 400mg three times daily. On Day 20, 400mg four times daily.

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