Everyone has experienced times in which we feel sad, lonely, isolated and melancholy. However, “clinical” depression is much more intense and much longer lasting than our isolated times of sadness.
According to the Center for Disease Control (CDC) it is estimated that 1 out of 10 Americans are clinically depressed. The median age of those being depressed is 32 years old. As many as two times the number of women versus men are depressed. The most likely to be depressed according to the National Institute of Mental Health are women ages 45-64, being Afro-American, Hispanic, mixed racial background, having less of a high school education, previously married, unable to work/disabled, unemployed and those without health insurance. Another interesting fact is that depression is the major cause of disability in the US ages 15 through 44!
The Anxiety and Depression Association of America found that it is not uncommon to treat those who suffer from depression and from anxiety. Approximately 1/2 of those with depression also have an anxiety disorder. The brain is an incredible organ, but also very sensitive to alterations in biochemistry which can have profound effects on behavior
DEFINITION OF DEPRESSION : “Clinical” depression is also known as major depression. Generally a person would be considered depressed if at least 5 of the 8 criteria below are experienced for more than 2 weeks:
- Little interest or pleasure in most activities.
- Feeling down, depressed, hopeless nearly everyday with thoughts of death and/or suicide
- Trouble falling asleep, staying asleep or sleeping too much
- Feeling tired and fatigued everyday
- Poor appetite or overeating. Weight loss or gain.
- Feeling bad about yourself or that you are a failure or let yourself or family down. Poor self esteem.
- Trouble concentrating on things like reading or watching TV.
- Moving or speaking so slowly or being so fidgety or restless that most people will notice.
Depression significantly impacts a person’s life where they have great difficulty functioning on a daily basis. Most people are incapable of working, go to school or keep up with daily tasks, chores and social activities. Over 90% of those that commit suicide have clinical depression. If you or someone needs help call the National Suicide Hotline: 1-800-273-8255
DIFFERENT CATEGORIES OF DEPRESSION
This months newsletter is mostly focused on clinical or major depression. However, there are other categories of depression and we will discuss them briefly.
Chronic Depression or Dysthymia: This is where someone has experienced a depressed mood for 2 years or more. Generally they do not have major depression symptoms that are disabling or nearly as severe. They may experience episodes of major depression.
Atypical Depression: This type of depression is characterized by overeating, oversleeping, fatigue and extreme sensitivity to rejection.
Bipolar or Manic Depression: This is a complex mood disorder that is characterized by major or clinical depression and episodes of extreme elation.
Seasonal Depression: This is also known as seasonal affective disorder (SAD) and occurs usually in the fall and winter months. This often is brought on by decreased sunlight. It is associated with serotonin imbalances and improper pineal gland function.
Psychotic Depression: This depression is associated with the patient experiencing hallucinations and delusions.
Post partum Depression: About 1 in 10 mothers experience this form of depression after giving birth. This is often due to poorly balanced adrenal gland function. This depression can last for months.
OTHER DISEASES LEADING TO DEPRESSION
The neurons in the brain are highly sensitive to biochemical changes caused by imbalances in blood flow, glucose, hormones, neurotransmitters, and other inflammatory/ immunological changes. Likewise other diseases can lead to depression due to the physical disabilities they cause and the subsequent emotional impact it has on a daily basis.
Depression can be brought on by hormonal changes such as hypothyroid or Cushing’s syndrome (adrenal gland related). Blood sugar imbalances such as hypoglycemia and diabetes can lead to depression. About 25% of diabetics also suffer from depression.
Changes in blood flow or oxygen delivery to the brain caused by anemia, heart attack, stroke and elevated blood pressure can lead to depression.
The inability to gain normal function of the body or inability to return to work after a stroke or heart attack can lead to depression.
Neurological diseases such as Parkinson, dementia, multiple sclerosis can lead to depression due to the changes in physical abilities and actual inflammatory , chemical and structural changes in the brain.
CAUSES OF DEPRESSION
The exact cause of depression has not been totally understood. This is probably due to the fact that the cells that make up the brain such as the neurons, microglial , astrocytes and oligodendricites, can be influenced by variety of factors. Therefore, the cause of depression in one person may not be identical in another although they appear to share some similar symptoms.
This may also explain the different types and wide variety of antidepressants in each single category of these medications.
To begin with, there appears to be a genetic component for depression. This can make an individual more likely to be sensitive to stress hormones and produce improper levels of various brain chemicals called neurotransmitters (NTs).
There does not appear to be a specific spot in the brain for depression rather it appears to encompass several areas and often they are linked by the types of neurotransmitters released. Some of the areas of the brain are, prefrontal cortex, hippocampus, amygdala, thalamus, ventromedial cortex anterior cingulated cortex and others. So, when treating depression we have to think of treating the entire brain and the chemistry of the brain.
Currently most of the treatments for depression involve balancing neurotransmitters (NTs). The two that seem to get the most attention are serotonin and norepinephrine. Serotonin does regulate anger, body temperature, mood, sleep, vomiting and appetite. Norepinephrine regulates attention, arousal response, sleep, learning, memory and a sense of well-being. Other NTs such as dopamine, acetylcholine and gammaaminobutyric acid (GABA) are also very important in depression.
Sexual hormones such as estrogen and testosterone also have profound effects on depressive states. Increased estrogen can increase levels of serotonin. Low testosterone leads to poor self-esteem, lack of motivation and decreased energy.
Elevated levels of the stress hormone cortisol causes shrinkage of the hippocampus in the brain and may lead to depressive states. Elevated insulin causes inflammation of the brain and may be a causative factor in degeneration of the brain leading to dementia. Furthermore, most of the NT levels are effected by blood glucose and insulin levels.
Another important factor is inflammation of the brain. The microglial cell can produce inflammatory cytokines. These cytokines can be released in response to food sensitivities, allergies, chemical irritants, environmental toxins, toxins from yeast and other microorganisms.
The thrust of treatment allopathically is to try to balance brain chemistry. Although recently they are finding using antidepressants and antiinflammatories seem to work better.
The most common antidepressant are called SSRI’s or selective serotonin reuptake inhibitors. They allow serotonin to remain longer and stimulate nerve synapses. Examples are Lexapro, Prozac, Paxil, Celexa and Zoloft.
Then there are some that prevent the reuptake of serotonin and norepinephrine. Examples are, Effexor, Cymbalta, andPristiq.
There also are tricyclic antidepressants, monoamine oxidase inhibitors and atypical antidepressants. All categories of theses medications have their side effects. It is often an art to get the proper medication and dosage to help. Most of these medications have not been studied for long term effects and there may be permanent changes in the brain.
NATURAL TREATMENTS FOR DEPRESSION
The key approach is balance all factors that affect brain function. The first is to make sure the brain has a proper glucose (blood sugar) levels. This is critically important because, nerve cells can only utilize glucose for energy. As a matter of fact the brain uses 33% of all of the glucose in the blood. Balancing the body to reduce hypoglycemia, insulin resistance and diabetes is the number one factor, with out doing so the NTs will never balance correctly. This can be accomplished by removing refined carbohydrates, taking vitamin B complex, magnesium, chromium. Further information on insulin resistance can be found on my website and we have a prior newsletter addressing IR.
Reduction of cortisol and other stress hormones So, balancing the adrenal glands and getting involved with stress reduction is absolutely necessary. Again please refer to a previous newsletter about the adrenal glands and stress.
Rebalancing the thyroid is very important. Without proper thyroid function the nerve cells cannot produce proper levels of NTs and the metabolism of the brain cells is severely hampered. Please, review our newsletter about the thyroid.
Inflammation is the next important factor to tackle. First, making sure there is proper levels of fatty hormones called prostaglandins is necessary. To help reduce inflammation it is important to have proper omega-3 levels. This would consist of flaxseed, walnuts and especially fish oils. Fish oils have been found to reduce depression and improve neural conduction.
Another important factor in NT production and nerve function is to make sure that chemical process called methylation is properly performed in the brain and body. Compounds such as SAMe, Lcysteine, methionine, choline, vitamin B12, and folate can help.
Balancing the immune system to reduce inflammation is another important approach. This is accomplished by avoiding foods that cause immune responses. This can be revealed with delayed food sensitivity blood test and applied kinesiological testing. Supplementing with vitamin D, vitamin C, zinc, selenium, green tea extract, curcumin, reservatrol, Co enzyme Q 10, biotin , alpha lipoic acid and other antioxidants.
Avoidance of toxins found in our food, water, plastic containers, plastic wrap, pesticides and other environmental toxins can affect the brain. Also, removing toxins from our gut due to poor digestion, microorganisms, and poor micro flora can have a profound affect on the brain as well. Eating more organically, using a detoxification program to cleanse the gut, saunas, regular exercise, drinking purified water and ionic foot baths can reduce depression.
Getting proper mental, spiritual counseling and other professional psychological help is recommended. With proper diet and nutrition the symptoms of depression diminish more quickly. Stress reduction programs are also of great value. Smile!