Depression is one of the most common mental health problems in America and around the globe. It is estimated that one in seven people will suffer from some type of depression in their lifetime. By the year 2020, the World Health Organization (WHO) predicts that depression will become the second cause of morbidity worldwide (1).
It’s normal to feel a little sad or low at times, but being depressed is so much more. Depression can be very serious, debilitating, and a potentially life-threatening illness. People who are depressed can find it extremely difficult to function on a day-to-day basis; they commonly have feelings of worthlessness and anxiety, often lack energy and motivation, and have poor concentration and sleep. Significant weight loss or weight gain is also commonly seen in depressed individuals.
Contributing factors that are associated with a greater risk of developing depression include hormonal imbalances (particularly women pre-menstrually, post-natally and during peri-menopause), environmental factors (financial and work stress, relationship problems, death of a loved one), neurotransmitter imbalances and nutritional deficiencies, certain prescription drugs (corticosteroids, the contraceptive pill), regular recreational drug use, and excessive alcohol consumption. Those with a family history of depression are also more likely to suffer from the illness at some point in their life.
Antidepressants are generally the first line of treatment for depression. Antidepressants have their place—especially for those suffering severe depression—however, like with any medication, some people can experience unwanted side effects. Common side effects associated with antidepressants include weight gain, sexual dysfunction, tachycardia, and drowsiness.
There is definitely a great need for complementary and orthodox practitioners to work together for the greater health and treatment of their depressive patients. Along with diet, herbal and nutritional medicines play a huge role in the management and treatment of depression.
After consulting with a medical practitioner for diagnosis, a consultation with an integrative doctor, naturopath, or herbalist to discuss the best natural treatments for depression is also recommended. A counselor or psychologist should also be an integral part of any treatment plan. If pharmaceutical medications are required, herbs and other natural medicines have been shown to help improve the efficacy of antidepressants while helping to lessen their potential side effects.
Good nutrition plays a fundamental role in the management and treatment of depression. We need optimal amounts of specific nutrients to support the production of neurotransmitters that enhance our mood, sleep, and emotional wellbeing.
POOR WESTERN DIET AND ITS ROLE IN DEPRESSION
There is a definite link between fast food consumption and depression. Common nutritional deficiencies associated with the standard Western diet—rich in refined sugars and fats, particularly high fructose corn syrup and trans-fats—can make you more susceptible to developing depression.
A large European study followed 12,000 non-depressed people for six years. Those who ate a diet rich in trans-fats (from pastries and fast food) had a forty-eight percent higher risk of developing depression compared to those who did not consume these harmful fats. (2)
There is now plenty of scientific evidence supporting the importance of eating a wholesome diet for emotional health and prevention of depression. A well-balanced diet delivers brain-boosting nutrients that help regulate brain chemistry to support emotional health. Specific amino acids, vitamins, and minerals received through a healthy diet are needed to produce the neurotransmitters serotonin, dopamine and GABA (γ-aminobutyric acid). Deficiencies in these neurotransmitters are associated with the development of depression. (3-5)
The healthy Mediterranean diet rich in healthy fats from olive oil and fish, and fresh fruits and vegetables, with lower amounts of red meat and dairy, has been found to be associated with a lower risk of depression. (6)
Alcohol and coffee are also a common part of the Western diet. Excessive amounts of caffeine can exacerbate anxiety and depressive symptoms. Too much caffeine can negatively affect dopamine transmission which will alter normal neurotransmitter function. Too much caffeine will also disrupt sleep, deplete essential B nutrients needed for neurotransmitter production, and will put stress on the adrenal glands. Adrenal stress is associated with depression, fatigue, and the inability to cope with stress. Drinking too much alcohol can also exacerbate depressive symptoms since alcohol is a known depressant.
Switching your morning cup of coffee to a caffeine-free herbal tea like chamomile, liquorice, holy basil, ginger, or peppermint is a great way to lower your caffeine intake while reaping the health benefits herbal teas have to offer. Green tea is another excellent lower-caffeine option.
AMINO ACIDS NEEDED TO PRODUCE KEY NEUROTRANSMITTERS
Including adequate good quality protein in the diet is paramount for anyone suffering from depression as protein plays a vital role in the synthesis of important neurotransmitters needed for emotional health and wellbeing. Studies have shown that supplementing with amino acids tryptophan, tyrosine, phenylalanine, and methionine is beneficial for enhancing mood and is useful in the treatment of depression. (7-9)
Serotonin, the neurotransmitter responsible for making us feel happy and content, is manufactured in the body using tryptophan. This essential amino acid cannot be produced in the body so it must be supplied through the diet or supplementation. Tryptophan is also needed to produce melatonin which is vital for sleep. Low serotonin levels are linked to depression, anxiety, insomnia, and fatigue. Supplementing with tryptophan has been shown to help restore serotonin levels and improve quality of sleep. (10)
A study published in JAMA psychiatry reported that people with clinical depression also have significantly lower brain levels of dopamine. (11) Dopamine is the neurotransmitter that is responsible for creating a positive mood and enjoyment of life. People with low dopamine levels feel a loss of pleasure for things they once enjoyed like exercising, socialising with friends, or sex. They have poor concentration and focus, and little or no motivation. The amino acid tyrosine is a natural dopamine booster. Tyrosine is converted to dopamine in the body, which makes it beneficial for enhancing mood and motivation.
Methionine is an amino acid that is needed by the body to make S-adenosylmethionine (SAMe). SAMe is a precursor to serotonin and dopamine. Supplementing with SAMe in the treatment of depression has been shown to be very effective without the common side effects of antidepressants. Supplementing with SAMe can also boost the efficacy of pharmaceutical antidepressants. (12-14)
According to a Japanese study published in the American Journal of Clinical Nutrition, higher green tea consumption is associated with a lower prevalence of depressive symptoms. (20) Polyphenols such as flavonoids found in high levels in green tea have been found to have antidepressive properties.
Scientists have also discovered that L-theanine, an amino acid found in green tea, has an antidepressant and anti-anxiety effect. (15,16) L-theanine can help improve mood by increasing brain dopamine, GABA (a neurotransmitter that inhibits the activity of nerve cells), and serotonin levels. (17) People with depression have lower brain GABA levels, so improving GABA levels will help promote relaxation to relieve anxiety and improve mood and sleep.
Mucuna pruriens, or velvet or lacuna bean, is a legume native to Africa and Asia. Mucana seeds have been traditionally used in Ayurveda medicine as a nerve tonic for the treatment of conditions such as Parkinson’s disease. Mucuna naturally contains high levels of L-dopa (levodopa) which is converted into dopamine. When taken as a supplement, it can cross the blood-brain barrier and boost dopamine and serotonin levels. (18)
The health of your digestive system is closely related to your emotional wellbeing. Our gut plays a key role in guarding against the development of anxiety and depression-related disorders. A large percentage of our brain chemicals, including serotonin, dopamine, GABA and norepinephrine are produced in the gut. In fact, around ninety percent of our serotonin is produced in the gut. Dysbiosis (altered gut microbiome) and gut inflammation have been linked to altered levels of serotonin levels and several mental illnesses including anxiety and depression. Incorporating probiotic rich foods in the diet and supplementing with a good quality broad spectrum probiotic will help restore normal gut microbiome to help improve mood and promote emotional health. Studies have shown that probiotic supplementation is effective at alleviating depression and anxiety symptoms. (19) Some of the best probiotic rich foods include yoghurt, kefir, miso, sauerkraut, kimchi, kombucha, and kvass.
MOOD BOOSTING VITAMINS AND MINERALS
Omega-3 essential fatty acids:
Current research has shown that people suffering from depression commonly have lower levels of omega-3 fatty acids. Omega-3 fatty acids play a crucial role in the development and function of the brain and central nervous system. Supplementing with omega-3 fatty acids can significantly improve depressive symptoms. (20)
Omega-3 fatty acids cannot be synthesized in the body so they must be supplied through the diet or supplementation. The best sources of omega-3 fatty acids include oily fish (salmon, trout, sardines, krill). Chia seeds, flax seeds, walnuts, and dark green leafy vegetables are also good plant-based sources of these healthy fats. A good quality fish oil supplement is recommended for anyone suffering from depression. Dosages of two grams daily have been found to be beneficial for alleviating depression. (21) A fish oil supplement with a higher ratio of EPA to DHA is recommended for treating depression.
B vitamins are needed to help maintain good mental health and emotional wellbeing. B vitamins are important for treating and preventing depression as they are required for the synthesis of neurotransmitters such as serotonin. B vitamins also support the body during times of stress and are needed to produce energy. Niacin (B3), pyridoxine (B6), and folic acid (B9) all work together with tryptophan to produce serotonin. Deficiencies in B vitamins are associated with mood changes, depression, insomnia, anxiety, and fatigue. Researchers have recognised that depressive symptoms are often seen in people with folate and B12 deficiencies. (22, 23) A study has shown that supplementing with 500mcg of folic acid can also enhance the efficacy of antidepressant medication. (24)
Eating a diet rich in B vitamins and supplementing with a good multi B-complex vitamin is recommended to help maintain optimal levels to support good neurotransmitter production. Foods rich in B vitamins include legumes, wholegrains, nuts, seeds, green leafy veggies, eggs, chicken, red meat, and milk. Diets high in processed foods and refined grains will lack these important mood-boosting vitamins.
Iron deficiency is one of the most prevalent nutrient deficiencies worldwide. Females—in particular teenagers and pregnant women—are prone to low iron levels. Iron plays a role in our emotional health as it is a cofactor for enzymes responsible for dopamine and serotonin synthesis, and it’s required for GABA homeostasis and energy production. Deficiencies in iron can strongly impact mood and are associated with apathy and the development of depression and anxiety. (25) Iron-rich foods include red meat, fish, chicken, eggs, legumes (lentils), and wholegrains. Supplementing with around 20mg of elemental iron daily is recommended for anyone with an iron deficiency.
Vitamin D is an important fat-soluble vitamin that plays a role in our mood and brain function, and prevention of depression. A majority of Americans are thought to be deficient in vitamin D due to lack of sun from either spending too much time indoors or wearing sunscreen all the time when outside. Vitamin D deficiency is linked to the development of depression, seasonal affective disorder (SAD), insomnia and anxiety. If you are deficient in vitamin D, it will affect your cognitive function and the production of dopamine and norepinephrine.
Sunlight is one of the easiest and healthiest ways to get sufficient vitamin D as your skin makes vitamin D when it is exposed to UV light. Sensible sun exposure of around fifteen minutes daily in summer, and two to three hours a week in winter, on the arms, legs, hands or face (without sunscreen) is all you need to help maintain adequate vitamin D levels.
Vitamin D is also found in oily fish (salmon, trout, mackerel, tuna, and sardines), eggs, organic butter and milk from grass-fed cows, cod liver oil, and mushrooms (exposed to UV light). It is recommended to supplement with around 6,000-8,000 IU of vitamin D3 daily if you are deficient in this important mood-boosting nutrient.
Spending time exercising outdoors is not only a great way to top-up your vitamin D levels, but exercise is an excellent natural antidepressant. When you exercise, endorphins and serotonin are released, which help boost mood. There is abundant evidence favouring the positive effects of exercise on mood, energy levels, quality sleep and, of course, a myriad other health benefits such as cardiovascular care, weight management, and social inter-activeness. Choose a form of exercise that you enjoy—walking, swimming, dancing, soccer, surfing, etc.
TOP HERBS FOR IMPROVING MOOD
St John’s Wort
St John’s wort (hypericum perforatum) is a medicinal herb commonly used by naturopaths and herbalists for its antidepressant effect. St John’s wort’s mood-boosting action is due to its ability to increase the availability of serotonin, dopamine and norephinephrine to the brain. Studies have shown that St John’s wort is beneficial for treating mild to moderate depression and anxiety, and is just as effective as SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft. (26) St John’s wort has also been found to be successful in treating SAD, and mood swings associated with pre-menstrual syndrome and menopause.
St John’s wort can interact with certain medications so take caution when taking this herb with pharmaceutical antidepressants, sedatives, migraine medications, or heart medications.
Ashwagndha (withania somnifera) is a highly effective ‘adaptogenic’ herb that helps improve the body’s resistance to stress. This popular Ayurveda herb is widely used by herbalists and naturopaths to treat anxiety and depression. Withania supports adrenal health and calms the nervous system. In studies, withania has been found to help combat stress and improve people’s emotional health and wellbeing. (27)
Rhodiola (rhodiola rosea) or golden root has been used for thousands of years in Europe and across Asia to improve stamina, strength, and mental performance. Rhodiola is another valuable ‘adaptogenic’ herb that is beneficial for improving depression and intense physical and emotional stress. (28)
Studies have shown that rhodiola can significantly reduce mild to moderate depression without the side effects of pharmaceutical antidepressants. (29)
Lemon balm (Melissa officinalis)
Lemon balm is a member of the mint family that has long been used for its soothing medicinal qualities and aromatic properties. The Arabs in the eleventh century introduced lemon balm as a remedy for depression and anxiety. They believed it caused the mind and heart to be merry. Today, lemon balm is popular among herbalists for treating insomnia and anxiety-related conditions as it has a sedative and calming effect on the nervous system.
Lemon balm and one of its key active compounds, rosmarinic acid, boosts levels of GABA in the brain by inhibiting the enzyme that normally breaks down this relaxing neurotransmitter. (30) Elevated GABA levels can help reduce anxiety and depression symptoms.
If you’re dealing with depression in your life, or you know someone who is, know that there are many avenues to take to improve mental health. While it can sometimes be difficult to believe, happiness isn’t an elusive gift meant for everyone else. With traditional medications, counseling or therapy, and naturopathic remedies, depression’s foggy layers can be peeled away, and your body can re-set to reveal the happy, positive, and optimistic person you deserve to be.
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