Out of the Blues

Out of the Blues by Lauren Piscopo Natural Health Magazine Blame the bad economy, the “normal” pressures of modern life, brain chemical imbalances or the labeling of what just may be the inescapable human condition— regardless of the cause, depression is rampant. About 1 in 10 Americans will face major, or clinical, depression at some point, and women have a 70 percent higher risk than men. Fewer than half of sufferers seek treatment, but if it’s not addressed, depression can seriously impact your productivity, your relationships and your overall health. A recent study found that depression increases the risk of heart disease more than smoking or having a family history of cardiac problems. The most commonly prescribed antidepressants, selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Prozac and Zoloft, stop your body’s reabsorption of the “feel-good” neurotransmitter serotonin. This causes its levels to increase, which boosts mood. But these meds also pose a long list of potential side effects, many of them identical to depression symptoms. What’s more, SSRIs may be no more effective than a placebo at treating depression. A recent National Institute of Mental Health study followed 4,000 depression sufferers and found that 75 percent of them still experienced at least five symptoms after taking antidepressants for three months. Are you really depressed? If antidepressant drugs don’t work that well, why are Americans taking 50 percent more of them than we were 20 years ago? “Many physicians think of antidepressants as a panacea and prescribe them without addressing the underlying causes of the depression or giving people the tools they need to help themselves,” says psychiatrist James S. Gordon, M.D., founder and director of The Center for Mind-Body Medicine in Washington, D.C., and author of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression (Penguin). Earlier this year, researchers reported in the Journal of Clinical Psychiatry that family doctors are prescribing antidepressants to a quarter of patients who exhibit a symptom or two but have not been diagnosed with depression. Another recent study found that at the same time, fewer people are visiting psychotherapists because insurance offers better coverage for pharmaceuticals. Your doctor may also be quick to write you a prescription without exploring other conditions that have the same symptoms as depression. “You might feel depressed because you love sushi and actually have mercury poisoning. Or you could be a fish hater so you have an omega-3 deficiency,” says Mark Hyman, M.D., founder of The UltraWellness Center in Lenox, Mass., and author of The UltraMind Solution (Scribner). “Or maybe you’re taking an acid blocker for reflux and as a result your vitamin B12 is depleted, which also leads to depression.” Other conditions that Hyman says can make you feel blue include low thyroid function, food sensitivities like celiac disease, sugar addiction, systemic yeast infection, adrenal exhaustion, hormone imbalances and nutrient deficiencies. He recommends visiting a naturopathic physician (N.D.) or an integrative M.D. for testing to determine if any of these issues are the real reason you’re feeling down. You can also try lifestyle changes and natural remedies before going on meds. For a quicker recovery, combine these holistic approaches, advises Gordon, who has helped depressed patients using mind-body medicine techniques for 40 years. Where should you start? “Ask yourself, ‘What am I doing now that actually makes me feel better?’ ” Gordon suggests. Do that, then explore the other possibilities described here. MOVE YOUR BODY Exercise is as effective as any antidepressant in reversing depression symptoms and has no negative side effects, numerous studies have found. “If you don’t exercise, you won’t make ‘happy mood’ chemicals like serotonin and endorphins or reduce your stress levels,” says Hyman, who advises exercising for at least 30 minutes, three to five days a week. FEED YOUR HEAD Your brain is mostly made up of fat, primarily docosahexaenoic acid (DHA), so nourishing it with omega-3 fatty acids is essential. If you’re not getting enough omega-3s (most of us are deficient), blues-busting brain chemicals won’t be properly utilized. Omega-3s also reduce inflammation throughout your body, yet another contributor to mood disorders. Gordon recommends taking 3,000 to 6,000 milligrams of omega-3s daily, at least half of which are EPA and DHA. Try: Barleans Omega Swirl Omega-3 Fish Oil Supplement in Mango Peach flavor ($20 for 12 ounces; barleans.com) GO WITH YOUR GUT Most of your body’s bliss-boosting serotonin is produced in your gut, not your brain. That means the levels of “good” and “bad” bacteria in your intestines may affect your state of mind. Hyman has seen this “second-brain” effect in patients who feel depressed because years of taking antibiotics have altered their digestive flora and affected their “gut brain,” which in turn affects their “head brain.” You can eat fermented foods like tempeh, sauerkraut or kimchi, or take probiotics. Try: American Health Probiotic CD ($30 for 60 tablets; luckyvitamin.com) AVOID VITAMIN D-FICIENCY If you live where the sun doesn’t shine much or you never let the rays hit your skin without first slathering on the SPF, low vitamin D levels may be the culprit behind your depression, or seasonal affective disorder (SAD) in winter. The sunshine-triggered vitamin helps regulate an enzyme essential in the production of the neurotransmitters norepinephrine and dopamine. If sun exposure is not an option, research indicates that you should supplement with at least 2,000 to 5,000 IU of vitamin D3 daily. Try: Nordic Naturals Vitamin D3 ($16 for 120 softgels; nordicnaturals.com) BE SURE TO GET YOUR B’S Without enough B vitamins, your brain can’t properly regulate mood-affecting neurotransmitters. Hyman suggests taking 800 micrograms daily of a food-based folate supplement (not folic acid, the synthetic form); 500 to 1,000 micrograms of B12; and 25 to 50 milligrams of B6. Try: Innate Response Formulas Folate, B6 & B12 ($25 for 90 tablets; pureformulas.com) FOLLOW A MEDITERRANEAN DIET When followed consistently, this heart-healthy diet has also been shown to lower depression risk by 30 percent. Staples include cold-water fatty fish like salmon, mackerel and sardines; dark leafy greens, such as spinach, kale and collards; beans, nuts and seeds; and olive oil. CUT OUT JUNK FOOD Sugar briefly energizes you until you crash, physically and emotionally, and it also causes inflammation in the brain, Hyman says; the artificial sweetener aspartame has been shown to deplete serotonin; and trans fats cause inflammation and raise depression risk by 48 percent, a Spanish study found. You might also try an elimination diet to see if certain foods are not ideal for your body. Hyman has seen longtime depression sufferers drop dairy and gluten—two causes of brain inflammation—and their depression lifts enough that they can go off the meds they’d relied on for years. DON’T DROWN YOUR SORROWS While drinking might seem to provide a temporary lift, alcohol is a known depressant that alters brain chemistry and mood. “If you’re drinking to avoid feeling sad or dealing with your problems, you need to steer clear of alcohol completely,” says Meredith Sagan, M.D., founder of Holistic Psychiatry in Santa Monica, Calif. Do not deny yourself wine at a party, but she advises stopping after one glass. BEWARE OF BPA Avoid eating foods from cans or drinking water from plastic bottles when possible because of potential bisphenol-A (BPA) exposure. This toxin alters the nervous system, and studies show it may be linked to depression and cognitive decline. MEDITATE BEFORE YOU MEDICATE “We’re constantly triggered emotionally by people or situations that send an overwhelming flood of fight-or-flight stress hormones into our bodies,” Sagan says. “Meditation can help us become less reactive and more observant of our emotions and stressors so we’re not as prone to depression and anxiety as a result.” Studies have found that regular meditation can be just as effective as SSRIs in preventing a relapse of depression. BREATHE DEEPLY Gordon recommends a four-minute deep-breathing technique in which you focus on your softened, relaxed belly rising when you inhale and falling when you exhale. “MRI scans show that regular slow, deep meditative breathing lights up the parts of our brains that are connected with optimistic thoughts and more relaxed feelings,” he says. DEAL WITH YOUR ISSUES Antidepressants can sometimes diminish the ability to feel emotions, and they don’t address what may have triggered depression in the first place. It’s often clear when a life event like losing your job is the cause, but Sagan says that a childhood trauma can affect how you cope with stressful situations later in life and could predispose you to depression. Many studies have shown that cognitive behavioral therapy—learning to “reframe” negative thought patterns and reactions—is more effective than drugs in easing depression symptoms and reducing relapse. Try side-effect-free supplements SAM-E One study showed that when antidepressant users who still exhibited symptoms also took SAM-e, they showed more improvement than those who only tried SSRIs. Take 800 milligrams twice daily, but for SAM-e to work, you also need 200 to 600 milligrams of magnesium a day, Hyman says. Try: Source Naturals SAM-e Double Strength ($22 for 30 tablets; vitacost.com) ST. JOHN’S WORT This herb is well-known for treating mild to moderate depression as effectively as SSRIs. Note: Do not take it if you are also taking prescription drugs for various medical conditions, as St. John’s wort interacts with many of them and makes them less effective. Take 300 milligrams three times a day. Try: New Chapter’s Mood Take Care ($14 for 30 softgels; amazon.com) ASHWAGANDHA This Indian adaptogenic herb will help you stand up to stress, stabilizes your moods and eases anxiety, despair and helplessness. Take 20 to 50 milligrams daily. Try: Organic India Joy! ($19 for 90 capsules; organicindiausa.com). Signs of depression According to the Centers for Disease Control and Prevention, you may have major, or clinical, depression if you have at least five of the symptoms below that cluster together, last for at least two weeks and impair your functioning: Changes in sleep, appetite or activity patterns Fatigue or lack of energy Loss of interest in activities that were once pleasurable Difficulty concentrating, remembering or making decisions Feelings of sadness, hopelessness, helplessness, guilt, worthlessness, irritability or agitation Thoughts of death or suicide