Tag Archives: Major depressive disorder

B Vitamin Helps Depression

Depression

Depression (Photo credit: Wikipedia)

 

Depression can be a debilitating condition. Symptoms run the gamut from mild to life altering.  It is also common. Depression is the leading non-fatal disease burden in the world. Approximately 1 in 10 people report being depressed.

 

Medically, drugs are given to patients that essentially increase the effectiveness of the serotonin system in the brain. This treatment, however, is very ineffective. Only about 30% of people achieve remission with one treatment and only 70% with 4 cumulative treatments. Clearly, there is room for more effective treatments out there.

 

The most popular class of drugs used to treat depression are called selective serotonin reuptake inhibitors or SSRIs. They prevent the nerves in the brain from vacuuming serotonin back up after it has been released. In essence, it makes serotonin more available to the brain. There is quite a bit of research that questions whether these drugs are actually any better than placebo, but that’s for another blog.  Examples of these drugs include Prozac, Paxil and Zoloft.

 

A recent study has found the addition of high dose L-methylfolate (active folic acid) to the regimen of patients already taking an SSRI helped improve symptoms dramatically in those who had no response or partial response initially.  The dose of L-methylfolate was 15mg/day and was tolerated very well by most patients.

 

Why use the active form of the vitamin?

 

Folic acid is a very inexpensive supplement that can readily be found at any health food store. When human beings consume folic acid, we must convert it to the active form called L-methylfolate. If we do not, our bodies cannot use it. In some people, however, there exists a genetic defect in which they do not efficiently convert folic acid into L-methylfolate.  To prevent this from confounding the results, the authors of the study used the active form. The active form is also available in supplement form as well. I have been using it in my clinic for years to treat people with depression, inflammation and many other conditions in which folic acid metabolism is an issue. It is also possible to use very high doses of the inactive folic acid to achieve the same results, although less rigorous study exists for that.

Depression is complex, but simple remedies exist to help people get relief. Active folic acid, or L-methylfolate, is a good option for those suffering or for those who have not gotten the relief they’ve been looking for from conventional treatments.

 

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Anxiety or Depression? Test the levels of your neurotransmitters to guide therapy.

Depression

Image via Wikipedia

Happy New Year!  A new era began at the Vreeland Clinic on January 1st this year.  Dr. Carrie and I would like to thank all of our friends and family for their well wishes.  We looked forward to continuing to serve the community for years to come!

Today I’d like to touch on something that has revolutionized the way I practice.

People come to me for many reasons.  Some people come to my clinic for weight loss or to get more energy.  Others for help with a chronic condition that hasn’t responded to traditional care.  Still others come to see me for a wide range of neurologic conditions.  These include things like Parkinson’s disease, multiple sclerosis, depression or anxiety.  It is the last two that I’d like to focus on today.

Anxiety and depression are extremely common in America.  Millions of Americans suffer from anxiety, depression or both.  These conditions may have many etiologies but one theory is a chemical imbalance in the brain.

Just what is this chemical imbalance?  When someone states that they have a chemical imbalance they are referring to an imbalance in the neurotransmitter system of the brain.  These neurotransmitters are really just proteins that each nerve in the brain uses to communicate with its neighbors.  Sometimes people can have too little of a certain neurotransmitter or too much of another.  This is problematic because it alters the way the brain functions.  It may cause anxiety and/or depression.

The pharmaceutical industry has figured that out and makes a large class of drugs that alters neurotransmitter function in the brain.  These are drugs like Prozac, Zoloft, Wellbutrin and Lorazepam to name a few.

Neurotransmitters are broken down into two categories – they are either excitatory or inhibitory.  That means they either tell the brain to go or tell the brain to stop.  The complexities of the neurotransmitter system are extensive and there is much more to it than “go” and “stop” but that basic principle holds true in most cases.

Examples of neurotransmitters include serotonin, GABA, epinephrine, norepinephrine, glutamate and dopamine.  Serotonin and GABA are inhibitory while epinephrine, norepinephrine, glutamate and dopamine are excitatory.

If you have anxiety and depression often times an imbalance exists in the levels of these neurotransmitters.

For example, high levels of glutamate may cause anxiety or seizures.  Low levels of GABA may cause anxiety.  Low levels of serotonin may cause depression.  Same goes for norepinephrine.

So how do you tell which neurotransmitters are low or which are too high?

Measuring Neurotransmitters

Measuring your neurotransmitters with a urine test is the best way to estimate your levels of neurotransmitters.  We do this routinely in our office for many patients.  It is incredibly insightful and directs our care for patients with anxiety, depression and many other conditions.

The measurement of neurotransmitters in the urine has been around for many years.  I’ve read studies dating to the 1960’s of scientists using similar methods to evaluate neurotransmitter levels.

Until relatively recently, perhaps the last 10-15 years, it has not been used frequently in clinical practice.  Now, through specialized laboratories, it is available to the general public and it is very affordable.

The knock on urinary neurotransmitter testing is that it does not correlate with brain levels of these hormones because the urine test is in fact testing whole body levels of neurotransmitters.

The very neurotransmitters that exist in our brain to make us happy exist outside the brain to serve the body in other ways.  So, yes, it is true that checking urinary neurotransmitter levels is technically a check of the entire body’s store of neurotransmitters.  But, through hundreds of thousands of tests these specialized labs have shown with high correlation that when neurotransmitter levels are abnormal certain psychiatric and neurological conditions are much more common.

Clinically, I have seen an almost one to one correlation in my patients with certain conditions an alteration in their neurotransmitter system.

The lab that I use will test all of the basic neurotransmitters plus a slew of metabolites of these neurotransmitters.  It provides a wonderful window into the neurological system.

If I find that serotonin is low, I supplement with something called 5-HTP.  If dopamine is low, I like to use L-tyrosine or an herb called mucuna pruriens.  The list can go on and on.

Once someone has been on a program for 6-8 weeks we recheck their neurotransmitter profile to gauge our therapy and adjust it if necessary.  We find that once a person’s profile returns to normal, their symptoms resolve.

If you have anxiety or depression, consider seeking out someone who does this kind of testing to improve your outcomes.  The brain is incredibly complex.  It never hurts to have a little extra information to guide your therapy.

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Fighting Depression Naturally

Depression

Image via Wikipedia

Depression is a huge problem in the United States.  The numbers are quite amazing. Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder. Depression is not just a disorder for adults, however. As many as one in 33 children and one in eight adolescents have clinical depression.

Depression is characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. Unipolar depression, the most common mood disorder in the U.S., was first described by Hippocrates in the 5th century B.C. He believed that depression was caused by an imbalance in the four humors – blood, phlegm, yellow bile and black bile.  Excess black bile caused depression according to Hippocrates. In fact, the Greek term for depression, melancholia, means black bile.

This view may seem far fetched, but the fact that depression is a physical process is correct. Even Freud wrote of the various presentations of depression which range from mild and cognitive, to severe and somatic.
There are several ’causes’ of depression.  I put ’causes’ in quotes because no one really knows for sure what ’causes’ depression.  There are many theories.  In my opinion, an imbalance in the neurotransmitter system is a scientifically sound explanation as to how a person could develop a mood disorder.  I also like to consider that if a person is not in good general health, depression is more likely to take hold.  This is a view that is also supported by the research.
So if these are two ’causes’ of depression, how can we effectively treat it?  Good question.  See my answers below.

Get Healthy

First and foremost a person that is depressed must make every effort to get healthy.  This includes exercise and dietary changes.  Junk in equals junk out.  Period.  If all one eats is McDonald’s value meals they are very unlikely to be healthy and much more likely to develop depression in my opinion.  Did you ever see the movie SuperSize Me?  A documentarian decides to eat nothing but McDonald’s for 30 days to see what happens.  Not only did he fall apart physically but he developed depression! Now, this is just one case and is a bit anecdotal, but the result confirmed the  hypothesis I made before I even saw the movie.

You must eat a healthy diet in order for your body to work properly and be healthy.  For some reason modern medicine has separated the health of our body from the health of our minds.  It is widely understood that to have a healthy body we need to eat nutritious foods.  It is far less accepted that to have a healthy mind we need to have a healthy diet.  Why is this the case?  The food that we eat provides fuel to our bodies and to our brains. The same food nourishes our entire system, not simply our physical bodies.

Exercise is unbelievably critical.  In fact, research has shown that the #1 cure for depression lasting less than 7 years is exercise.  Exercise does many things for the body. It improves blood flow, is a great stress reliever and changes the chemical balance in the brain to name just a few.  If you feel as if you suffer from depression and you do one thing for yourself this should be the one.  It has long lasting benefits in terms of depression and helps get the rest of your body healthy as well.

Supplements to take

There are several supplements that have been shown to reduce depression.  I would not suggest trying them all at once.  And I would suggest you consult a physician that is trained in functional medicine before you start a program.

5-HTP

If your problem is low serotonin this may help you.  5-HTP is short for 5-hydroxytryptophan.  5-HTP is the direct precursor in the body for serotonin.  Taking it may increase your serotonin levels and improve your mood.

St. John’s Wort

This is an herbal product that is used here in the U.S. to help with depression.  It acts by affecting the serotonin system.  I have found that it helps some, but not all depressed patients.  It’s a popular depression treatment in Europe.

SAMe

Short for the chemical name S-adenosylmethionine, it is pronounced “sammy.”  This has worked well in my practice for many people.  It is available over the counter in the U.S., but it’s used in Europe as a prescription drug to treat depression.

Omega-3 Fatty Acids

Diets higher in omega-3 fatty acids are known to protect people from depression.  It also appears that consuming more omega-3s reduces the symptoms of depression.  Consuming more in one’s diet is not likely to be enough.  Most people will have to supplement their diet with the oil or capsules to gain the most benefit.

This is just a small sample of the things that one can do to naturally ease depression.  People are most successful when combine exercise, diet and supplements together.  It will give you the best chance of improving your mood and feeling happier and more alive.

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