Clinical depression affects 15 million Americans yearly, and countless more suffer from milder versions of this illness. Antidepressants are among the most commonly prescribed drugs. By the end of 1995, 12 million people around the world (half in the U.S.) were taking Prozac, despite the high side-effect profile of this, and most other, antidepressant drugs, notably headaches, drowsiness, dry mouth, sexual dysfunctions and insomnia. Like most other disease, depression can be largely relieved by lifestyle and nutrition changes. Addiction and depression interface to a large extent. Many people claim that they smoke, drink alcohol, or take drugs because it calms them down. In reality, the “high” is very short term; these addictions ultimately add more stress to the system because of obsession with the next “fix.” (Please read Lifestyle Factors In Reducing Depression at the bottom of this post, for a list of changes you can make in your lifestyle that will have a direct impact on alleviating depression).

In a nutshell, people who suffer from depression must stop smoking, and avoid alcohol, street and prescription drugs and caffeine. Alcohol is definitely a “downer” and even “upper” type drugs will leave the user down and out in the long run. Nicotine raises cortisol levels by “whipping” the adrenal gland; high cortisol levels are a clinical feature of depression. (Psychol Med 6:235-44,1976) In fact, individuals with severe depression not helped by faithful adherence to the natural methods outlined below should be evaluated by a physician for both adrenal and thyroid problems.

The other critical lifestyle modification for alleviating depression is regular exercise. It is more difficult to get started on an exercise program than to maintain one because once you are in the habit of regular exercise you will feel so much better that you’ll want to continue. You don’t have to commit to running marathons; start with brisk walking 30 minutes 3 times weekly and work up to five 45 minute sessions of a variety of cardiovascular workouts each week. Go slow at first. Get a fitness evaluation or invest in a few sessions with a trainer at your local health club. Exercise naturally raises endorphin levels, will help keep you at an optimal weight, reduces physical tension, and will improve your appearance, your mood, your self-esteem and your cardiovascular health. Try it — you’ll like it!

Top Supplements To Remedy Depression

• Essential Fatty Acids – 1 tablespoon daily
• B vitamins, especially folic acid (800 mcg daily), B12 (1000 mcg daily) and B (50-100 mg daily).
• St. John’s Wort (900 mg 0.3% hypericin daily)
• Gingko biloba (120-240 mg standardized 24% gingkolisides daily)
• Homeopathic remedies
• Acupuncture treatments

Essential Fatty Acids

EFAs are so called because you can’t produce them in your body; they must be ingested. The principal EFAs for combating depression are the Omega 3 oils, high in cold-water fish and certain seeds, such as hemp and flax. Each of the more than 3 trillion cells in your body are surrounded by a fatty membrane, the quality of which determines what gets in and out of the cell. Cell membranes composed of Omega 3 oils are much more fluid, therefore function better, than a stiff membrane made of lard or other animal fats. The brain and spinal tissue is naturally extremely high in fat; mostly whatever kind of fat you eat. The fluidity of central nervous system cells (brain and spinal nerves) is directly linked to behavior, mood and mental functioning. Diminished brain function can cause, or significantly worsen, depression. Epidemiological studies have borne out the correlation of depression with decreased consumption of omega-3 fatty acids. In addition, rates of suicide, homicide and depression are relatively higher in those individuals with excessively low (below 120 mg/dl) total cholesterol and in those who take cholesterol-lowering medications. (J Am Coll Nutr 8:567-72,1989) Taking 1 tablespoon daily of a high quality Flax oil (raw only; never cook with this precious oil) or eating 4-5 ounces of fresh deep-sea fish daily will help maintain optimal brain function. If you have very dry skin, hair or mucous membranes, start with 2-3 T daily of flax oil, then reduce to 1T maintenance after 6 weeks.

B Vitamins

Known collectively as the “anti-stress” vitamins, a deficiency of B-vitamins can cause many nervous disorders, including depression. While I generally only recommend supplementing with a multi-B during high-stress periods, people suffering from depression or other mood disorders will almost always benefit from regular use of Bs. Plan on taking a good B-complex for at least 6 months, particularly during the winter months, to alleviate the “blues.” A good multi should contain 100-150 mg each of B1, B2, B3, and B6. Vitamin B5 is also very helpful for skin problems and wound healing, but not as commonly found; it is also known as pantothenic acid. The chemical names for the other Bs are Thiamin (B1), Riboflavin (B2), Niacin (B3), Pyridoxine (B6) and Cobalamin (B12). B1 deficiency is known to produce psychosis, apathy, anxiety and irritability as well as depression. Lack of B2 can lead to depression and irritability. B3 is essential to offset apathy, anxiety, depression, hyper-irritability, mania, memory deficits, delirium, dementia and emotional lability. B6 combats not only depression, but extreme sensitivity to noise. B6 is especially important for women on oral birth control pills, as estrogens can cause pyridoxine deficit. The proper dosage for B12 is about 1000 mcg daily (1mg). Some people have difficulty absorbing B12 because absorption requires the presence of a certain “intrinsic factor” secreted by stomach lining cells. Not everyone secretes intrinsic factor and this population is deficient in B12. My favorite trick for overcoming this problem is to get your B12 separately, in a sublingual form. This means a lozenge (or “troche”) that dissolves under the tongue and is taken up into the bloodstream directly from the mouth. B12 has been documented to prevent psychosis, confusion, memory loss, hallucinations, delusions, paranoia and irritability, as well as depression. Another important nutrient in the B family for a happy, peaceful disposition is folic acid, or folate. Best known as a preventer of neural tube defects in utero, this important nerve nutrient should be dosed at 400 mcg daily. It makes sense that if it can prevent malfunction in very early formation of brain and central nervous system tissue, it will continue to protect against CNS anomalies throughout life also. Folic acid is now being added to bread and milk; but not all of us eat those foods so additional supplementation may be wise, especially in women planning on becoming pregnant. Folate offsets forgetfulness, insomnia, apathy, irritability, depression, psychosis, delirium and dementia. All B vitamins are formed in the liver except for B12, which is found in meats and must be ingested. Good food sources of the other Bs are dark leafy greens, but in times of stress supplementation is more likely to give consistent results than diet alone.

Herbal Remedies

St. John’s Wort

My two favorite phyto-medicines (“phyto” is Greek for plant) for alleviating depression are St. John’s wort (Hypericum perforatum) and Gingko (Gingko biloba). St. John’s wort is a beautiful little yellow flower with pointed-oval leaves pierced with many tiny holes, visible held against the light. This is why, centuries ago, St. John’s wort was used to treat puncture wounds, and since it really did help, especially when there was nerve damage involved in the wound, the “old witch’s tale”, like many others, evolved into durable medical folklore. St. John’s wort flowers ripen in late June, reputedly around the birthday of St. John the Baptist, and additionally “bleed” a deep red “juice” when crushed. Hence the name. If you purchase St. John’s wort commercially in oil or tincture form, make sure it has a deep red color, otherwise it is not the real thing. However, you are more likely to get it in capsule form to treat depression, in which case the powdered plant has an olive-green color. Do ensure that the potency of the St. John’s wort is 0.3% hypericin, the principal active ingredient in remedying depression. The most effective starting dosage is 300 mg (of 0.3% hypericin content) 3 times daily for at least 6 weeks, then 300 mg just once or twice daily may suffice. Although St. John’s wort does have direct serotonergic activity in the central nervous system (like Prozac and other SSRI’s), it is best known for its so-called MAO-inhibitor activity. Mono-amine-oxidase is an enzyme that degrades serotonin (the calm-down, feel-good hormone, with a more or less opposite action to adrenaline). So, inhibiting the effect of MAO will prolong the half-life of serotonin. St. John’s wort is indicated for mild to moderate depression and may not work as well in people who have blood type O. Side effects at these dosages are virtually unknown.

Ginkgo Biloba

If you are over 50 years old and/or a blood type O, Ginkgo biloba may work better for you. The gingko tree is the oldest living species of tree known to mankind, with a fossil record dating back 200 million years. The species name, biloba, means “two-lobed” and the leaves of this attractive tree do indeed look like big-thumbed mittens. Since depression may be linked to decrease in mental functioning, especially in the elderly, improving mental acuity may well also improve mood. Gingko works primarily by improving blood flow to the brain. In one study, a group of sixty patients with both depression and a lack of adequate blood flow to the brain were given, once a day, 160 mg of Gingko biloba extract and compared with a group given a placebo. Within two weeks, the ginkgo-treated group had less depression, irritability, memory loss, headaches, and concentration difficulties than the placebo group (Pizzorno, J. Natural Health 1996). Usually, 40 mg 3 times daily of standardized gingko works well to alleviate depression, but some people may need up to 240 mg daily. All of the research on Gingko’s power to stimulate cerebral circulation (it also helps tinnitus, failing eyesight and reductions in smell and taste sensation) has used an extract containing 24% gingko heterosides, or gingkolisides. Make sure that 24% active ingredient is claimed on the label of the gingko you are investing in, or it won’t be as effective.

Homeopathic Remedies

For those readers not familiar with the principles of homeopathy, very briefly, it is a 200+ year old system of medicine based on matching a person’s symptoms to an extremely dilute plant, mineral or animal substance which in large doses would produce the very symptoms needing to be cured. It is sort of like an herbal (or mineral or animal substance) “vaccination” to stimulate the body’s energy to overcome whatever is producing the undesired symptoms. Homeopathic remedies must be tailored to the individual, but here is a brief description of six common remedies for depression:

• Natrum mur (table salt): for emotional, tearful depression. These people are irritable, independent, practical rather than intellectual; always worse from sympathy and consolation. They want to be left alone with their misery.
• Lycopodium (club moss spores): These persons are intellectual and needs company, being more social than Natrum mur. They aren’t very emotional; their time and energy is spent thinking and making endless speculative plans or projects. They worry about the future.
• Arsenicum album (arsenic trioxide): A useful remedy for fussy, obsessional people who worry about the past rather than the future. They are often exhausted because of constant fidgeting; tossing and turning even in sleep. They tend to be thin and chilly.
• Nux vomica (poison nut, or strychnine): These people are depressed because of some slight, incident or imperfection leading to a mixture of anger, indignation and depression. They always wish that they had dealt with the situation differently, more forcefully, at the time. They are preoccupied by the past.
• Capsicum (cayenne pepper): These people live in the past also, and they display both irritability and depression. Whatever the situation, they want to be elsewhere. The feel intensely homesick and long for the familiar. Any new situation is threatening; these are highly emotional individuals.
• Naja tripudians (cobra venom): These depressives are overwhelmed by torpor; they have a complete collapse of energy accompanying their depression, which provokes additional anxiety and restlessness because of a sense of being paralyzed. Palpitations are common.

Acupuncture

Last, but not least, is another form of “energy” medicine, the very ancient treatment of stimulating the vital force through thin filaments inserted into acupoints at specific points distributed across the body surface. These acupoints connect through an intricate network of channels to organs, including sensory organs, and regulate physical functioning and emotional well-being by restoring an even, balanced flow of “energy” throughout the system. Health, as defined by Traditional Chinese Medicine, is balance of the vital force, known as “Qi” (pronounced chee), within the 14 major meridians of the body. The filaments (or needles) act like tiny lightening rods to galvanize the energy to flow, instead of stagnating as it tends to in areas of pain or dysfunction. Acupuncture is an excellent tool for joint pain, at a very physical level, and also for emotional distress, at a deeper level. Acupuncture, like homeopathy, is best applied constitutionally, after assessing the particulars of the patient through compassionate listening, then checking physical findings such as pulse, respiratory rate, clarity of the eyes, the appearance of the tongue, the briskness of deep-tendon reflexes, and so on. However, several general principles may be applied diagnostically such as the connection of certain internal organs with specific emotions. Depression that is coupled with anger, for example, will be best treated by stimulating the liver meridian. The “Liver” is thought to be the organ that holds anger, which creates “stagnation” along that meridian. The liver meridian is connected to the eyes, and may also produce red, bleary eyes or frontal headaches. The “Lung” is, by contrast, the organ of grief, and depression accompanied by lots of sighing, melancholy or crying jags may well be best addressed by stimulating the vital force along the lung meridian. The “Kidney” is the fear organ, whereas depression that alternates with mania requires treatment of the “Heart” meridian. There are several “Calm Spirit” points on the body, including a pair on the surface of the outer ear. I like to use a trio of points I learned in China at the hairline above the bridge of the nose to treat depression. If you decide to use acupuncture as part of your protocol to break through depression, allow yourself 3 sessions before deciding it’s not for you. A “course” of acupuncture is usually 6-12 sessions, depending on the skill of the practitioner and the duration of the complaint, but maintenance treatments may also be required for optimal effect.

The remedies described above need not be taken simultaneously. In fact, it usually works better to try one therapy at a time to best evaluate what’s working. However, the lifestyle suggestions should ideally be adopted for the rest of your life; good clean living may be all the therapy for need to feel great most of the time!

Lifestyle Factors In Reducing Depression

• Please don’t smoke, drink alcohol or use street drugs.
• Minimize prescription drugs.
• Exercise regularly.
• Avoid processed food.
• Avoid sugary drinks and candy.
• Avoid people or situations that consistently bother you.
• Drink plenty of clean water.
• Spend time outdoors regularly.
• Spend time with people you enjoy and care about.
• Eat small, nutritious meals at regular intervals.
• Go to bed and get up at the same time daily.
• Get enough rest.
• Laugh, play, sing, dance and do something FUN every day.

References

• Werbach M., Nutritional Influences on Mental Illness: A Sourcebook of Clinical Research. Third Line Press, Tarzana, CA, 1991
• Murray M, Pizzorno J. Enclyclopedia of Natural Medicine. Prima Publs, Rocklin, CA 1991
• Smith T. The Homeopathic Treatment of Emotional Illness. Thorsons Publs, New York, NY 1984
• Quillin P. Healing Nutrients, Vintage Books 1989