Posted January 22, 2011 in Plans

We all have times when we feel down -- days when life seems bleak and getting out of bed is nearly impossible. If those days turn into weeks and then months, you may feel compelled to visit your doctor. However, far too often doctors are likely to prescribe antidepressants that may come with a number of side effects and yet are no more effective than placebo. That's right, recent studies have shown that antidepressants are, in most cases, no more effective than a sugar pill.

The majority of studies demonstrating positive effects from antidepressants also showed that using placebo produced virtually the same result [1,2,3] In fact, a meta-analysis of all published and unpublished studies has shown that on average placebos are about 80% effective, which is exactly the same as antidepressants. [1]

Taking antidepressants generally fails to address the underlying cause of depression. These can be a wide combination of factors ranging from social, physiological, psychological, to environmental.

Consult professional care if you are feeling symptoms of depression, but before you pick up that prescription for antidepressants, consider a more natural alternative. In most cases depression can be fixxed with natural treatments such as increasing vitamin B12 intake, DHEA, DHA, vitamin D, or exercise.

Antidepressants first came into being back in the 1950's when scientists developed a drug called Imipramine, which is still available as Tofranil. This drug increased brain levels of the neurotransmitters serotonin and norepinephrine, with the interesting effect of curbing the symptoms of depression.

Since then, the generally accepted cause of depression has been a chemical imbalance in the brain, namely lowered serotonin. Unfortunately, there has yet to be any research validating this theory. While just a theory, it still launched the rampant over-prescription of anti-depressants over the past few decades of well-known drugs such as Celexa, Paxil, Luvox, Prozac, and Zoloft. These anti-depressants have side effects that include fatigue, weakness, cardiovascular problems, sexual dysfunction, nausea, vomiting, bloating, cramping, and increased risk of suicide.

Multiple studies on subjects taking a drug vs those taking a placebo have shown that positive results rose to 82%, regardless of whether participants were taking the actual drug or placebo. Researchers did note that drug–placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of depression to a relatively small difference for patients with very severe depression. This means that the drugs reached clinical significance only for patients at the upper end of the severely depressed category. [4]

With this in mind, if you are experiencing mild to moderate levels of depression, you may be much better off addressing the problem with one of the possible solutions below.

Vitamin B12
If you or someone you know is suffering from depression, the most common cause is a vitamin B12 deficiency. Scientists believe vitamin B12 is essential for mood maintenance because its deficiency can lead to an oxygen-transport problem that can lead to symptoms ranging from lethargy, short attention span, and reduced motivation to more extreme symptoms such as mild confusion, hallucinations, memory loss and paranoia.   People generally get their Vitamin B12 from their diet (Meat is a good source of vitamin B12 and it is especially high in beef liver), but unfortunately our ability to assimilate B12 diminishes in some people as we age. If you suspect absorption issues may be a problem, consider talking to your doctor about acquiring a B12 shot or taking supplements. [5]

Dehydroepiandrosterone (DHEA)
If B12 is not the issue, the logical next step is to speak with your doctor about adrenal hormone levels, specifically DHEA and cortisol. Lowered levels of both DHEA and cortisol have been found to correlate with symptom severity in depressive psychosis. [6]

Some metabolites of DHEA are neurosteroids, which play important roles in the brain for anxiety and depression. Allopregnelone is one such neurosteroid that has been found to exert anti-anxiety effects. Moreover, changes in allopregnanolone levels have been associated with depressive disorders. [7]

If you suffer from fatigue or depression, there is a reasonable chance that you have low levels of DHEA. Ask your doctor to test your DHEA-sulfate level. If your DHEA-sulfate level shows borderline-to-low or worse, consider purchasing a small amount of over-the-counter DHEA. The effective dose is age-dependent, so if you’re not sure, start small and only increase the dosage as necessary. DHEA can be beneficial at doses between 5 and 50 mg per day. In conjunction with DHEA testing, also ask your doctor about measuring your cortisol levels. If your cortisol measurements are abnormal, it can significantly alter your ability to handle stress.

Docosahexanoic acid (DHA)
DHA is a derivative of Omega-3 fatty acids that is gaining attention as a key player in factors potentially contributing to depression. It has been observed that societies that consume large amounts of fish containing Omega-3 fatty acids have lower rates of depression. Scientists stipulate this is because DHA plays a fundamental role in brain functioning and there is continued interest and research on the biomechanism of how DHA impacts neurotransmitter systems and membrane functions. [8] DHA is a big component of the brain’s gray matter and it helps with the synthesis of seratonin which is a neurotransmitter that helps relax the body and can help you feel better.

Vitamin D
Vitamin D plays an integral role in brain function although research to date has demonstrated its role mainly in cases of seasonal affective disorder. If you are noticing a mood shift going into winter months, try increasing your intake of Vitamin D. Vitamin D is vital in the production of hormones that can affect brain function and it also increases the production of glutathione which is a hormone necessary for brain detoxification pathways. [9] The best way to get vitamin D is from UVB sunlight, but you would have to get a lot of it and it is tough to get a lot of UVB rays without exposing yourself to UVA rays, which are damaging to cells.

Exercise
The links between exercise and depression are not entirely clear, though research has shown that exercise yields both physical and psychological benefits that can turn someone towards a more positive outlook on life. Exercise is known to release feel-good chemicals (endorphins) that can trigger positive feelings in the body. It can also help boost your self-confidence (because you may look and feel better), it may help distract you from the negative thoughts that are causing the depression and it can also mean increased social exposure that might mitigate feelings of isolation and loneliness.

If symptoms still prevail after you have tried the above, an integrative physician may be able to identify other possible underlying causes of depression-- such as deficiencies in folate, malabsorption syndromes, and heavy metal toxicity. There are also natural remedies such as sam-e that can be found in all of our cells. Again, the cause of a specific individual's depression may be none of the above or all of the above and it is important to keep in mind other treatments such as counseling or psychiatric therapy.

References
[1] PLoS Med 08;5(2):e45
[2] Jun 26, 1998 ... Kirsch, I., & Sapirstein, G. (1998)
[3] JAMA. 2010;303(1):47-53.
[4] Begley, S. The Depressing News about Antidepressants. Newsweek. 2010 Jan 27. Available from: http://www.newsweek.com/2010/01/28/the-depressing-news-about-antidepressants.html
[5] Schimelpfening, N. Can vitamins help depression. 2009 May 4. Available from: http://depression.about.com/cs/diet/a/vitamin.htm
[6] J Psychiatr Res. 2010 Jul 7
[7]   Psychopharmacology 2003, 165:97-110.
[8] J.R. Hibbeln and N. Salem Jr. Am J Chin Nutr. 1995; 62:1-9.]
[9] Cannell, John J. Vitamin D and Depression. 2004 Mar 20. Available from:
http://www.vitamindcouncil.org/depression.shtml

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