If you have ever experienced depression, you are not alone. One in five people will experience depression at some time during their lifetime. Therefore, about eight million women and four million men live with depression. Many people often suffer without realizing they have the condition, may be misdiagnosed, or receive inadequate treatment when they are diagnosed.

Depression has multiple, diverse causes including imbalances in neurotransmitters (the brains chemical messengers that affect mood), underlying diseases, prescription and recreational drugs, food allergies, chemicals and heavy metal overload, and vitamin and mineral deficiencies.

There are several natural approaches that can improve function and quality of life for someone with depression. Remember that with so many different causes, there can be no single "magic bullet" cure. Ideally, to alleviate depression we want to provide the brain and nerves with the optimum building blocks for cells and neurotransmitters, keep the blood sugar balanced, avoid toxins that may overwhelm normal body function, add supplements to fine tune the balance after day-to-day life stresses, replace negative thought patterns with an uplifting positive frame of mind, and adopt a lifestyle to exercise your body, mind and spirit. Although these steps may be beneficial for many, they may not be effective for serious depression or manic-depression.

Chemical messengers pass between nerves to send messages that influence mood. These messengers are made from amino acids, the building blocks of protein. If there is an inadequate supply of messengers, or the nerves cannot transmit or receive them, then depression can result. Some messengers are stimulating, such as noradrenaline, dopamine, and glutamine, while others are calming, like serotonin and GABA (gamma-aminobutyric acid). Most of us already know how to influence our neurotransmitters, with the use of caffeine, sugar, chocolate, and nicotine to stimulate us, or alcohol and marijuana to relax ourselves.

Here are several helpful tips for improving mood and function: 1. Fuel the body with good raw materials, like whole, unprocessed, organic foods. Whole grains, vegetables, beans, seeds, nuts, and fruits are good choices. Processed foods are lacking in the original food nutrients and lead to deficiencies, while non-organic foods may contain chemicals that are toxic to your body. Clean, filtered, distilled, reverse osmosis or spring water is preferable to chlorinated, fluoridated water. Avoid stimulants like sugar, caffeine, and nicotine, which may provide a quick energy fix but usually leave you fatigued and craving more, and alcohol, which is a depressant. Complex carbohydrates break down into glucose gradually, which provides a steady supply of fuel, contrasting with simple, refined sugars, which are quickly broken down, leading to energy and mood swings. Adequate high quality protein is essential, as it is the building block for hair, muscles, enzymes, hormones, and neurotransmitters. In order to optimize the amino acids, like tryptophan, that can help with depression, you can either chose sources that have relatively high amounts, like pumpkin and sunflower seeds, milk, bananas, peanuts and lentils, or eat protein meals with carbohydrates, so that the other amino acids get used, leaving tryptophan available in the bloodstream. Fats are also important, as certain fatty acids are essential building materials for nerve membranes, neurotransmitter receptor sites and nerve impulse transmission. Unfortunately, we usually consume far too much unhealthy fat, which can actually impair nerve and membrane functions and can cause poor concentration and fatigue. Good sources of essential fatty acids include cold water, fatty fish; walnuts; pumpkin seeds; soybeans; kidney beans; sea vegetables; and flaxseed. Poor fat choices include saturated and hydrogenated fats found in red meat, fried foods, and processed foods.

2. Vitamins and minerals are needed for hormone secretion, neurotransmitters, nerve transmission, and cellular metabolism. Deficiencies usually occur due to poor diet or depletion of these essential functions from detoxification of chemicals and medications in the body. There may be multiple deficiencies rather than one solo deficiency. B vitamins have more dramatic mood elevating effects than the other vitamins, since most of them influence metabolism of neurotransmitters, sugar, or fat. Magnesium is also a valuable mineral that is often deficient and can help with anxiety and insomnia. Common deficiencies found in psychiatric patients include vitamin B6, B12, folate, inositol, choline, NADH and magnesium.

3. Low levels of omega-3 essential fatty acids (EFAs) have been linked to depression. EFAs are the building blocks for cell membranes and receptor sites, and also enhance nerve transmission. They may be deficient due to low fat or processed hydrogenated fat diet, low cholesterol diets and drugs, which exacerbate deficiency, or they may be inhibited from use due to refined fat intake. Good sources include the foods listed above and supplements like flaxseed, hempseed oil, fish oil, and microalgae. Oils tend to be perishable so keep in refrigerator or somewhere cool, dry, and dark, and keep tightly closed.

4. Amino acids, the building blocks of neurotransmitters, can be supplemented to improve mood. As there are side effects and contra-indications, an experienced practitioner should supervise use. Note that the naturally occurring L-form is preferable to the synthetic D-form, which is less biologically active. Tryptophan and 5-HTP are precursors of serotonin and can improve mood, relaxation, and sleep. 5-HTP is ten times more potent than tryptophan and more readily available. Both should be avoided if taking prescription antidepressants, like SSRIs or MAOIs. Phenylalanine and tyrosine are precursors of dopamine and noradrenaline, two neurotransmitters that help energy levels, memory, and alertness. Tyrosine has the additional advantage of supporting thyroid gland function. Both may cause over-stimulation, increased blood pressure, insomnia, and irritability. Glutamine, a precursor of the neurotransmitter GABA, decreases fatigue, boosts alertness, and can help with addictive tendencies, especially alcohol and sugar. GABA, the main inhibitory neurotransmitter, can also be taken as a supplement to improve mood and relieve anxiety. It should be avoided with alcohol or other relaxants. SAMe (S-adenosylmethionine), is an amino acid derivative, which can improve neurotransmitter activity. Studies have shown it to be equal or superior to antidepressants with a faster onset of action. It must be avoided if you are manic-depressive. Finally, acetyl-L-carnitine can improve mood and mental performance.

5. Herbal therapies are usually safe, effective, and nonaddictive, readily available and inexpensive. They work more subtly to promote the body's natural function, but can have powerful effects, so consult an expert before trying them. They are most effective when used as close to their natural form as possible, as concentrating the extract may eliminate some of the active compound or remove protective compounds. St John's wort and gingko biloba are mood elevators. St. John's wort can also help with anxiety and sleep, but should not be used with SSRIs or 5-HTP supplements. Gingko can improve alertness and memory. It also has a blood thinning effect, so caution should be used if taking blood-thinning medications like aspirin or coumadin. There are several herbs that can boost energy levels, usually by supporting the adrenal glands. These include Siberian ginseng, ashwaganda, licorice, reishi mushrooms, and rhodiola rosea. They have few side effects, except licorice, which can raise blood pressure. Various herbs provide relaxation, improved sleep, and decreased anxiety, e.g. valerian, kava kava, hops, passionflower, and lemon balm. They should not be combined with other prescription sedatives or alcohol.

6. Homeopathic Remedies, when used by a skilled practitioner, can accomplish significant energy shifts and healing, rather than just masking symptoms.

7. Aromatherapy has been used for centuries to affect mood. Stimulants include clove, ylang-ylang, cinnamon, lemon, cardamom, fennel, angelica, peppermint, and eucalyptus. They can also relive drowsiness, irritability, and headaches. Some relaxant aromas are lavender, rose, bergamot, cypress, balsam fir, chamomile, and orange. Make sure to buy good quality natural essential oils and patch test them to check for allergic reactions. They can be used for massage, added to bath water, and used to scent rooms or as perfumes.

8. Several lifestyle changes can improve depression and anxiety. Exercise has been proven to decrease depression by releasing endorphins, the body's natural mood elevators. Likewise, laughter raises the spirits by effecting neurotransmitters and endorphins. Strong social connections and family ties decrease the risk of depression. Also nurturing touch, either with a partner, children, friends, pets, and even massage, is an important element of emotional health. Conscious relaxation, via breath work, meditation, yoga, prayer, progressive relaxation, visualizations, and t'ai chi can elevate spirits and decrease anxiety. Exploring your spirituality provides connection to your deepest sense of self and life purpose. Working on replacing negative beliefs with positive messages and releasing unexpressed emotions is very helpful. Improving the quality of your sleep provides your brain with a chance to slow down and sets your mind free to work on unresolved fears via dreams. Please remember that depression is a common illness, which unfortunately has significant stigma attached to it. However, a wide variety of help is available to those that are suffering. I hope that this information is useful.

Some fabulous resources are Natural Highs, H. Cass, M.D. & P. Holford; Depression Free for Life, G. Cousens, M.D.; Depression Cured At Last, S. Rogers, M.D.; Natural Alternatives to Prozac, M. Murray N.D.; The Natural Medicine Guide to Depression, S. Marohn.

Dr Linda Rayner ND, ABHM is a holistic family practice physician, working with Millennium Healthcare in Dunwoody and Alpharetta, Georgia. She can be reached at 770-390-0012 or lrayner@millennium-healthcare.com

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