Everyone feels down at one time or another.
Here's how to rise about the emotional clouds, naturally.
By Jack Challem
Copyright 2002 by Jack Challem, The Nutrition Reporter™
All rights reserved. This article originally appeared in GreatLife magazine.
Some Warning Signs of Depression
- Feeling tired
- Feeling guilty or unloved
- Not enjoying activities
- Sleeping too much or too little
- Crying often
- Suicidal thoughts
Maybe it's one of those cloudy gray days. Or it's just hard getting motivated for the "same-old, same-old" routine. Or perhaps you're feeling trapped in your job or a relationship that's seen better days.
Everyone has occasional "down" days - they're part of the normal vicissitudes of life. But an estimated 19 million Americans suffer from more serious, prolonged depression. And while television commercials for prescription drugs might promise to banish these dark days, the truth is that no one can feel happy all of the time.
So, what's the answer to navigating life's ups and downs?
Before doing anything, it's important to gauge whether you're just feeling blue for a day or two or whether you have been depressed for weeks or months. If you are depressed, consider whether your feelings might be normal: you should feel depressed after someone close to you dies, but it's not normal to feel depressed without a reason. Finally, true depression is characterized by feelings of sadness and hopelessness - the belief that life will not get better.
Feeling down or depressed either causes - or is caused by - a chemical imbalance in the brain. Major life events, such as losing a job or going through a divorce, trigger changes in serotonin and other neurotransmitters, chemicals that influence mood and behavior. Sometimes, it is difficult to reverse these changes and to bounce back emotionally.
Food and Mood
Just as diet affects your physical health, it also affects your mood and mental health. That's because food provides, or fails to provide, the many chemical building blocks needed to produce neurotransmitters.
This relationship between food and mood was clearly demonstrated in a study by Anita S. Wells, M.D., of the University of Sheffield, England. Wells asked 20 healthy men and women to eat high- and low-fat diets for several weeks. People following the low-fat diet developed greater feelings of depression, dejection, and anger. In contrast, those eating high-fat diets had improvements in mood. Still other research has found that people who eat fish less than once a week are one-third more likely to experience mild to severe depression. Fish is rich in good omega-3 fats needed for normal brain function.
Nutritionally oriented psychiatrists, such as Priscilla Slagle, M.D., of Palm Springs, California, routinely coach their patients on how diet and specific nutrients impact mood and feelings of depression. Slagle asks her patients to avoid foods high in refined sugar (such as soft drinks and sweets) and other refined carbohydrates (white bread and pasta), in favor of more wholesome foods, such as lean meats, fish, and vegetables. These wholesome foods help stabilize blood sugar levels.
The relationship between blood sugar and depression may, in fact, be very significant. Researchers have long known that people with diabetes are particularly susceptible to depression, but their moods improve when their blood sugar levels remain relatively stable. Until recently, the reason had not been clear.
Recently, Malcolm N. McLeod, M.D., a psychiatrist at the University of North Carolina School of Medicine, Chapel Hill, treated a depressed patient with a leading pharmaceutical drug. The patient happened to start taking supplements of chromium picolinate, which is well established for its role in improving insulin function and normalizing blood sugar levels. The cheomium supplements led to a complete reversal of the patient's depression, fatigue, and over eating - problems he had for 25 years.
Intrigued, McLeod and colleague Robert N. Golden, M.D., asked other depressed and bipolar (manic-depressive) patients to try chromium picolinate supplements, ranging in dosage from 200-400 mcg daily. All of the patients recovered, some after failing to respond to prescription medications. In an article in the International Journal of Neuropsychopharmacology, the doctors speculated that the chromium supplements may help by improving insulin function, in turn boosting the brain's serotonin.
B-complex vitamins. Many B-complex vitamins play key roles in mood and preventing down feelings and depression. For the occasional down day, Slagle recommends two supplements, 500-1,000 mg of the amino acid tyrosine and 500-1,000 mcg of sublingual vitamin B12 after waking but before eating breakfast. Both nutrients are building blocks of key neurotransmitters.
Considerable research points to the mood-lifting benefits of three B vitamins: B6, B12, and folic acid. Vitamin B6 is essential for the body's production of serotonin, which most anti depressant drugs are designed to elevate. Slagle describes the use of vitamin supplements as "precursor therapy," in effect boosting levels of the nutrients needed to make neurotransmitters.
Not surprisingly, low intake of B vitamins is strongly associated with depression. In a recent report in the American Journal of Psychiatry, Jack M. Guralnik, M.D., Ph.D., of the National Institute of Aging, Bethesda, Maryland, found that elderly women with vitamin B12 deficiency were twice as likely to be depressed, compared with women who had normal levels of the vitamin. The vitamin is involved is needed for neurotransmitters and phospholipids (phosphorus-containing fats) that enable brain cells to communicate with each other.
Meanwhile, other research has found that people with low levels of folic acid have an increased risk of depression and are also less likely to benefit from antidepressant drugs, according to a study of 213 patients by Maurizio Fava, MD, of Massachusetts General Hospital.
"Overall, the results are consistent with findings linkng low folate levels to poorer response to antidepressant treatment," Fava wrote in the American Journal of Psychiatry. "Folate levels might be considered in the evaluation of depression patients who do not respond to antidepressant treatment."
Tryptophan. The B vitamins enhance the body's production of the amino acid tryptophan, its precursor 5-hydroxytryptophan (5-HTP), and S-adenosyl-L-methionine (SAMe). In turn, each substance boosts levels of serotonin. Several studies have found that depression and aggressiveness increase when people are deprived of tryptophan. Supplemental tryptophan or its 5-HTP precursor can significantly ease depression. Although 5-HTP and SAMe may be more expensive than B vitamins, they may leapfrog biochemical bottlenecks limiting serotonin production.
Melatonin and light. Long work days and artificial lights alters the normal day/night cycles of people, shifting or reducing production of melatonin. This hormone is a key regulator of the circadian, or daily, biological rhythm, with levels normally increasing at night and decreasing by morning. But melatonin seems to exert broader roles in mood. Depression is associated with low melatonin levels, and this is especially the case with people who become during the shorter days of autumn and winter.
Melatonin supplements, taken in the early evening, can safely induce sleepiness, help reset the biological clock, and reverse some cases of depression. In addition, early morning exposure to intense light, such as by walking outside for 20 minutes, can also reset the body's production of melatonin so it increases, as it should, in the evening.
Physical activity. Researchers have known for more than 20 years that physical activity improves mood and reverses depression. In a study conducted in England, researchers found that an aerobic dance session improved the mood of subjects who had been depressed before exercising. Another study, conducted at the University of New Orleans, found that aerobic activity reduces depression, tension, fatigue, and anger in healthy men and women.
St. John's wort. Patients with mild to moderate depression often prefer to live with their symptoms rather than deal with the side effects of prescription antidepressants. The herb St. John's wort offers a reasonable compromise, easing symptoms with a low risk of causing side effects.
Several clinical trials have pitted St. John's wort against leading anti-depressant medications, including fluoxetine (Prozac), sertraline (Zoloft), and imipramine (Tofranil). In all of the studies, St. John's wort either matched or exceeded the drug in benefits. In the fluoxetine study, which involved 240 patients, both herb and drug reduced depression to the same extent, but about one-third more patients responded to the herb.
In sum, while everyone has an occasionally down day, it is important to respond when those days turn into a depression lasting weeks or months. Often, selecting healthier foods, spending more time outdoors, and taking one or two natural anti-depressant nutrients can part the emotional clouds and brighten your life.
What to Take
Overall diet: Emphasize fish, chicken, and a diverse selection of vegetables.
Physical activity and light exposure: Take a daily 20-minute walk in the morning or early afternoon.
Chromium picolinate: 200-400 mcg daily.
B-complex vitamins: High-potency "B50" multiple.
5-HTP: 400 mg, before bed. Take with a small protein snack to enhance absorption.
SAMe: 800 mg daily.
St. John's Wort: 300 mg of standardized extract, three times daily.
Cautions: do not combine 5-HPT, SAMe, and St. John's wort without a physician's guidance. Similarly, do not combine these three supplements with a prescription antidepressant unless instructed by a physician. If you are taking a prescription antidepressant, your physician may reduce the dosage after seeing an improvement in your mood.