Dr. Jacob Teitelbaum's Column
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Monday, February 25th, 2008:
by Jacob Teitelbaum MD
Depression is becoming increasingly common, but often goes away with natural therapies. Although how we feel has a lot to do with psychological issues, it can also be dramatically affected by our biochemistry. The same applies to bipolar, obsessive-compulsive and other disorders that are classified as being psychological. Although doing one's "psycho-spiritual" work is important in treating any illness, you will be amazed at how much better you can feel when you optimize your biochemistrynaturally! This article will teach you how. (For the "short and sweet" version, skip to the "Important Points" summary at the end.)
By looking at American society today, one would think that there is a massive epidemic of Prozac deficiency. Millions of Americans are complaining of being unhappy and depressedyet most doctors simply throw a pill at the problem! I prefer to go after the underlying causes, while using natural therapies to support the biochemistry of happiness. When you do this, most depression can be effectively treatedwithout the loss of libido, weight gain, fatigue or increased risk of suicide seen with prescription antidepressants.
I'm tired of being depressed and want to be happy! How should I begin?
Let's look at both the physical and psycho-spiritual componentswhich is a good approach for any illness.
From a psychological perspective, depression usually represents repressed anger which has been turned inward. This is why choosing to allow yourself to be angry or even to sometimes go into a rage can be healthy when you're depressedeven if the people around you don't like it. You can tell when the anger is healthy because it will feel good. Remember though, that you are choosing to be angry, and what you are angry about is nobody else's fault (so don't beat up others with your anger). When you don't allow guilt to get in the way, notice how your depression decreases and you feel better after a good fit of anger!
My book "Three Steps to HappinessHealing through Joy" (available at www.vitality101.com) will take you through the three steps that psycho-spiritually will help you to get past depression and leave you feeling great. These are:
1. Feel all of your feelings without the need to understand or justify them. When they no longer feel good, let go of them. The book will teach you how to do this.
2. Make life a "no-fault" system. This means No Blame, No Fault, No Guilt, No Judgment, and No Expectations on yourself or anyone else. This means you'll be changing habits of thinking. For example, if you find yourself judging somebody, simply drop the judgment in mid-thought when you notice it. And no judging yourself for judging others!
3. Learn to keep your attention on what feels good. We sometimes are given the misconception that keeping attention on problems is more realistic. That is nonsense! Life is like a massive buffet with thousands of options. You can choose to keep your attention on those things that feel good. You'll notice that if a problem truly requires your attention at any given time, it will feel good to focus on it. Otherwise, you're living your life as if you have 200 TV channels to choose from, and you only choose to watch the ones you don't like!
From a physical perspective, depression often reflects faulty biochemistry. Begin by asking yourself this simple question"Do I have many interests?" If the answer is yes, you're probably not depressed but rather have other physical problems causing how you feel. Common causes would include poor sleep, infections, thyroid and other hormonal deficiencies (despite normal blood tests!) and nutritional deficiencies. For more information on treating these areas, see www.vitality101.com or my book "From Fatigued to Fantastic!" This is especially important to do if you have a combination of exhaustion, poor sleep, and in many cases widespread achiness. If this is so, you may well have chronic fatigue syndrome/fibromyalgiafor which effective treatment is now availableand not depression. If you do not have many interests, you probably are depressed and the treatments below will be very helpful for you. Fortunately, depression is very treatable.
What can I do to feel better while I'm going after these underlying problems?
Happiness has its own biochemistry which can be powerfully balanced and enhanced naturally. Let's start with the basics:
1. Overall nutritional support is essential, and I would recommend a good multivitamin powder (my favorite is the Energy Revitalization System).
2. Begin a walking program. Research has shown that walking briskly each day is as effective as Prozac for depression.
3. Get more sunshine (maybe while you are walking ;-) Inadequate sunlight is a common cause of depression (called Seasonal Affective Disorder or SAD), which should be considered if your depression is worse in the winter.
4. Use herbal support if needed to get eight hours of sleep a night as well.
These simple steps are very healthy in general, and will usually help improve how you feel considerably!
Sounds like a good foundation. What can I add specifically for the depression?
1. Take fish oil. Fish oil has been shown in numerous studies to be very helpful in depression and many other psychological problems. Most of your brain is actually made of DHA (docohexaenoic acid), one of the 2 key components of fish oil. In fact, taking fish oil during pregnancy (see Having a Healthy Pregnancy) markedly decreases the risk of post partum depression. Fish is called "brain food" for a good reason! If you have depression or other psychological problems, try eating 3+ servings of salmon, tuna or herring each week, and/or take fish oil. Be sure the oil is toxin and mercury free, and not rancid. I recommend Eskimo 3 or Nordic Naturals brands. Take 1 teaspoon or 3 (1000 mg) capsules 3x day for 6 weeks and then you can lower it to once a day.
2. Optimize thyroid function. Natural Armour thyroid (or compounded T3) thyroid hormone (by prescription) has been shown to be very helpful in treating depression in two separate studieseven when thyroid blood tests were normal! Taking the thyroid hormone helped even when Prozac failed. Interestingly, only the forms of thyroid mentioned above (i.e. which contain T3 thyroid hormone) helped. The T4 thyroid hormone found in Synthroid (and most thyroid prescriptions used by non-holistic physicians) was NOT effective.
3. Be sure to treat other hormonal disorders as well. Suboptimal testosterone and estrogen levels can frequently cause depression and are easily treated by Holistic Physicians .Excellent ones can be found at www.FibroAndFatigue.com, where I have trained the physicians, or at www.holisticboard.com. These hormonal deficiencies often need treatment even if the tests are low normal.
Happiness 1-2-3! A natural way to enhance your mood!
It is also critical that your body has what it takes to make the three key "happiness" neurotransmitters that your body needs. These are serotonin, dopamine, and norepinephrine. B vitamins and magnesium are critical for energy production, as well as for producing the hormones and neurotransmitters that contribute to your feeling good! The good news is that many neurotransmitter enhancers can be found in the "Happiness 1-2-3!" supplement. Unlike most natural antidepressants that contain one or two things that help you feel better, this product combines 12 different treatments in optimal levelsto help get you feeling great again! Many of these are each individually as effective as antidepressant medications in head on studies. Let's review what's in "Happiness 1-2-3!" beginning with the basics:
1. B12 and folate/folic acid seem to be especially important, and I believe that the term RDA may as well stand for Ridiculous Dietary Allowances! You want at least 600-1800 mcg of vitamin B12 and 400-1200 micrograms of folic acid a day to be sure that optimal levels are getting into the brain where they are needed.
Approximately a third of patients with depression have been found to be deficient in folic acid, and this by itself can cause depression as can B12 deficiency. In addition, these two nutrients together contribute strongly to the production of both serotonin (the "happiness molecule") and a powerful depression fighting nutrient called SAMe. In fact, studies of high-dose folic acid have shown this nutrient by itself to be as effective as antidepressant medicationsbut much safer and without side effects!
2. The B vitamins riboflavin and niacin are critical for energy production. In fact, these vitamins are key components of the "energy molecules" (like "energy dollars"wouldn't it be nice to have your own printing press!) NADH and FADH. Depression is a common symptom of niacin and riboflavin deficiency.
3. Vitamin B6 levels are generally quite low in depressed patients, and this is especially problematic in women taking birth control pills or estrogenboth of which can deplete vitamin B6 levels. Vitamin B6 is critical in the production of serotonin, dopamine and norepinephrine. Sadly, it is likely that millions of people on Prozac are simply suffering from depression caused by vitamin B6 deficiency.
4. Magnesium deficiency is the single most important nutritional deficiency in the United States. Where the average Chinese diet contains ~ 650 mg of magnesium a day, because of food processing the average American diet only contains around 250 mg. This contributes to pain, fatigue, and increased risk of heart attacks, depression and numerous other problems, as magnesium is critical in over 300 different reactions in our body. In fact, numerous studies have shown that in areas with higher magnesium levels in the water, heart attack deaths decreased markedly.
5. Prescription antidepressants like Prozac, Paxil and Wellbutrin work by raising levels of the neurotransmitters serotonin, dopamine and Norepinephrine. Unfortunately, because these medications work by poisoning critical pathways in your body, they are rife with side effects. A much safer and more effective way to raise these neurotransmitter levels is to give your body the building blocks it needs to make them. Serotonin is made from 5 Hydroxytryptophan (5-HTP), and dopamine and Norepinephrine are made from tyrosine. Numerous double-blind (i.e. "gold standard") studies have shown 5-HTP to be as effective as prescription antidepressants but much better tolerated. Another placebo-controlled study has shown tyrosine to also be as effective as antidepressants without side effects. In addition, if 5-HTP is given without tyrosine, it often stops working after a few months. Giving tyrosine along with the 5-HTP results in long-lasting improvement.
I would note one caution though. If taken with serotonin-raising antidepressants and medications, 5-HTP and St John's Wort can raise serotonin too high. This would reflect as a high pulse and sometimes anxiety. If you have a rapid pulse for no reason, ask your Holistic practitioner to lower the dose of serotonin and epinephrine-raising medications (even if not on the herbal) and stop the herbal and see if it resolves. This side effect is much more commonly caused by combining medications than by the herbalsanother good reason that your holistic practitioner opts for these natural therapies!
6. Most of you have heard of St. John's wort, and 25 double-blind studies with a total of over 1500 patients have shown it to be as effective as prescription antidepressantswithout the side effects. In addition to being effective in eliminating depression, it also helped sleep, anxiety and low self-esteem.
7. Magnolia bark has a long history of use in traditional Chinese formulas that relieve anxiety and depression without leaving you feeling like you've been drugged. Magnolia Extract is rich in two phytochemicals: honokiolwhich exerts an anti-anxiety effect, and magnololwhich acts as an anti-depressant. Like many of the other components in the "Happiness 1-2-3" product, magnolia has the ability to alleviate depression and stress without sedating you. Dozens of animal studies have shown that it is a non-addictive, non-sedating antidepressanteven at low doses.
The good news is that you can now effectively eliminate depression without the side effects of antidepressantsnaturally! The "Happiness 1-2-3" product, which contains everything discussed above, is available from Health Freedom Nutrition or www.vitality101.com. Begin with three capsules three times a day (unless you are also on antidepressants, in which case I usually only give 2-3 capsules twice a day in my practice). Although some effect is seen within 2-3 weeks, the effects continue to powerfully increase over 6 weeks with continued use. Once your depression is under control, the dose can then be lowered, and you can ask your physician about tapering off of your antidepressants (which should not be stopped suddenly or you can go through withdrawal). With "Happiness 1-2-3" and a natural treatment approach, it's time to say goodbye to Prozac and depression!
To help eliminate depression naturally:
1. Optimize nutrition with the "Energy Revitalization System" vitamin powder and B Complex (1/2-1 scoop a day as feels best).
2. Go for a 45+ minute walk (outside so you also get sunshine) daily.
3. Optimize thyroid (using T3 thyroid hormone) and Estrogen and Testosterone levels using bio-identical hormones.
4. Fish oil (Eskimo 3 or Nordic Naturals) 3 caps or 1 teaspoon 3x day for 6 weeks then once a day, or eat salmon or tuna 3+ times per week. Fish oil is very helpful for depression.
5. Take Happiness 1-2-3! Use only 2 caps 2-3x day if on antidepressant medications. Otherwise, 3 caps 3x day for 6 weeks. Then you can lower the dose when the depression lifts.
6. Check a DEXA scan for Osteoporosis, as Osteoporosis is more common in depression. Osteoporosis is fairly easy to treat naturally though. If bone loss is present, read the Osteoporosis article and consider taking Bone Health.
7. Give these treatments 6 weeks to begin working.
To paraphrase the Mastercard/Visa commercials:
1. Benefits of Prozac and prescription antidepressants Prozac is only about 10% more effective than placebo .
2. Side effects Despite 90% of the benefit coming from the placebo effect, most of the side effects come from the medication. These include loss of libido, weight gain, emotional flattening, and sometimes becoming downright suicidal (and perhaps even homicidal).
3. Getting back your full and happy feelings and your lost libido when you're able to wean off the Prozac, priceless...
Used with permission from Dr Jacob Teitelbaum's free newsletters-available at www.Vitality101.com
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