By Richard Malik, ND
As published in the Lakeville Journal, Millerton News, & Winsted Journal
28 December 2006

The holiday season is an emotional time for many people. Sometimes, the holidays can be emotionally difficult because of sadness that comes on at this time of the year or increased feelings of guilt over sadness that is present most or a lot of the time.

Depression is a very common complaint at any time of the year, with as many as 1 out of every 5 people experiencing major depression at some point in their life and the annual sales of prescription anti-depressants estimated at $10 billion annually. The symptoms of a major depressive episode may include: depressed mood and/or diminished interest or pleasure; significant changes in weight; changes in sleep patterns; fatigue; feelings of worthlessness; indecisiveness and diminished ability to concentrate; and even thoughts of suicide or harming oneself. These episodes last for at least 2 weeks.

Helping people address their depression and improve their mood is a process that is unique for every patient, in my experience. First of all, possible physical causes of depression must be identified and addressed. Low thyroid gland function can commonly cause or increase depression. Other physical conditions that may contribute to depression include anemia, poor blood sugar regulation, chronic infection, and changes in hormone production.

Diet and lifestyle habits may also contribute to feelings of sadness. Avoiding substances that affect neurotransmitter release like illicit drugs, smoking, caffeine, chocolate, and alcohol is helpful for some. Because of its effects on blood sugar levels, avoidance of refined carbohydrates which include sugar, refined sweeteners, and white grains can be helpful too.

Exercise is very important for improving mood; it helps the body work better and enhances the release of mood elevating chemicals called endorphins. When starting out, I typically advise people to do whatever form of exercise works best for them. Some options are walking, swimming, hiking, yoga, weightlifting, running, playing sports, aerobics or going to the fitness center.

When using natural supplements and herbs to treat depression, it is most important to avoid the adverse effects that can be caused by taking too many things that alter neurotransmitter levels in the brain. These side effects can be very serious, so working with a medical provider that is knowledgeable in the use of natural depression therapies is important.

St. John’s Wort is probably the most famous natural therapy for depression with clinical studies that show it is effective for treating mild or moderate depression with maximal effect occurring after 3 to 6 months of therapy. Unfortunately, St. John’s Wort increases the activity of liver enzymes that affect many prescription drugs – either increasing OR decreasing their effectiveness. For this reason, St. John’s Wort can be dangerous if you are taking other important medications.

Other herbs are used for patients with depression, but none with as strong anti-depressant effect as St. John’s Wort. There are, however, great herbs for helping with anxiety, insomnia, fatigue, and other concerns of depressed patients. The herbs used depend upon the symptoms of the individual patient.

Most pharmaceutical anti-depressants work by increasing the levels of neurotransmitters in the brain. The neurotransmitters most commonly targeted are serotonin, norepinephrine and dopamine. Serotonin is produced by the body from the amino acid L-tryptophan (turkey is famous for having this amino acid). While it can be hard to find this amino acid in stores, 5-Hydroxytryptophan (5-HTP) can be easily found. In the body, L-tryptophan is converted to 5HTP before it can be made into serotonin.

Both norepinephrine and dopamine are formed from the amino acid L-tyrosine. While there is little clinical research on the effects of L-tyrosine and depression, it makes biochemical sense to ensure the body’s ability to make these important neurotransmitters through supplementation of L-Tyrosine.

Treating depression can be a complicated process; there are so many approaches and patients often need an individualized approach to get the best results. While I have outlined some basic thoughts and approaches to the natural treatment of depression, it is important to get guidance from a knowledgeable healthcare professional to ensure safety and optimal results.

Please ask for help if feelings of depression and thoughts of harming yourself become strong. Great local resources include the Northwest Center for Family Service and Mental Health at 860-435-2529; the Northwest Mental Health Authority at 888-447-3339; and, in case of emergency, you may always dial 911.