Depression

Naturopath for Depression

What are the symptoms of depression?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), depression, also called major depressive disorder or clinical depression, is a persistent low mood:

• not explained by another disorder or caused by substance use (e.g., alcohol, drugs, meds)
• not due to normal grief over the death of a loved one
• without manic episodes
• with at least five of the nine symptoms below most of the time for a continuous two weeks or more, and
• this is a change from your prior level of functioning. One of the five or more symptoms must be either (a) depressed mood, or (b) loss of interest:

1. Depressed mood. Children and teens may be irritable.
2. A significantly reduced level of interest in most or all activities.
3. Weight fluctuations: a 5% or more change in weight over a month when not dieting. There may also be an increase or decrease in appetite. For children, this may be a lack of expected weight gain.
4. Sleep disorders: difficulty falling or staying asleep, or sleeping more than usual.
5. Behaviour that is agitated or slowed down.
6. Fatigue or low energy.
7. Feelings of worthlessness or extreme guilt.
8. Reduced ability to think, concentrate, or make decisions.
9. Frequent thoughts of death or suicide or attempted suicide.

These symptoms:

1. are a cause of great distress or negatively affect functioning at home, work, or other important areas
2. continue for more than two months OR
3. include frequent thoughts of worthlessness or suicide, OR
4. include symptoms that are psychotic, or behaviour that is slowed down.

Who Does Depression Affect?

• It affects twice as many women as men, implying a hormonal aspect.
• And, over the course of a lifetime, major depression will affect 10%-25% of women and 5%-12% of men.
• The average age of onset is in the mid-’20s.
• Having a parent or sibling with depression increases the risk of depression by 1.5-3 times the baseline risk.
• Two-thirds of those with major depression will recover completely.  The remaining third will not.

What is the conventional treatment for depression?

Conventional treatment for this disease may include anti-depressant medications (SSRI’s like Zoloft, Celexa, Prozac etc, SNRI’s like Effexor, Pristiq, and Cymbalta, NDRI’s like Wellbutrin, Tricyclic Antidepressants and MAOI’s) and cognitive behavioral therapy (CBT).

Medications can be very effective.  But, they also come with unwanted side effects such as weight gain, and low libido.

What Tests Can Be Done for Depression?

As a naturopathic doctor, I like to see the following conventional blood tests for depression:

1. Thorough thyroid testing including TSH, free T3, free T4, anti-TPO, and anti-thyroglobulin
2. red blood cell magnesium levels and
3. a thorough hormone work-up including estradiol, DHEAs, total testosterone, prolactin, androstenedione, and a.m. cortisol. Imbalances in any of these can cause depression.

I also offer more innovative testing that includes a urine Organic Acids Test or OAT test. Food sensitivities have also been proven to affect the brain.  In the presence of other signs of food sensitivities, this test may be important.

What is the naturopathic treatment for depression?

As a naturopathic doctor treating this disease involves a thorough understanding of all of the factors that may be contributing to it.

Hormones

Cortisol, DHEAs, testosterone, estradiol, allopregnanolone, DHT, and androstenedione are hormones that have all been linked to depression. My treatment program will better balance hormones through diet, exercise, stress reduction, vitamins, minerals, natural remedies, and herbs.

Neurotransmitter balance

Neurotransmitters are chemicals that your brain makes that regulate how it works.  The neurotransmitters Serotonin, GABA, dopamine, epinephrine, and norepinephrine may all influence your mood. Neurotransmitter balance requires an adequate supply of the building blocks to make proteins. Tyrosine, tryptophan, and glutamic acid are important. Also, your brain needs to have enough vitamin B6 and magnesium to make neurotransmitters.  Read more on this page about how to increase serotonin naturally.

Life circumstances

Life circumstances that contribute to feelings of despair and depression:

• Work stress
• Relationship difficulties
• Family problems
• Alcoholism
• Drug use
• Terminal illness, and
• Death of a loved one

Sleeplessness

Sleeplessness contributes to fatigue, low motivation, and neurotransmitter and hormone imbalance. Healthy sleep hygiene, as well as diet, vitamins, herbs, and minerals that are conducive to good quality and quantity of sleep, can help.

Thyroid function

Underactive thyroid gland function or hypothyroidism causes feelings of sadness and lethargy.  Other symptoms of hypothyroidism include low energy, weight gain, mental sluggishness, and hair loss.

Herbal Medicine

Herbs relieve the symptoms of depression, balance hormones, and help with sleep, stress, and energy. People are often familiar with St. John’s Wort for depression.  It causes side effects like sun sensitivity and should never be used in combination with other medications.  There are many other herbal options.  Studies show that Rhodiola, Saffron, and Magnolia are among the herbs that help with depression.

Omega 3’s

The omega 3 fatty acids EPA and DHA influence how healthy your brain is.  They also lower inflammation that adversely affects your brain.  Eating fish 2-3 times per week helps.  So do good quality fish oil supplements.

My job as a naturopathic doctor is to dig deep to unearth any of the factors that might be contributing to depression.  That way we can address the root of the problem. Helping you feel good long-term requires a thorough understanding of and addressing the cause. Book an appointment here or call the office for more information at 416-481-0222.

By Dr. Pamela Frank, BSc(Hons), Naturopathic Doctor

Dr. Pamela has practiced as a naturopathic doctor in Toronto since 1999. She has received numerous “Best Naturopath in Toronto” awards. She is registered with the College of Naturopaths of Ontario.

Dr. Pamela Frank uses a natural treatment approach that may include acupuncture, herbal medicine, nutrition, diet, vitamins, supplements, and other natural remedies to restore balance and provide long-term resolution to almost any health problem.

Depression & Natural Treatment Research:

Mocking RJ, Pellikaan CM, Lok A, Assies J, Ruhé HG, Koeter MW, Visser I, Bockting CL, Olff M, Schene AH.DHEAS and cortisol/DHEAS-ratio in recurrent depression: State, or trait predicting 10-year recurrence? Psychoneuroendocrinology. 2015 May 21;59:91-101. doi: 10.1016/j.psyneuen.2015.05.006.

Rodgers S, Grosse Holtforth M, Hengartner MP, Müller M, Aleksandrowicz AA, Rössler W, Ajdacic-Gross V. Serum testosterone levels and symptom-based depression subtypes in men. Front Psychiatry. 2015 May 4;6:61. doi: 10.3389/fpsyt.2015.00061. eCollection 2015.

Xu Y, Sheng H, Tang Z, Lu J, Ni X. Inflammation and increased IDO in hippocampus contribute to depression-like behavior induced by estrogen deficiency. Behav Brain Res. 2015 Jul 15;288:71-8. doi: 10.1016/j.bbr.2015.04.017. Epub 2015 Apr 20.

Schüle C, Nothdurfter C, Rupprecht R. The role of allopregnanolone in depression and anxiety. Prog Neurobiol. 2014 Feb;113:79-87. doi: 10.1016/j.pneurobio.2013.09.003. Epub 2013 Nov 8.

Weber B, Lewicka S, Deuschle M, Colla M, Heuser I. Testosterone, androstenedione, and dihydrotestosterone concentrations are elevated in female patients with major depression. Psychoneuroendocrinology. 2000 Nov;25(8):765-71.

Fakhoury M. New insights into the neurobiological mechanisms of major depressive disorders. Gen Hosp Psychiatry. 2015 Mar-Apr;37(2):172-7. doi: 10.1016/j.genhosppsych.2015.01.005. Epub 2015 Jan 16.