Depression – a conventional view
In conventional medicine depression remains somewhat of a mystery. Theories of the cause of depression have shifted over the years. However a key area of focus has consistently been on neurotransmitter imbalances, and a variety of medications have been marketed and prescribed with this in mind. Despite the widespread use of antidepressant medications, recent rigorous studies have indicated that anti-depressant medications are barely more effective than placebo. In addition, the safety of these medications have been called into question in recent research.
More complex than a singular cause
Ultimately depression is a condition with multiple underlying causes. Neurotransmitter imbalances are likely to be the result of these underlying drivers, rather than the true cause of depression. Alterations in neurotransmitters (and hormones) are typically the way in which our bodies attempt to temporarily address an imbalance. When these imbalances aren’t addressed, and the alterations persevere, dysfunction and disease will typically be the result. By identifying and addressing the underlying drivers and causes of depression, the body can return to a state of balance.
Let’s dive into the 5 key causes of depression now:
1. Low thyroid function
Low thyroid function (or hypothyroidism) often manifests with depression as one of the first signs. Unexplained weight gain, hair loss, and dry or oily skin may indicate a thyroid issue. Thyroid dysfunction is more prevalent in females, and will often set in during menopause. There is also a strong familial tendency so a history of thyroid issues in females of a family line may suggest a higher likelihood. Treatment is beyone the scope of this article, but if suspected then a complete thyroid blood panel including TSH, T4, T3, thyroid antibodies and reverse T3 is a good place to start investigations.
2. Adrenal dysfunction
Dysfunction of the adrenals will often masquerade as depression, especially in the latter stages. Fatigue, memory loss, poor sleep, body pain, and increased weight gain around the middle may all indicate adrenal dysfunction. A history that includes childhood trauma, chronic infection, blood sugar disturbances, and PTSD may all predispose to adrenal issues. Testing for dysfunction is best done with multiple salivary cortisol measurements throughout the day (rather than a single blood sample as is done through a conventional Doctor which has little value outside of pathological adrenal disease).
3. Hypoglycaemia
Hypoglycaemia (or low blood sugar) can result in symptoms of depression, as well as irritability, fatigue, headache, blurred vision, and mental confusion. This is closely linked to adrenal dysfunction, as one of the roles of cortisol is to stabilise blood sugar when it gets too low. If there is dysfunction in the adrenals and the cortisol response is inappropriate, low blood sugar and severe sugar cravings result. Several studies have shown a clear link between hypoglycaemia and depression. Dietary intervention is crucial here, with avoidance of refined sugars the most important measure. Increased intake of fresh vegetables and a moderate intake of fish and lean meat is typically also helpful. In those with severe blood sugar imbalances, avoidance of all grain based foods may also be neccessary.
4. Nutrient deficiency
There are many nutrients that if deficient, may result in symptoms of depression. Nutrition can powerfully influence mood and behaviour, and unfortunately these days many people are starving of the vitamins and minerals needed for optimal function (despite being overloaded with the simple sugars, unhealthy fats, and toxic chemicals that make up most of the modern processed diet). Listed below are the key nutrient players in preventing depression:
B9 (folate) and B12
Deficiency of both B9 and B12 can result in depression. B9 and B12 act as methyl donors in the body, in turn producing the monoamine neurotransmitters serotonin and dopamine.
B6
Like B9 and B12, vitamin B6 is crucial in the production of serotonin and dopamine. The oral contraceptive pill and HRT will typically reduce levels of B6 in the body, as will many other medications.
Zinc
Zinc serves as a mineral cofactor in more than 70 enzymes in the body, and supplementation of this mineral in conjunction with antidepressant medication has been shown in this study to significantly reduce depression scores as compared to medication alone.
Chromium
Through it’s ability to regulate insulin production and blood sugar, the mineral chromium may assist in relieving depression associated with hypoglycaemia.
Vitamin D
There is significant evidence linking vitamin D deficiency to depression, as well as impaired brain function. A simple blood test can ascertain whether you are deficient, however standard pathology ranges tend to go far too low. Ideally serum vitamin D should be at least 80 nmol/L.
Omega 3
Omega 3 fatty acids (EPA and DHA) are crucial for brain function, and low levels correlate to increased incidence of depression. High quality fish oil is the best source, with krill oil a close second due to its extra antioxidant properties. Flax, chia and hemp oil are a poor substitute due to only the precursor to omega 3 being supplied, which we typically struggle to convert to active omega 3.
5. Environmental toxins
Heavy metals (lead, cadmium, mercury, arsenic, nickel, and aluminium) as well as other environmental toxins such as formaldehyde, pesticides and herbicides, all have the ability to effect neurological tissue and trigger depression. Other symptoms such as tingling in the extremities, numbness, headaches, mental illness and confusion may also indicate toxin exposure. Detailed questioning will often indicate a history of toxin exposure, and hair tissue mineral analysis as well as urinary organic acid testing may be used to determine the exact toxin causing the issue. A process of detoxification and limiting ongoing exposure is crucial to repairing the damage these all too common toxins can cause.
I hope this article helps you or anyone you know suffering from depression to look beyond the limited neurotransmitter viewpoint and discover (and resolve) your underlying drivers. Please share this article so that others can use this information to help navigate their way out of this often crippling condition.
Anything to add? Please leave a comment below.
In wellness,
James Marr
