Depression Info

studies of folie acid or 5-MTHF as a stand-alone treatment for depression related to folate deficiency; however, the studies that have been conducted are promising. Depressed individuals with low serum folate also tend to not respond well to selective serotonin reuptake inhibitor (SSR!) antidepressant drugs. Correcting the insufficiency by dosing folate along with the SSRI results in a significantly better antidepressant response. Med fteu 2008:13:216-226)

we look for potential underlying causes of depression instead of choosing which SSRI (selective serotonin reuptake inhibitor) to use. One interesting cause is MTHFR deficiency.



MTHFR stands for methylene tetra hydro folate reductase. Say that five times fast! Basically, MTHFR is the enzyme needed to process folate (also called folic acid, a B vitamin found in many vegetables, grains and supplements) and allow it into the brain. Folate in the brain is the necessary building block for many neurotransmitters (including serotonin), which helps regulate our MOODS!



As many as 20% of the population has inherited a defective copy of the gene that makes this MTHFR, a condition that makes it harder for folate to get into the brain. These patients have an increased risk of depression, anxiety, bipolar disorder and schizophrenia; it also predisposes them to be resistant to medical treatment. Usually, they have a strong family history of psychiatric disorders as well.



Fortunately, the treatment is easy once the defect is found, which can be done by simple blood testing. Patients can be prescribed folate which is already processed! After 2-4 weeks, patients usually feel much better, and can often be weaned from their antidepressant, or the dose can be decreased.

So far in my blogs, I have discussed reversible causes of depression, including MTHFR deficiency and vitamin D deficiency. Another nutritional deficiency that has been associated with depression is omega-3 fatty acid deficiency. Omega 3 fats are found in fish, sea vegetables, nuts (especially walnuts), seeds (especially flaxseeds and chia seeds), and beans (especially soybeans.) Long chain omega-3 fats (DHA and EPA) have been found in hundreds of studies to be beneficial for so many common human conditions from depression, arthritis, eczema, and dry eyes, to heart disease and strokes.



Short chain omega-3 fats (ALA) have only a very limited ability (5-10%) to be converted to the longer chain omega-3 fats. As a society, we eat very little fish (the highest source of long chain omega-3s), and omega-3 fat deficiency is likely epidemic. Testing for omega-3 levels is currently not standard. Most hospitals’ labs are not currently offering routine blood testing for omega-3 fats.



I recommend a minimum of 1,000mg/d of omega-3 fats for healthy individuals. For patients suffering from depression, I recommend doses ranging from 2,000 to 4,000mg/d. Studies utilizing the higher doses have shown the most benefit, with minimal side effects. In fact, since omega-3s are a necessary component of every cell in your body, most patients will report “side benefits” of taking omega-3 supplements. Not only is their depression improved, but their skin and eyes are less dry, and they usually report fewer aches and pains!



Note: Mercury is an issue in recommending eating more fish. The fish highest in omega-3 fats with lowest mercury levels include anchovies, herring, mackerel (Atlantic, NOT King or Spanish, from the Gulf of Mexico), sardines, trout, and salmon.

Major depression is a serious, but treatable, illness. Your doctor will most likely give you a prescription antidepressant medication. He or she may also suggest that you receive a specialized form of "talking" counseling called psychotherapy.

Certain medicines work better for some people than for others. It may be necessary for your doctor to try different drugs at different doses to determine which medicine will work best for you.

There is no blood, X-ray, or other laboratory test that can be used to diagnose major depression; however, your doctor may run some blood tests to help detect any other medical problems that have symptoms similar to those of depression (such as hypothyroidism).

We have to start thinking of depression the way we would any so-called "tangible" health problem, like heart disease or cancer. Catch it early, and you've got a good shot at curing it. Let the problem linger, and you'll increase the chances that your brother-in-law is going to be drafting your eulogy pretty darn soon. The myth about depression and other mental conditions is that they're "soft" diseases, that you can will yourself out of them, that all you have to do is suck it up and be happy, dagummit. But depression isn't a "mental" disease - you can't control it, as you can your moods; it's a "chemical" disease, no less of a threat to your health than HIV/AIDS or diabetes.
Specifically, some believe that depression may be related to an abnormality in the functioning of hormones in the brain. That's because people with severe depression tend to have higher levels of the stress hormone cortisol, and the size of their hippocampus actually decreases

Although it may not show, depression contains an underlying component of fear and anxiety. Depression is pain directed against the self. Looking at depressed people's facial expressions, you immediately read how dull, withdrawn, exhausted, and sad they feel. Their approach to life is passive and resigned. We tend to forget this and treat depression as a weakness, particularly our own; if others can find joy in life, then it's our fault that we have failed to. Such judgments get connected to guilt, and depressed people are often acutely aware of letting down family and friends. They see themselves as the gray cloud threatening every happy occasion.

If you look at depression without judgment, it can be seen as the final battlefront against fear. Depressed people are on the verge of giving up, and indeed some will make the perilous choice of trying to end their lives. But before that stage, depression is a last line of defense, in which the mind runs for cover, shutting all operations down to a minimum, providing just enough life support for survival. Although it has become so commonplace that the word "depression" falls from our lips carelessly, as though we were discussing the flu or a bad headache, I can't escape its deep pathos. To me, seeing a depressed person is like watching a magnificent racehorse that has broken its leg. So much magnificence is possible for a human being that to see it shut down and almost extinguished is heartbreaking

Some of the supplements that are purported to help anxiety and depression are omega-3 fatty acids (which are so safe that they should be no-brainer, and they help make you brainier - 600 milligrams a day for adults makes a big difference). New mothers can reduce postpartum depression if they add 600 milligrams of plant based DHA omega-3 (or 2 grams of fish oil) to daily diet. DHEA (which should never be taken without checking your blood levels first), SAMe, kava root, and St. John's Wort also have substantial data supporting their benefit for depression treatment and suppression. We favor DHA and SAMe, as St. John's Wort has a lot of conflicting data and you should absolutely discuss all other than DHA with your doc, because there can be some interactions with other anti-depressants

When I say depression, I'm not talking about losing 20 bucks in the office Super Bowl pool. A more passive negative emotional state over the long term is strongly associated with heart disease. In fact, people with depression are statistically four times more likely to have a heart attack than people who are not depressed. A feeling of helplessness appears to weaken the immune system. Beyond that, we need to learn a lot about how the depressed state of mind affects the body; what we know now is that it does affect it profoundly.

For instance, one study has shown that depression increases platelet aggregation, which means that being depressed may make you more prone to arterial clotting and arterial aging. Seeking professional help and managing depression requires recognizing it in yourself or friends, and getting help or helping your friends get help results in more than a 90 percent reduction in symptoms and consequences in just three months. Seeking help, whether through therapy or medication, is a needed first step to help you and your heart

While some signs of depression are self-evident, many of us hesitate to call ourselves depressed. We'll write it off as being too tired or too stressed or justifiably sad because Boozer, our 18-year-old cat, couldn't hang on anymore. But here's the thing: Depression is actually one of the ways that your body sends a signal to you that something isn't quite working right - and that you should be thinking of coping strategies to get your mind and body on the right track.
The reason why depression is trickier than a David Blaine stunt is because some of the symptoms are on the subtle side. Your doctor - trained to be a medical detective - can put together a good treatment plan, but only if they know the whole picture. In an exam, they'll ask you about medical problems that could be related to depression. But you also want to be up front about your recent history - the changes in your life that might not be medical but can certainly influence your mood. While it may sound like you're going to confession, you should talk to your doc about major life events (like deaths in the family or financial stresses, and yes, changes in sexual pleasure or frequency, too), as well as changes in job and family situations (a retirement, for example).

Here's a simple medical truth: When you have a broken leg, you can't run. No matter how hard you try, you're just not going to be able to do it. That's how your body works sometimes; it shuts down so you physically can't perform certain tasks.

It's surprising to a lot of people to learn that depression works similarly. Depressed people also have broken parts—most likely a chemical reaction in their brains—that make them unable to perform daily activities. And no matter how hard they try or how hard someone tries to convince them to be happy, they can't just get up and run.

Maybe the best way to illustrate the point is through the story of renowned cardiologist Dean Ornish. One day at a conference in Switzerland, he was sitting in the most majestic of settings—a hotel overlooking the Alps. There was the light glistening off the Alps, the carved ice tables, the big band playing in the background. It looked and felt like a scene from The Great Gatsby.

When Ornish looked over and witnessed the scene, he remarked how beautiful the day was—and how clear it was that life is worth living. Then, reflecting back to his days in medical school, he said, "It's ironic; that's exactly how I felt the day I almost killed myself." Ornish went on to explain that when you're depressed, everything is as clear as it is when you're not depressed—that the outside world may think you're crazy, but you can see perfectly that you're not.

See, depression isn't something that you can just click on and off like a nose-hair trimmer. Although it's come a long way since the days when people who were deemed depressed were freaks and Cubs fans, depression still has a societal stigma.

Perhaps the best lesson to be learned from Ornish is that even though he was depressed while in medical school, he found ways to treat himself and shift the chemical imbalance in his brain—through methods such as diet, meditation, and yoga

Physicians prescribe imipramine to help prevent headaches. It is classified as a tricyclic antidepressant. It has been shown to be effective in preventing both migraine and tension type headaches. It can also be used in children to help prevent bedwetting and for neuropathic pain in adults. It works by increasing the levels of the neurotransmitters serotonin and norepinephrine within the brain.

This drug may have beneficial effects on mood, sleep, appetite, libido and memory, in addition to controlling your headaches. This drug is taken at night to prevent daytime drowsiness. This drug usually takes 3 to 6 weeks to become effective. Therefore, you should take it for at least 2 months to determine its effectiveness. Your dosage will be determined by your physician