Depression involves the body, mood, and thoughts, and it affects the way you eat and sleep, the way you feel about yourself, and the way you think about life. It's also a gender thing: women in North America are nearly twice as likely as men to be diagnosed with depression. Approximately 12 million women in the U.S. experience clinical depression each year. It occurs most frequently in women aged 25 to 44.
There is often no single cause of depression, but a multitude of factors can contribute, including:
- Hormonal imbalances-Menstrual cycle changes, pregnancy, low thyroid, miscarriage, postpartum, perimenopause, and menopause.
- Stress-Stressful life events such as trauma, loss of a loved one, a bad relationship, work, and caring for children and aging parents.
- Medical illness-Dealing with serious conditions such as stroke, heart attack, or cancer.
- Environmental toxins-Heavy metals (lead, mercury, cadmium, arsenic, nickel, and aluminum), as well as pesticides, formaldehydes, and benzenes.
Depression has been linked to a variety of hormonal and health issues, including:
Perimenopause/Menopause-The Massachusetts Women's Health Study observed that rates of depression begin to decrease as women move through perimenopause into menopause, and are lowest for women who have been postmenopausal for at least 27 months. These results show that depression is moderately associated with perimenopause, and that the depression is transient and may decline about two years after menopause.
Hormone fluctuations can be quite extreme during perimenopause, which causes stress on the adrenal glands. The adrenal glands also become the main hormone producers when a woman's ovaries shut down during menopause, so it's important to support adrenal function during this transition, if not before.
PMS-As many as 90 percent of all women experience PMS at some point during their reproductive years, while 30-40 percent of all women experience symptoms severe enough to interfere with their everyday lives-including depression.
Gut Health-Emerging information suggests that leaky gut syndrome is a strong contributor to mood disorders such as depression. Over a long period of time, gut-induced inflammatory responses in the stomach wall can significantly compromise both the structure and repair mechanisms of the digestive tract. When these structures break down, the intestinal wall becomes more permeable to toxins or microbes that would normally not cross into the bloodstream.
Evidence shows that bowel disorders are often correlated with poor mood. Almost one-third of patients with irritable bowel syndrome (IBS) suffer from anxiety or depression. While a healthy microbiome appears to promote a positive mood, an unhealthy one does the opposite.
Thyroid-Depression is often a first or early manifestation of thyroid disease, and even subtle decreases of thyroid hormone are suspected of producing symptoms that impact your mood.
Adrenal Health-The primary area of the brain that deals with stress is the limbic system. Because of its enormous influence on emotions and memory, the limbic system is often called the "emotional brain." Disturbances in the serotonin system and the limbic hypothalamic-pituitary-adrenal axis are most consistently associated with mood-altering illness.
Supporting the stress adaptive system-the adrenal glands-may hold the key to preventing and treating mood disorders.
Diet and Lifestyle Factors
In addition to underlying fluctuations and imbalances in the body, other common factors that contribute to depression include:
Alcohol-Alcohol is a depressant that increases adrenal hormone output. It interferes with many brain cell processes and disrupts normal sleep cycles. Chronic alcohol ingestion will deplete a number of nutrients, all of which will disrupt mood.
Caffeine-Several studies have linked caffeine intake and depression. For example, one study found that among healthy college students, those who drank moderate or high amounts of coffee scored higher on a depression scale than did low users.
Exercise-Regular exercise may be the most powerful natural antidepressant available. Various clinical studies have indicated that exercise has profound antidepressant effects. Much of the mood-boosting effect of exercise is attributed to endorphins, which are directly correlated with mood and become elevated when you work out.
Blood Sugar-Many individuals who suffer from hypoglycemia also experience depression, so ensuring blood sugar stability is a key dietary goal for improving mood. Reducing your intake of refined carbohydrates and focusing your diet on lean, healthy protein such as free-range chicken and turkey, fish, eggs, nuts and seeds, and grass-fed beef can help.
Key Supplements To Combat Depression
The good news is that the right combination of nutrients can help correct many common issues that underlie depression, improve mood, and help you keep your sunny outlook. These include:
Vitamin B6-B6 levels are typically low in depression, especially in women who take birth control or are on hormone replacement therapy for menopausal symptoms. Considering the many functions that B6 performs in the brain-it's absolutely essential in the manufacture of dopamine and serotonin-it is likely that a B6 deficiency contributes to many cases of depression.
Adrenal formulas-As mentioned above, adrenal support is an important strategy for combatting mood disorders. Herbs such as rhodiola, Siberian ginseng, and ashwagandha are powerful adaptogens that help to balance stress hormones such as cortisol.
Vitamin D-New research shows that low serum levels of vitamin D are associated with clinically significant symptoms of depression in otherwise healthy individuals.
Vitamin B12 and folic acid-Folic acid, vitamin B12, and SAM-e function as methyl donors. That is, they carry and donate methyl molecules to important brain compounds including the neurotransmitters serotonin and dopamine. One of the key brain compounds that is dependent on methylation is tetrahydrobiopterin (BH4). This compound functions as an essential coenzyme in the activation of enzymes that manufacture serotonin and dopamine. BH4 synthesis is stimulated by folic acid, vitamin B12, and vitamin C.
5-Hydroxytryptophan (5-HTP)-5-HTP is the precursor to serotonin. Numerous studies have shown that 5-HTP is as effective as pharmaceutical antidepressants, better tolerated, and associated with fewer and much milder side effects.
Estrogen detox formulas-If liver function is compromised, estrogen metabolism is compromised, leading to excess estrogen levels and what is often described as estrogen dominance. Estrogen dominance may contribute to PMS as well as perimenopausal symptoms. Supporting the liver's detoxification processes can help treat this issue. Indole-3-carbinol (I3C) and/or DIM, a byproduct of I3C, are phytochemicals found in cruciferous vegetables such as broccoli. They excel at helping the liver detoxify excess estrogen for fewer hormonal ups and downs. Milk thistle also supports the liver's ability to detoxify hormones.
Saffron (Crocus sativus)-Saffron has been shown to be an effective natural antidepressant in several clinical trials. One study compared the effects of saffron with fluoxetine (Prozac), and both treatments resulted in significant improvements in depression symptoms and severity, with no difference in the amount of improvement between the two groups. Saffron's antidepressant properties seem to be related to serotonin metabolism.
Chaste Tree (Vitex agnus-castus)-Chaste tree may be the single most important herb for the treatment of PMS and other hormonal imbalances that lead to poor mood. It affects the hypothalamus-hypophysis axis, where it increases secretion of luteinizing hormone and also produces progesterone-favoring effects that can help equalize estrogen dominance.
Probiotics-Remember that a healthy microbiome promotes a healthy mood. So support gut health and balance with friendly bacteria.
Alleviating Postpartum Depression
Postpartum depression (PPD) affects 1.3 million mothers each year.
Fortunately, there are steps women can take to help improve their physical, emotional, and mental health, says Shoshana Bennett, PhD, author of Beyond the Blues, and a sufferer of PPD herself after two pregnancies. Bennett advises all moms-to-be (including adoptive moms) to have a plan in place before the baby joins the family. This plan should include:
- Sleep: Even breast-feeding mothers need a few hours of uninterrupted sleep at night. This can mean the difference between depression and no depression since nighttime sleep protects and promotes healthy serotonin levels.
- Nutrition:Get adequate amounts of protein and water, and supplement with vitamin D3, folic acid, and omega-3s from fish oil. Also: eat organic food whenever possible, and avoid processed foods that contain chemicals and additives.
- Exercise: Do anything that oxygenates your brain-e.g., walking outdoors once per day.
- Emotional support:It helps to have someone nonjudgmental in your life who you can talk to.
- Physical support: Find at least one person who you can count on to give you regular breaks.
- Mental support: Educate yourself about postpartum depression and other mental health issues surrounding pregnancy. A good resource is Postpartum for Dummies, also written by Bennett.
If you need additional support, consider making an appointment with a naturopathic doctor. To find a licensed naturopath in your area, visit naturopathic.org.
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Supplements for a Brighter Mood
Bio Nutrition Saffron Extract contains a standardized form of the spice. Use one capsule daily with meals.
Garden of Life RAW Probiotics Women uses specific strains of bacteria to balance a woman's body.
Natural Factors EstroSense has I3C, DIM, milk thistle, and other detoxifying, hormone-balancing nutrients.
Nature's Answer Adrenal Blend is a smart mix of adrenal herbs, including ashwagandha and rhodiola.
Vitanica Uplift, formulated by women's health expert Tori Hudson, ND, has folate, and vitamins B6 and B12.
Nordic Naturals Postnatal Omega-3 addresses the needs of new moms with therapeutic levels of fish oils, including EPA for mood support.