Depression is the number one cause of disability in the Western world. Younger adults and adolescents are most affected, and increasingly at younger ages; suicide is now the second leading cause of death for youths aged 10 to 19. Mental illness is the leading cause of disability in children.
Not a chemical imbalance in the brain
In the late 1980s, serotonin imbalance was suggested as a physical cause of depression, described like a deficiency of thyroid hormone or insulin, and theoretically correctible with the new SSRIs (selective serotonin reuptake inhibitors) anti-depressants. These drugs are believed to block the reuptake of the chemical messenger serotonin into neurons to make more serotonin available to improve messages between neurons.
But a 2016 review of 13 drug trials published in the Journal of the Royal Society of Medicine “found that antidepressants double the risk of suicidality and violence, and it is particularly interesting that the volunteers in the studies we reviewed were healthy adults with no signs of a mental disorder,” said the researchers – “There can be little doubt that we underestimated the harms of antidepressants”.
Furthermore, no data have ever been produced to support the theory that these drugs are indeed correcting a ‘chemical imbalance in the brain’, and as a result the imbalance of neurotransmitters theory has now been scientifically ruled out as the underlying cause of depression.
Unexpressed emotions
All negative emotions such as grief, fear, sadness, guilt, remorse, disappointment and anger cause physical changes in our bodies and brains via our hormones. Repeated unhealthy thinking patterns can result, especially when these negative emotions are not expressed and are stored in the body. Unhealthy thinking patterns can easily lead to low mood, requiring their exploration and resolution in psychoanalysis.
Inflammation
In 2015, Canadian researchers used positron emission tomography (PET) to scan the brains of 20 patients with depression and compare them to 20 healthy control participants. They paid special attention to the activation of microglial cells that play a critical role in the immune system’s inflammatory responses.
They discovered significant inflammation in the brains of people with depression, which was most severe among participants with the most severe depression. People who were diagnosed with clinical depression had about 30 percent more inflammation in their brains than the healthy controls.
Many studies have since confirmed the impact of inflammation on mental health. A new generation of integrative psychiatrists now take a functional medicine approach to mental illness, looking at inflammatory markers, and the possible sources of that inflammation (for example amino acid or vitamin deficiencies, hormone imbalances or microbial infections or imbalances). James Greenblatt, of Tufts and Dartmouth universities, is the author of the groundbreaking book: Integrative Medicine for Depression: A Breakthrough Treatment Plan That Eliminates Depression Naturally (Friesen Press, 2019). He says: “The health of the brain, or what we might call the mind, depends directly on the health of the body”.
What can be done about inflammation?
Many common deficiencies that can cause inflammation can be remedied with food sources, and/or food supplements. Below are examples of the inflammatory factors an integrative psychiatrist will consider and test for:
Hormones
It is well documented that low thyroid hormone causes depression and anxiety. If needed it can be optimally supplemented in its natural form rather than as synthetic hormones.
Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands that wanes after midlife. A 2005 study published in the Archives of General Psychiatry concluded that DHEA is “an effective treatment for midlife-onset major and minor depression”.
Minerals
Zinc is abundant in the central nervous system and is critical to hundreds of enzymatic reactions that fuel a wide range of functions, from DNA synthesis and digestion, to immune system function. A 2013 review of 17 studies found lower levels of zinc in depressed people than in those without depression.
Magnesium deficiency has been linked to nervousness, anxiety, insomnia and depression. A 2017 review of magnesium’s role in neurological disorders similarly found that participants consuming just 248 mg of magnesium chloride per day for six weeks showed marked improvements on depression scores compared to those receiving no treatment.
Vitamins
A range of B vitamins – B1 (thiamine), B3 (niacin), B6 (pyridoxine), B9 (folate) and B12 (cobalamin) – are essential for neuronal function, and deficiencies have been linked to depression in multiple studies.
Diet
A diet that restricts inflammatory foods, such as red meat and refined carbohydrates, can reduce inflammation.
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