If you’re depressed, you might consider asking your doctor to prescribe anti-depressants.
But as best-selling author Christiane Northrup, MD, notes:
In 2008, we learned that the benefits of antidepressants had been greatly overstated. Former FDA psychiatrist Erick H. Turner, M.D. uncovered some startling information about Selective Serotonin Reuptake Inhibitors (SSRIs), including Prozac, Paxil and Zoloft, the most commonly prescribed antidepressants. In reviewing all the medical literature, he learned that 94 percent of the reports showing the therapeutic benefits of SSRIs were published compared to only 14 percent of the reports showing either no benefits or inconclusive results (of taking SSRIs were published). When he weighed all the literature, Dr. Turner determined that SSRIs were no more effective than a placebo for treating most depressive patients. Those with severe depression were helped, sometimes greatly, but those with mild to moderate depression, the majority of cases, received little relief. British researchers using the Freedom of Information Act uncovered identical findings.
In January 2010, another study published in the Journal of the American Medical Association (JAMA) confirms these findings. The newest study also evaluated another class of antidepressants, tricyclic antidepressants. Again, researchers determined that the typical patient, one with mild to moderate depression, gets the same amount of relief from a placebo as from an antidepressant. The first author of the study, Jay C. Fournier, MA, told Medscape, “I think the most surprising part of the findings was how severe depression has to be in order to see this clinically meaningful difference emerge between medication and placebo, and that the majority of depressed patients presenting for treatment do not fall into that very severe category.”
The New York Times reported that the co-author of the study, Robert J. DeRubeis, shared this important insight: “The message for patients with mild to moderate depression is ‘Look, medications are always an option, but there’s little evidence that they add to other efforts to shake depression–whether it’s exercise, seeing the doctor, reading about the disorder or going for psychotherapy.’”
(In addition, modern SSRI anti-depressants have been shown to increase violent and suicidal behavior in a certain percent of the population.)
So what can those with depressive tendencies do?
Secret of Human Evolution
Getting enough Omega 3 fatty acids in your diet is also crucial in preventing depression. As Science Daily notes:
Researchers from Inserm and INRA and their collaborators in Spain collaboration, have studied mice fed on a diet low in omega-3 fatty acid. They discovered that reduced levels of omega-3 had deleterious consequences on synaptic functions and emotional behaviours.
Details of this work are available in the online version of the journal Nature Neuroscience.
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The researchers studied mice fed a life-long diet imbalanced in omega-3 and omega-6 fatty acids. They found that omega-3 deficiency disturbed neuronal communication specifically ….This neuronal dysfunction was accompanied by depressive behaviours among the malnourished mice.
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Consequently, the researchers discovered that among mice subjected to an omega-3 deficient dietary regime, synaptic plasticity … is disturbed in at least two structures involved with reward, motivation and emotional regulation: the prefrontal cortex and the nucleus accumbens.
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“Our results can now corroborate clinical and epidemiological studies which have revealed associations between an omega-3/omega-6 imbalance and mood disorders,” explain Olivier Manzoni and Sophie Layé. “To determine if the omega-3 deficiency is responsible for these neuropsychiatric disorders additional studies are, of course, required.”
In conclusion, the authors estimate that their results provide the first biological components of an explanation for the observed correlation between omega-3 poor diets, which are very widespread in the industrialized world, and mood disorders such as depression.
Dr. Northrup writes:
One of the best ways to support health brain chemistry is by taking fish oil. Fish oil has been shown time an again to relieve mild to moderate depression. The omega-3 fatty acids are essential to brain health and, according to Capt. Joe Hibbeln, M.D., these important fats support the serotonin system, may help reduce stress and lower your risk of all kinds of mental illness. Dr. Hibbeln, Chief of Outpatient Services for the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is one of the world’s leading researchers on omega-3 fats. His findings have been compelling and encouraging.
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Also encouraging is the largest ever clinical trial presenting in 2009 showing that fish oil may benefit half of all people with moderate to severe depression.
How could something as obscure as Omega 3s be so critical in preventing depression?
We’ve previously explained that humans evolved to eat a lot of Omega 3s:
Wild game animals have much higher levels of essential Omega 3 fatty acids than domesticated animals. Indeed, leading nutritionists say that humans evolved to consume a lot of Omega 3 fatty acids in the wild game and fish which they ate (more), and that a low Omega 3 diet is a very new trend within the last 100 years or so.
In other words, while omega 3s have just now been discovered by modern science, we evolved to get a lot of omega 3s … and if we just eat a modern, fast food diet without getting enough omega 3s, it can cause all sorts of health problems.
So something just discovered by science can be a central fuel which our bodies evolved to use.
Here’s further detail focusing on beef:
For all of human history – until the last couple of decades – people ate beef from cows (or buffalo or bison) which grazed on grass. The cows were usually strong and healthy. Their meat was lean, with very little saturated fat, as the critters ate well and got outdoor exercise. Their meat was high in good Omega 3 fats. See this and this, and humans evolved to consume a lot of Omega 3 fatty acids in the wild game and fish which they ate (more).
Today, on the other hand, beef is laden with saturated fat and almost entirely lacking healthy fats like Omega 3s, because the cows are force-fed food which makes them sick. Specifically, instead of their natural menu – grass – they are force-fed corn, which makes them sick. Because their diet makes them ill, they are given massive amounts of antibiotics. Even with the antibiotics, the diet and living conditions would kill them pretty quickly if they aren’t slaughtered.
Science Daily explains:
In industrialized nations, diets have been impoverished in essential fatty acids since the beginning of the 20th century. The dietary ratio between omega-6 polyunsaturated fatty acid and omega-3 polyunsaturated fatty acid omega-3 increased continuously over the course of the 20th century. These fatty acids are “essential” lipids because the body cannot synthesize them from new. They must therefore be provided through food and their dietary balance is essential to maintain optimal brain functions.
So insufficient Omega 3s is a major source of depression in modern industrialized countries.
The flip side of getting enough healthy Omega 3s is to stay away from the kind of fats which cause depression: trans fats.
(Contrary to what you’ve heard, getting enough of the right kind of healthy cholesterol also decreases depression.)
Vitamins, Minerals and Antioxidants …
Antioxidants also help to prevent depression. Specifically, oxidative stress has been correlated with depression (and see here).
On the other hand, antioxidants reduce depression. See this, this and this. Here are the tricks for finding the least expensive, most powerful antioxidants.
Moreover, a multivitamin might be smart. Specifically, Hugh D. Riordan, M.D., argues:
It is possible to become depressed because of the lack of a sufficient amount of a single trace element.
And as we’ve previously noted, modern foods can be nutritionally depleted:
We evolved eating foods which were high in vitamins and minerals ….
But as the Journal Current Opinion in Obstetrics and Gynecology notes:
With soil depletion, overfarming and transportation of foods over hundreds of miles with loss of nutrients en route, together with the increased use of convenience and fast foods, women can be over-fed, but under-nourished in our modern society.
The Nutrition Journal points out:
In 1927 a study at King’s College, University of London, of the chemical composition of foods was initiated … to assist with diabetic dietary guidance. The study evolved and was then broadened to determine all the important organic and mineral constituents of foods, it was financed by the Medical Research Council and eventually published in 1940. Over the next 51 years subsequent editions reflected changing national dietary habits and food laws as well as advances in analytical procedures. The most recent (5th Edition) published in 1991 has comprehensively analysed 14 different categories of foods and beverages. In order to provide some insight into any variation in the quality of the foods available to us as a nation between 1940 and 1991 it was possible to compare and contrast the mineral content of 27 varieties of vegetable, 17 varieties of fruit, 10 cuts of meat and some milk and cheese products. The results demonstrate that there has been a significant loss of minerals and trace elements in these foods over that period of time.
Scripps Howard News Service noted in 2006:
The nutritional content of America’s vegetables and fruits has declined during the past 50 years — in some cases dramatically.
Donald Davis, a biochemist at the University of Texas, said that of 13 major nutrients in fruits and vegetables tracked by the Agriculture Department from 1950 to 1999, six showed noticeable declines — protein, calcium, phosphorus, iron, riboflavin and vitamin C. The declines ranged from 6 percent for protein, 15 percent for iron, 20 percent for vitamin C, and 38 percent for riboflavin.
“It’s an amazing thing,” said Davis, adding that the decline in nutrient content has not been widely noticed.
Many other studies have reported ongoing soil depletion around the world.
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And many people eat highly processed foods in which most antioxidants have been destroyed.
So – just as with the low levels of omega 3s – there might be less antioxidants like vitamin C in the modern diet than the levels we evolved to run on.
Good Bugs
Live Science reports:
Researchers have increasingly begun to suspect the gut was somehow linked with the brain. For instance, bowel disorders seem linked with stress-related psychiatric disorders such as anxiety and depression in people.
To learn more, scientists experimented with mice by feeding them a broth containing Lactobacillus rhamnosus JB-1. This species naturally lives in our gut, and scientists are exploring whether strains of it can be used as “probiotics” to improve our health. They discovered these rodents displayed significantly less behavior linked with stress, anxiety and depression than mice fed plain broth. Bacteria-fed mice also had significantly lower levels of the stress hormone corticosterone in response to stressful situations such as mazes.
“By affecting gut bacteria, you can have very robust and quite broad-spectrum effects on brain chemistry and behavior,” researcher John Cryan, a neuroscientist at University College Cork in Ireland, told LiveScience.
“Without overstating things, this does open up the concept that we could develop therapies that can treat psychiatric disorders by targeting the gut,” Cryan added. “You could take a yogurt with a probiotic in it instead of an antidepressant.”
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The investigators found that one GABA receptor component was present in higher levels in bacteria-fed mice in parts of the brain where it is normally lowered during depression. In addition, several GABA receptor components were reduced in parts of the brain where they are normally increased in stressed or anxious animals.
Next, the researchers severed the vagus nerve, which helps alert the central nervous system to changes in the gastrointestinal tract. They found the bacteria-induced effects on behavior and GABA receptors were diminished, suggesting this nerve is the pathway by which changes in the gut can influence the brain.
Vagal nerve stimulations have been used at times to treat depression resistant to other therapies, but “that’s a surgical technique,” Cryan said. “By targeting the gut with probiotics, we could indirectly target the vagus nerve without surgery.”
And see this.
As with Omega 3s, this sounds strange until you realize how humans evolved.
As NPR notes, our bodies are largely made up of – and supported by – bacteria:
Jeffrey Gordon, a professor at the Washington University in St. Louis School of Medicine, who studies the microbes that live on and in us, offers this factoid: “We think that there are 10 times more microbial cells on and in our bodies than there are human cells. That means that we’re 90 percent microbial and 10 percent human. There’s also an estimated 100 times more microbial genes than the genes in our human genome. So we’re really a compendium [and] an amalgamation of human and microbial parts.”
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Gordon’s research shows that these microbes living in our bodies aren’t just there for the ride — they’re actively contributing to the normal physiology of the human body. He points to the trillions of microbes that live in our gut, doing everything from encoding enzymes to serving as pathways for vitamin production to digesting the parts of food we can’t digest on our own.
Many native cultures ate a lot of fermented foods containing healthy bacteria. Think yogurt, miso and Inuit fermented seal blubber (gross, we know …)
In addition, antibiotics kill a lot of the healthy bacteria in our gut. (The over-use of antibiotics has also been linked to obesity and other health problems. See this and this. Indeed, the prestigious journal Nature suggests that antiobiotics may permanently kill off healthy gut bacteria.).
Given that the modern diet contains less fermented foods, and that antibiotics have killed off some of our intestinal flora, probiotics – sold in health food stores – are an important preventative measure against depression.
Sunshine …
The New York Times points out:
A new, carefully designed randomized controlled trial— of the kind considered the gold standard in medicine — suggests bright light therapy deserves a closer look.
The study was small, involving only 89 patients ages 60 and older, but the results were remarkable. Compared with a placebo, light therapy improved mood just as well as conventional antidepressant medications, said Dr. Ritsaert Lieverse, the paper’s lead author and a psychiatrist at the VU University Medical Center in Amsterdam.
“The effect sizes we found in this study are comparable to those reported for antidepressants, so I think efficacy is of comparable magnitude,” Dr. Lieverse said in an e-mail.
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Since depression is often accompanied by poor sleep and other symptoms suggestive of circadian rhythm disruption, the scientists also examined markers of circadian function. The theory is that bright light therapy may act to elevate mood by activating the brain’s so-called circadian pacemaker, a structure called the suprachiasmatic nucleus. As part of the study, researchers assessed sleep quality and measured patients’ melatonin, a hormone critical for sleep-wake cycles, and urinary cortisol and salivary cortisol levels, measures of stress.
Dr. Lieverse said bright light therapy may also work by targeting depression-associated neurotransmitter systems that regulate serotonin and dopamine.
Sunshine has many if not all of these properties. So getting some sun will help with depression.
Exercise and Sex
Many studies show that exercise reduces depression. For example, see these reports by the Mayo Clinic, New York Times and WebMD.
Sex also helps to prevent depression.
Testosterone
And naturally boosting your testosterone level also wards off depression.
Mindfulness Meditation
Last – but not least – meditation can prevent depression. Psychology Today reports:
Imagine if you could cure depression with a therapy that was more effective and long-lasting than expensive drugs, and which did not have any side effects. These are the claims being made for a form of Mindfulness meditation.
Psychologists from the University of Exeter recently published a study into “mindfulness-based cognitive therapy” (MBCT), finding it to be better than drugs or counseling for depression. Four months after starting, three quarters of the patients felt well enough to stop taking antidepressants.
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MBCT was developed in the mid-Nineties by psychologists at the Universities of Oxford, Cambridge and Toronto to help stabilize patients’ moods during and after use of antidepressants. About half of patients relapse into depression – even if they continue taking the medication. One common reason for a relapse is when a normal period of sadness turns into obsessive brooding.
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The MBCT technique is simple, and revolves around “mindfulness meditation”. In this, you sit with your eyes closed and focus on your breathing. (See box for details). Concentrating on the rhythm of the breath helps produce a feeling of detachment. The idea is that you come to realize that thoughts come and go of their own accord, and that your conscious self is distinct from your thoughts. This realization is encouraged by gentle question-and-answer sessions modeled on those in cognitive therapy.
In the University of Exeter study, funded by the UK’s Medical Research Council, 47 per cent of patients with long-term depression suffered a relapse; the figure was 60 per cent among those taking medication alone. Other studies, including two published in the Journal of Consulting and Clinical Psychology, had comparable outcomes. As a result, the UK’s National Institute for Health and Clinical Excellence has recommended MBCT since 2004. Availability is still patchy though, with many sufferers seeking courses at Buddhist centers.
“One of the key features of depression is that it hijacks your attention,” says Professor Williams. “We all tend to bring to the forefront of our minds the thoughts and feelings that reflect our current mood. If you are sad, depressed or anxious, then you tend to remember the bad things that have happened to you and not the good. This drives you into a downward spiral that leads from sadness into a deeper depression. MBCT prevents and breaks that spiral.”
Psychology Today provides an example of a typical MBCT meditation:
1. Sit upright in a straight-backed chair, with your spine about an inch from the back of the chair, and your feet flat on the floor.
2. Close your eyes. Use your mind to watch your breath as it flows in and out. Observe your sensations without judgment. Do not try to alter your breathing.
3. After a while your mind will wander. Gently bring your attention back to your breath. The act of realizing that your mind has wandered – and bringing your attention back – is the key thing.
4. Your mind will eventually become calm.
5. Repeat every day for 20-30 minutes.
Postscript: If you are severely depressed and suicidal, contact a mental health professional.
We are not health professionals, and this does not constitute mental health or medical advice.
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