Functional and holistic approach to depression

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Depression is a tricky subject. On the one hand conventional medicine has become strongly specialised in its treatment, on the other hand more and more people fall victim of poor mental health. Diagnosing depression is also questionable. Since there are no standard diagnostic criteria, it’s at the doctor’s discretion to determine if one needs help, usually in the form of medication. Anti-depressants are hugely profitable and, although often needed, they don’t address the root cause, unless one suffers from Prosac deficiency. Moreover, finding the right medication with long term desired effect is rare and the majority of affected people are left without a lasting solution.

ONE CAN BE DEPRESSED WITHOUT HAVING A DEPRESSION

My way of telling the difference is that being depressed is a state of the mind while having a depression is a state of the brain which then affects the mind. I’ve seen so much depression in my own family that I can honestly tell that depression is often misunderstood by those who have never suffered from it. While therapies that focus on the mind are great for depressed people, those with true depression need brain support first. People with depression often don’t have any reason to feel the way they do but can’t find a reason to be happy either. In fact, they can feel guilty for not being more grateful so they shut down for fear of being judged. If only biological root causes were spoken about more, people would not feel so alienated or think that they have gone crazy.

WHY IS TREATING DEPRESSION SO DIFFICULT?

Because depression is not a standalone condition but a symptom of underlying physiological imperfections which eventually affect the brain, and often goes hand in hand with other ‘conditions’ like anxiety. All of my clients with depression have a whole series of other symptoms including poor digestion, deficiencies, blood glucose dysregulation, anaemia or hormonal imbalances. Interestingly, most of them report dramatic mood and energy improvement once these symptoms have been addressed. Rarely anyone talks about food as a trigger because people don’t find it relevant. To me, it is central. But not in a way that one should just eat a balanced diet. Depression requires therapeutic nutritional support.

CLINICAL SIGNS AND SYMPTOMS OF DEPRESSION

  • sadness, withdrawal, feeling of doom and gloom

  • self-harm or suicidal thoughts

  • anxiety, panic attacks, fear

  • addictive behaviour (drugs, sugar, alcohol, food)

  • insomnia or oversleeping

  • decreased or increased appetite

  • extreme fatigue or / and restlessness

  • brain fog, confusion

  • no motivation

  • detachment from reality

DEPRESSION FROM THE FUNCTIONAL MEDICINE PERSPECTIVE

Depression is a limiting word. I think that ‘debilitating lack of vitality’ comes a lot closer to what it really is. In the field of neuroscience and functional neurology, this lack of vitality is caused by the brain’s frontal lobe not firing properly. For some reason, it is rarely talked about and addressed. The most common causes of the frontal lobe dysfunction include:

  • impaired digestion leading to deficiencies in nutrients that support the brain, e.g. cholesterol, vit A, D, K2, essential fatty acids, B vitamins, magnesium, zinc, antioxidants, certain amino-acids. If you don’t break down proteins well, you will not be able to produce neurotransmitters

  • impaired detoxification pathways, e.g. MTHFR gene mutation or too many toxins produced internally which can slow down detoxification

  • brain inflammation caused by the leaky gut which eventually leads to the leaky brain. The leaky brain is a gateway for all sorts of inflammatory triggers. This is where I put in a lot of work with my clients

  • unstable blood glucose levels leading to impaired neurotransmitter production

  • pyroluria: genetic condition related to zinc and B6 deficiency

  • underactive thyroid and / or thyroid autoimmunity

  • hormonal imbalance

  • diet rich in pro-inflammatory foods and social toxins

  • anaemia and poor circulation leading to poor brain oxygenation

  • traumatic brain injury

  • biochemical, structural and emotional stress

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DEPRESSION MAY BE MISUNDERSTOOD

As seen above, brain biochemistry is determined by multiple factors. The question then arises: what if depression was misunderstood? What if it wasn’t a mood disorder but a protective mechanism and a state of hibernation to store energy that has been chronically depleted by other health issues? Should mood improvement really be the key point before the necessary steps are taken to address the root cause?

HOLISTIC APPROACH TO DEPRESSION

My priority is to find the root cause. I almost always start with addressing gut dysbiosis, the leaky gut, the leaky brain, brain inflammation and balancing blood glucose levels. Further stages depend on individual factors. General aspects to look into include:

Delegating self-care to those who can look after you: it’s almost impossible to do it on your own, especially at the initial stages where motivation can be very poor and it’s important to stick to a food plan. Perhaps someone can shop and cook for you for a little while?

Whole foods: they have no list of ingredients; they are ingredients. Things to watch out for include: glucose and fructose syrup, anything that ends with -ose, flavour enhancers, E’s, and generally anything you don’t understand the meaning of. The more additives, the more processed the food which means it is devoid of nutrients that support the brain.

Digestion in check: observe your body and see what foods make you bloated or change your bowel habits. If you can’t digest something, it means you’re not absorbing the nutrients properly. Quit these foods until digestion gets better. A little water with raw apple cider vinegar, HCL + pepsin, digestive enzymes, ox bile and certain probiotics can help tremendously.

Basic anti-inflammatory elimination: removing added sugar, wheat, commercial cow’s dairy and plant oils like sunflower or rapeseed is a great start. These are known inflammatory triggers and most people notice a relief when avoiding these. Removing gluten and proteins that cross-react with gluten can make a big difference due to their negative effect on gut and brain barriers, and stimulation of the immune system (common allergens)

Anti-inflammatory support: additional compunds include but are not limited to omega 3 (EPA and DHA), curcumin and resveratrol.

Neurotransmitter support: depending on the symptoms, there are various ways to help the body produce, retain or degrade appropriate neurotransmitters.

Sleep: realistically, try and go to bed by 23:00 and get up by 07:00, at least mid-week. Organs regenerate at specific times so it’s not just the length of sleep that matters. Put your phone or alarm clock away so that you have to get up to turn it off.

Screen exposure: try and not look at screens after 8pm. It can do wonders to the quality of sleep.

Improving brain oxygenation: enjoyable movement, resolving anaeamia, addressing underactive thyroid and easing chronic tension all help to bring oxygen to the brain.

Natural light exposure: it’s important that the sun rays hit your retina during the day as much as possible, even when it’s cloudy. The more you look at natural light in the morning, the better you will sleep at night.

Friends and community: on days when you feel a little more social, surround yourself with people who lift you.

Therapist: they are there for YOU when you’re ready. The more channels you try, the better the results because depression is complex.