Depression is a tricky subject. Although conventional medicine has become strongly specialised in its treatment, 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 sometimes 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 FEEL DEPRESSED WITHOUT HAVING A DEPRESSION
Being depressed is a state of the mind while having a depression is predominantly a state of the brain, which affects the mind. I’ve seen so much depression in my own family that I can honestly say it is often misunderstood by people who have never experienced it. Clinical depression is not simply sadness or pessimism that someone can think their way out of. Psychological therapies (like mindset work) can be incredibly valuable, but in genuine depression we need to consider what may be happening biologically with brain function. Depression deserves to be approached as a whole-person condition, addressing biology, psychology and spirituality simultaneously, rather than assuming that either exists independently. And when the brain is supported properly, the mind and soul can flourish.
WHY IS TREATING DEPRESSION SO DIFFICULT?
Because depression is not a standalone condition but a symptom of various underlying causes which eventually affect the brain, and often goes hand in hand with other ‘conditions’ like anxiety. All of my clients with depression experience 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.
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, often (but not always) due to chronic neuroinflammation. The most common direct causes include:
Impaired digestion: foods that are maldigested may act like toxins which can pollute the brain through a hyper-permeable gut wall, called ‘the leaky gut’
‘The leaky brain’: once you have developed the leaky gut, this will eventually lead to ‘the leaky brain’. The leaky brain is a gateway for all sorts of inflammatory triggers, including toxins produced by microbes residing in our bodies, dietary and environmental. This is where I put in a lot of work with my clients
Brain injury and chronically elevated cortisol (stress of any origin), both of which can lead to prefrontal cortex damage. This is an area of the brain where serotonin and dopamine fire
Anaemia and poor circulation leading to poor brain oxygenation, poor brain energy and poor brain regeneration
Underactive thyroid and / or thyroid autoimmunity
There are some major aspects that perpetuate that state, and these include:
Unstable blood glucose levels leading to impaired neurotransmission (the brain likes a stable influx of fuel and really suffers when glucose rises too high or drops too low)
Pyloruria: genetic condition related to severe zinc and B6 deficiency, both of which stabilise mood
Hormonal imbalance (esp. rapid decline that is seen postpartum or during perimenopause)
Diet rich in pro-inflammatory foods and social toxins
Loss of connection with oneself: people who feel disconnected or lose their sense of meaning can experience greater hopelessness and emotional numbness
The gut-brain connection
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 depleted by chronic stress or 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 as you’re getting through the hardest bit? Can someone do a little meditation with you or take you for a walk?
Whole foods: they don’t have a list of ingredients; they are ingredients. Things to watch out for include: glucose and fructose syrup, anything that ends with -ose, flavour enhancers, 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.
Basic anti-inflammatory elimination: removing added sugar, wheat, commercial cow’s dairy, commercial seed oils like sunflower or rapeseed and fried foods 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.
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 and most probably create toxic metabolic byproducts that act like toxins. 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.
Anti-inflammatory support: additional compunds include but are not limited to omega 3 (higher EPA to DHA), curcumin and resveratrol.
Learn to do less: have you ever wondered why you need to be on the go all the time? 0ne or two hobbies is enough. A busy lifestyle is destructive, especially that it blocks the time that can be devoted to connecting with yourself, your partner, family, with food or even meditating a little. People who cannot and don’t want to relax often suffer from ADHD so addressing this is key.
Neurotransmitter support: depending on the symptoms, there are various ways to help the body produce, retain or degrade appropriate neurotransmitters. The most common ones include 5-HTP, l-tryptophan, St John’s wort, saffron, magnesium, zinc and methylated B vitamins.
Sleep: realistically, try and go to bed by 23:00 and get up by 07:00, at least mid-week. 22:00-06:00 would be ideal. The brain regenerates the best most 22:00 and 02:00 so it’s not just the length of sleep that matters but timing.
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 exposure to light: 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.
WHAT ABOUT ANTIDEPRESSANTS?
Antidepressants can be a very valuable crutch, especially at the beginning, when depression is so debilitating that a person struggles to function or engage with other forms of support. Many of the strategies I discussed can be used alongside medication. Where appropriate, my preference is to address depression as holistically as possible and, once someone is genuinely stable, to review with their prescribing doctor whether the medication is still needed. If the decision is made to stop, antidepressants should be tapered gradually.
I can help you through a holistic therapy which includes natural medicine, nutritional therapy and functional medicine diagnostics. For more details, visit my consultations page.