With the world changing at a faster rate than ever, it’s easy to feel as if things are out of control. Keeping up with work and social demands, parenting, and living in the uncertainty and fear of Covid-19 are triggers for stress, anxiety, and even depression. This is particularly true for those that are already prone to depression. For those dealing with depression, I want to offer hope that there are things you can do to help with your depression.
Understanding What Depression Is
Did you know that 1 in 13 Americans, starting at the age of 12, will report experiencing symptoms of depression? This mood disorder that leaves people feeling lonely, sad, and uninterested seems to be becoming more and more common. Other common symptoms include:
- A decrease in sleep
- Insomnia, often awaking between 2 am and 4 am
- Angry outbursts
- Increased sleep
- Difficulty concentration
- A decrease in energy
- Lack of appetite or weight loss
- Feelings of emptiness
- Unexplained pain
- Psychomotor retardation
- Feelings of guilt and worthlessness
- Thoughts of death and suicide
How is Depression Diagnosed?
While many conditions are diagnosed through blood or lab testing, depression can be diagnosed through simply talking with and screening a patient. Specific symptoms must be mentioned, or a doctor may have a standard questionnaire like the PHQ-9 form to understand exactly what his or her patient is dealing with. Doctors are looking for symptoms to be present for at least two weeks and to be severely impacting the quality of life. Doctors will also work to rule out health conditions, as these can sometimes present as symptoms of depression.
It’s also important to mention that major depression is different from sadness and grief. With sadness or grief, feelings will come in waves and self-esteem is generally maintained. With depression, however, a decreased mood can occur for several weeks and self-loathing is common even to the point of suicidal thoughts. However, despite this, depression is gaining more attention than ever, and it is a treatable condition.
What Causes It?
While doctors are not entirely sure what causes it, they believe there are several contributing factors. These include:
- Hormonal changes brought on by thyroid problems, menopause, or other conditions.
- Life changes including the loss of a loved one, a job, or a relationship, trauma, or financial insecurity.
- Lifestyle (e.g., screen time, sedentary lifestyle) and nutrient deficiencies.
- Isolation and lack of social support.
- Physical differences or changes in the brain that vary from a healthy brain.
- Chemical imbalances in the brain.
Successfully coping with symptoms may include several different steps. Counseling is helpful to identify and address those issues that may be causing depression. On the other hand, medications may help with imbalances and lessen or improve the symptoms of depression.
As an integrative medicine physician, I often get asked about supplements that can be supportive of mood symptoms. While these are not a substitute for the treatment of depression, it is worthwhile discussing these with your doctor as potential ways to support your well-being and mood.
While the omega-3 fatty acids in fish oil are known to benefit heart health, they’ve also been found to help relieve symptoms of a depressive state. The omega-3’s found specifically in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These are excellent for normal functioning of the body, and more specifically for neurological development and growth, but the body is unable to make omega-3’s on its own.
When first implementing fish oil, individuals may consider starting with a range of 600-1200mg of EPA and 400-800 mg of DHA. While higher doses may be even more beneficial, fish oil can interact negatively with prescribed medications and should only be recommended and monitored by a health professional.
B vitamins, including B9 (folate), B12, and B6 are important to mention when addressing depression because they play a role in how the brain functions. More specifically, they are involved in several reactions that help produce neurotransmitters like serotonin. Therefore, having a deficiency in these can have negative effects for your mental health.
One can consider taking vitamin B supplements and/or increasing sources of B vitamins through foods such as:
- Starchy vegetables
- Non-citrus fruits
Keeping in mind that they are consuming a plant-based diet.
Dosing to support mood may range between 1-25 mcg a day; however, higher doses can result in side effects such as blood clots, itching, and diarrhea. B-vitamin supplementation may also interfere with medications and should always be discussed with a doctor before using them in large doses.
Iron deficiency, especially in premenopausal women, is not uncommon and can have an impact on mental health and quality of life. Poor concentration, fatigue, apathy, and an altering of neurotransmitter production in the brain, can all result from iron deficiency.
Aside from not getting enough iron in the diet, causes of iron deficiency include heavy periods, Celiac disease, autoimmune gastritis, H. pylori infection and blood loss from the gastrointestinal tract (e.g., due to colorectal cancer). Consult with your doctor for dietary changes and supplemental dosing recommendations.
Zinc is another helpful supplement for tackling symptoms of depression. Zinc is not only found in high amounts in the brain, it is believed that there is a strong relationship between low zinc levels and the onset of depression.
While it is recommended that women take about 8mg per day and men 11mg, most multivitamins will contain about 15mg. For those trying to supplement for depression, one study suggests that 25 mg of Zinc should be consumed.
Though incorporating this supplement into your routine could be beneficial, it should be noted that high absorption of zinc could limit the absorption of copper leading to a deficiency in that nutrient as well. Therefore, it may be necessary to take a low-level copper supplement in addition to zinc supplementation.
We all know that Vitamin D can help the body absorb calcium and keep bones strong, but few realize the role it plays in easing depressive symptoms. Vitamin D activates neuron receptors located in regions of the brain that impact behavior, initiate the release of neurotrophins and provide protection. This means that this vitamin has links to bipolar disorder, depression, and cognition.
Therefore, adding more sources of Vitamin D or supplementing with this nutrient may positively impact the brain and ease this mood disorder. The suggested dosage of Vitamin D is between 400 and 800 IU’s, however, in practice, this rarely increases vitamin D sufficiently. Consult your doctor to have your vitamin D measured and determine if supplementation is appropriate. Note that vitamin D supplementation can impact the efficacy of other medications and should only be taken under a doctor’s supervision.
Lastly, SAMe, or S-adenosyl-methionine, is a compound made naturally within the body that has several important functions, including helping the brain to produce serotonin, melatonin, and dopamine. It can also be made artificially and, when taken, has been proven to have antidepressant effects, especially when used with antidepressant medication.
Dosing of this compound for depression ranges from 400mg to 800mg twice a day with a starting level of 200mg and a maximum dose of 1600mg. As SAMe works in conjunction with B12 and Folate, it is important that these supplements be considered as well. And, like all supplements, it’s always important to monitor for side effects and consider any current medications being taken as well.
Considering Your Options
Depression not only comes with devastating symptoms, it comes with confusion and uncertainty for both you and your loved ones. The good news is, however, that there are options for treatment.
Consider taking the next step and working with your doctor to discuss the possible triggers for your depression, as well as strategies and treatment options that will support you, identify and address the root causes, and improve your symptoms. These strategies can include counseling, cognitive behavioral therapy, mindfulness, meditation, yoga, lifestyle (nutrition, sleep, movement, community, and support), support group, medications, when indicated, neurofeedback, and others.
If you work with an integrative medicine physician or an integrative psychiatrist, they can do the appropriate testing and recommend supplements that may support your well-being.