The Moody Blues...

Do you take less pleasure in activities that previously gave you great joy? Are you feeling run-down and tired all day and then finding that you can't sleep during the night? Are worries about your family and finances leading to chronic tension headaches and stomach upset? If you answered yes to one or more of these questions, you are not alone. These are common complaints from people who are struggling with feelings of anxiety and depression.

Depression and anxiety are two of the most common medical complaints. They affect 1 in 5 adults in the US. Many experts believe these conditions are caused by altered brain chemistry. Chemical messengers in the brain called neurotransmitters play a central role in the control of mood, energy, impulsivity, focus and appetite. Antidepressant and anti-anxiety medications often target three major neurotransmitters: serotonin, nor-epinephrine and dopamine.

Unfortunately, many people experience negative side effects to these types of medications including weight gain, low libido and other sexual side effects. Some people are not able to tolerate these medications even at low doses. In addition, a groundbreaking study published in the Journal of the American Medical Association in the January 2010 issue concluded that prescription anti-depressant medications may provide little to no benefit for those experiencing mild to moderate depression. That said, those with more severe forms of depression often find these medications more effective. We see many people in our clinic seeking alternative treatments for anxiety and depression.

Symptoms of anxiety and depression often occur together at the same time. If you are experiencing any of these symptoms, it is best to consult with a healthcare practitioner experienced in treating mood disorders.

When initially experiencing changes in mood, it is helpful to look at the over-the-counter and prescription medications in the cupboard. Although often overlooked, many medications can cause depression and anxiety as unwanted side effects. In addition, many legal and illegal substances used for recreational reasons can cause people to feel and act differently.

When treating patients with emotional changes and mood fluctuations, we often look beyond brain chemistry. Nutritional deficiencies, hormonal imbalances, family history, recent and chronic life stresses and changes in overall spiritual outlook can influence mood. The best treatments to improve emotional health and well-being are often much more complex than we would like. Lifestyle basics such as exercise, sleep, regular sunshine and a well-balanced diet are the foundation for any treatment plan that addresses moodiness and irritability. We find that a combination of diet and lifestyle changes along with appropriate natural therapies can help address many mood disorders. Here are some of the most efficacious and well-studied natural treatments for depression and anxiety.

Herbal Medicine

• St. John’s Wort: One of the best known natural antidepressants, this herbal medicine works similarly to conventional medications. However, when compared to its medication counterpart in scientific studies, it often has less negative side effects. The dose typically used in these studies is 900mg of a standardized extract per day divided in 2 or 3 doses. We find that St John's Wort can help those with insomnia, fatigue and body aches related to depression.
• Adrenal Adaptogens: This group of medicinal herbs is known for protecting the body from the negative effects of chronic stress. Special testing can track stress hormones throughout a typical day. When these hormones are out of balance symptoms of fatigue, insomnia, anxiety and depression may occur.

Amino Acids

• SAMe (s-adenosyl-L-methionine): SAMe is an amino acid that helps facilitate the chemical messages throughout the brain. SAMe can be used either as a standalone treatment or in combination with antidepressant medications. As with all amino acids, SAMe should be taken away from food. Many supplement companies cut corners when providing good quality SAMe products due to high costs. Testing performed on over-the-counter products has sometimes shown that these products have very little to no active ingredients. When purchasing SAMe be sure to use a trusted pharmaceutical grade product that meets strict testing standards.
• Tyrosine, L-Tryptophan, and 5-HTP: These amino acids are the building blocks the body uses to make the neurotransmitters serotonin, nor-epinephrine and dopamine. This nutritional support helps the body produce more of its own natural neurotransmitters. These supplements may be used in a blended formula or individually to improve brain chemistry and overall mood.
• Acetyl-L-Carnitine: This amino acid has been studied as a treatment for depression related to aging. It can also be helpful for improving focus, attention and memory. It appears to have multiple effects including hormonal regulation and increased blood flow to the brain. Typically 1500 mg to 3000 mg of acetyl-L-carnitine per day is supplemented for 2-3 months before full benefit can be seen.
• L-Theanine: This major amino acid found in green tea has been commonly used for anxiety. Theanine helps promote feelings of peace and tranquility without sedation.
• GABA: Gamma-aminobutyric acid (GABA) is the neurotransmitter responsible for calming and producing relaxation during times of too much stress and irritability. Natural GABA found in fermented foods increases the production of alpha-waves in the brain which have the unique ability to promote physical relaxation of the body while simultaneously maintaining sharper mental focus. When purchasing GABA supplements make sure that the GABA is from the natural form as the synthetic GABA does not demonstrate the same benefits.

Other vitamins and nutrients

• Fish Oil (EPA and DHA): A rich source of omega-3 essential fatty acids, fish oil is one of the first nutritional interventions recommended by conventional and alternative practitioners alike. A deficiency in essential fats is common in people suffering from depression. These essential fats are important for developing normal brain structure. We recommend starting with at least 2 grams and frequently as much as 4 grams of fish oil per day taken with a meal to optimize absorption.
• B-complex vitamins: There are 9 different vitamins that comprise a B-complex vitamin. These nutrients are required for the production of neurotransmitters and are a common deficiency, especially in women. Studies have shown that those with low folate and B12 levels are found to have an increase in depression as well as a poor response to antidepressant medication. Vitamin B6 has been shown to be helpful for those women who experience mood fluctuations before their menstrual cycle.
• Vitamin D: Known as the sunshine vitamin, vitamin D has gained popularity for improving mood and energy. In addition it appears to help boost the immune system and play a role in cancer prevention. Many people in the northern hemisphere are deficient in vitamin D. We often recommend at least 1000 IU per day for most of our patients. Some people may be so extremely deficient in vitamin D that 10,000 to 50,000 IU per day will be prescribed for limited amounts of time. We recommend having your vitamin D levels checked by your physician before taking these high doses. Vitamin D is a fat soluble vitamin, so it can be toxic in the case of an overdose.

As you can see, there are many different natural therapies to promote healthy emotional expression. We often start off with a simple treatment plan involving a basic allergy elimination diet to decrease inflammation and stabilize blood sugar, a light exercise program that involves 3000 to 5000 steps per day, and supplementation with a combination of pharmaceutical grade herbs and/or nutrients. After around 6 weeks using these natural therapies, many of our patients feel an improvement in their mood and well-being.