A Holistic Approach to Depression
What is it to be affected by depression? I can state numbers and statistics, such as roughly 17 million adults nationwide being diagnosed, 7% of the population, in any given year. I can tell you that women consistently rank higher in this statistic, as much as 2x the diagnoses globally. Incidences of postpartum depression, PMS and PMDD, post menopausal depression, anxiety, abuse, and more all contributing to this. I can tell you that depression often coincides with insomnia, anxiety, numbness, substance abuse, and isolation. Nevertheless, none of these facts and numbers really matter to you when you are in the pits of this disease.
What matters is finding relief. What matters is feeling seen and heard.
Medicine should always be individualized, and this matters on an even deeper level when we are discussing the health of your brain. For some, SSRI’s are a life saver and an anchor keeping them afloat. For others, the long list of side effects weigh them down even deeper. The purpose of this blog is to inform you of everything you can do to support your brain and mental health either alongside, before, or after looking to medication.
What is Depression and How Does it Manifest?
Depression can cause inflammation in the brain. This is a disease just like that which would affect any other organ in your body, and should be treated as such. Holistically and with great attention to detail. Depression can look like apathy, loss of sex drive, fatigue, severe mood swings, headaches, digestive issues, difficulty concentrating, and more.
Depression can spring from a number of factors, such as genetic vulnerability, multiple stressful/traumatic life events causing a shrinkage of the hippocampus, comorbidity with other chronic disease, hormonal imbalance, or poor sleep and diet. To live with depression is to walk through life in a fog. It is not a constant episode of lashing out and sobbing. It can look different on different people - there’s no one size fits all. For some it may be low emotions and for others it may be an absence of emotions. Maybe a combination of both.
When it comes to medication, The American Psychiatric Association states that many antidepressants are “potentially unnecessary and sometimes harmful”, advising to not use them as a first line of defense and be overtly cautious in prescribing. To quickly summarize, SSRI’s work by preventing serotonin from being wiped up from the synapse. More serotonin is now hanging out in the synapse and will be taken up by the neuron. This changes how effective and functioning the serotonin already in you brain is, by changing neuronal activity.
There are major side effects, however. Not to mention 1/3 of people who take them have no benefit at all.
Depression = Stagnation
Many women can be repressing anger, shame, and guilt in one way or another as a product of how we are raised, how we are programmed, and societal norms around mental health. When this sits stagnant over a long period, over a lifetime, it gets stuck in our body. Trauma, shame, repressed anger, all of this remains stuck when it isn’t properly processed. The longer this stagnation sits around, it begins to creep up and manifest in our bodies as inflammation, chronic disease, digestive issues, and depression. To move this energy around and out, we have to go through the body. Acupuncture, breath work, talk therapy, and physical release can all accomplish this.
In the meantime, there are a plethora of science backed ways to alleviate symptoms and support your brain.
St. John’s Wort
Named after John the Baptist for its’ tendency to bloom on the summer solstice date of June 24th, St. John’s Wort is an incredible herbal medicine. The entire plant, leaves and flowers, are used for their healing properties. What began as a way to ward off demons, is now proven in multiple double blind studies to be just as or more effective than SSRI’s. One study even described is at “significantly superior” when compared to a placebo.
Similar to an SSRI, the compounds in St.John’s Wort increase the uptake of serotonin, dopamine, GABA, and norepinephrine
Both adaptogenic and restorative to the nervous system
Has been found to even decrease symptoms of PMS by 50%
The standard dosage is 300 mg , 3x a day.
Caution: DO NOT take these with SSRI’s and always consult with your doctor before adding in any supplements or herbs.
Holy Basil (Tulsi)
In Hindi, Tulsi is considered to be the “Queen of Herbs” for its’ plethora of medical capabilities. Native to India, this plant is described as liquid yoga, as a result of its’ soothing and balancing abilities when used preventatively and daily.
Supports a healthy stress response through adrenal health and the HPA axis, which mediates the effects of stressors in the body
Tulsi can also aid in microbiome balance and digestion given its’ warming properties…which links to decreasing inflammation
Highly antioxidant and protects and detoxifies the bodies cells and organs. This halts further neuronal damage and stressors to the brain.
Can help enhance cognitive functioning and memory
Shown in animal studies to reduce the affects of acute and chronic stress
Anti-inflammatory abilities comparable to that of ibproufen, alongside anti-diabetic capabilities that reduce inflammation and lower blood glucose response
It is recommended to take 500mg a day or consume it in the form of tea by steeping the leaves
Disclaimer: Always consult with your doctor before adding in any supplements or herbs.
Ashwagandha
Many people have heard of the magic of Ashwagandha for stress relief and calming the nervous system. Said to rejuvenate the body and promote tissue health in ancient medicine, this herb should not be overlooked for depression.
GABA is the most important inhibitory neurotransmitter in the central nervous system. Compounds in Ashawaganda can modulate and interact with GABA receptors in the brain, explaining its’ significant anti-anxiety effects
One study had participants take dosages ranging from 240-1000 mg for 8-12 weeks. A significant improvement was seen on the DASS (depression anxiety stress scale) and PANSS (positive and negative syndrome scale)
Antioxidant and serotonergic properties (linked to the increased release of serotonin). The human brain is very prone to oxidative stress, which is linked to many psychiatric disorders, making antioxidants of the utmost importance
Helps control mediators of stress such as serum levels of cortisol
Massively improves quality of sleep, which lowers inflammation and reduces depression
Disclaimer: Always consult with your doctor before adding in any supplements or herbs.
Saffron
Found in 21 randomized, controlled trials to have the same positive effectiveness as antidepressants, Saffron is a wonder herb. Saffron originates from the crocus sativus flower and is native to Asia and used traditionally for low mood, as a sedative, aphrodisiac, to reduce inflammation and more.
At a dose of 30mg/daily for 6 weeks in 5 clinical trials resulted in similarity to antidepressant medications
Saffron may reduce serum cortisol in response to stress in both acute and chronic rodent studies. This suggests a link to modulating the HPA axis
One study has shown that healthy women exposed to saffron aroma for 20 min experienced a decrease in salivary cortisol levels, which was accompanied with a decrease in anxiety measured using the State–Trait Anxiety Inventory (STAI)
Demonstrated improvement in social relationships and significant reduction in depressive symptoms after 56 days of saffron use when compared to placebo group
Inhabitation of dopamine, norepinephrine, and serotonin reuptake, similar to an SSRI
In one study, saffron was dosed at 15 mg twice daily and compared against fluoxetine (20 mg daily) in the treatment of mild to moderate postpartum depression over 6 weeks. It was found to have equal efficacy with remission and partial response rates almost identical between the groups
Disclaimer: Always consult with your doctor before adding in any supplements or herbs.
Controlling Inflammation: Nutrients and Movement
Before you talk to your provider about going on a medication, you should be doing bloodwork and assessing any nutrient deficiencies you may have. Testing your sex hormones, cortisol, thyroid, nutrients, gut health, and inflammatory markers are a great way to establish a baseline of where your health may need support.
What can you do with your lifestyle to support mood and reduce inflammation?
Blood sugar balancing. Eating meals that consist of high protein, fat, and complex carbohydrates keep your blood sugar balanced and inflammation under control. Eating carbs or sugar alone leads to a massive blood glucose spike
Exercise. Inflammatory cytokines released during stress inhibit serotonin, norepinephrine, and dopamine AND the synthesis of them! They also cause tryptophan to stop being converted to serotonin…instead it is being converted into a neurotoxic pathway. Roughly 150 minutes a week of cardio is shown to have a positive effect on tryptophan to serotonin pathway, overall increasing available feel-good serotonin levels
Fatty Acids. The brain is primarily composed of fatty acids and needs them for survival. The EPA variety of Omega-3 relief of depressive symptoms matches SSRI’s in newer studies. Be sure to check bottle for how many mg of EPA, 1000 mg is the critical threshold for relieving depressive symptoms
Vitamin D. 400-800 mg daily is shown to have significant improvements in depressive symptoms. It is thought to help regulate various functions of the central nervous system and control chemical balances.
Vitamin B12, B6 and Folate. B Vitamins play a vital role in calming anxiety, increasing GABA, and metabolizing serotonin
Complex Carbohydrates. Studies show a direct link between complex carbs such as beans, fiber rich vegetables, and whole grains with levels of serum serotonin
Although all of these methods are incredible, it can be difficult to get yourself up to exercise, eat healthy, and take supplements when you are suffering. Please remember to cut yourself some slack if this is the case. Depression is a medical condition, not a choice or an emotion.
There are always small ways to bring light into your days, no matter where you are in this journey. Beginning each day by stating to yourself that this will be a great day and you are exactly where you are supposed to be, will prime your brain to look for proof of this. Ending the day by listing what you are grateful for will do the same.
When adding things on to your daily habits, the scent of lavender has been shown to have significant anti-depressant qualities when inhaled 4x a day, keep some by your desk and bed!
Finding a cure to your depression is not a one stop shop. You have to find what works for you, work with a trusted provider who will truly listen to you and work from every angle before prescribing, and give yourself the grace of patience. Find a doctor who will walk alongside you in your healing, and note that sometimes you cannot believe everything you think. Negative thought patterns get stuck in our minds, just as trauma does in our bodies. Have more faith in yourself than your mind is leading you to believe.
As always, if you’re interested in working with Dr. Paria on your health you can click here to schedule a discovery call!
