Depression has been classified as a mood disorder or "affective" disorder. Mood is defined as a powerful, sustained emotion that, in the extreme, markedly affects a person’s perception of the world and ability to adequately function in society. Mood disorders are among the most common health problems doctors see every day.

The American Psychiatric Association has a list of criteria that are used to diagnose depressive disorders. These criteria are as follows:

1. Five (or more) of the following symptoms have been present during the same two-week period and represent a change from the individual’s previous emotional state; at least one of the symptoms is either depressed mood or loss of interest or pleasure.
• Depressed mood most of the day, nearly every day.
• Markedly diminished interest in pleasure in all, or almost all, activities.
• Significant weight loss (not dieting) or weight gain, or increase or decrease in appetite nearly every day.
• Insomnia or excessive sleep nearly every day.
• Sluggishness or agitation nearly every day.
• Fatigue or loss of energy nearly every day.
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive or inappropriate guilt (may be delusional) nearly every day.
• Diminished ability to think or concentrate, or indecisiveness.
• ecurrent thoughts of death, recurrent suicidal thoughts without a specific plan, or a suicide attempt or specific suicide plan.

2. The symptoms cause significant distress or impair the person’s ability to function in everyday tasks. The symptoms are not due to the direct psychological effects of a substance or general medical condition.

   The symptoms occur most of the day, nearly every day and cannot be due to any drugs, substance, or general medical condition.

C A U S E S

Several factors seem to combine to trigger depressive disorders. Studies have shown that heredity does seem to play a role. Depression is not simply "all in the head” but rather has physical causes, many of which link to abnormalities in brain chemistry. The symptoms of major depression consistently reflect changes in the neurotransmitters (substances that regulate the function of the brain and nervous system).

The neurotransmitters closely related to depression are norepinephrine, serotonin, and dopamine. Serotonin is a key neurotransmitter for maintaining mental and emotional health with low levels often resulting in depression. Prolonged stress, be it physical, mental, or emotional can deplete the body’s serotonin supply. A host of health problems can contribute to depression by diminishing serotonin levels. These include: adrenal exhaustion, hypothyroidism, heavy metal toxicity, and leaky gut syndrome with subsequent food intolerances. Deficiencies in nutrients such as vitamin B12, folic acid, and certain amino acids can also be involved.

Intestinal toxemia is also associated with a variety of mental disturbances. In 1917, medical researchers, Satterlee and Eldridge, presented 518 cases to the AMA which showed that by treating a patient's bowel toxicity, there was an alleviation of the following symptoms: mental sluggishness, dullness, stupidity, loss of concentration, memory, and mental coordination, irritability, lack of confidence, excessive worry, exaggerated introspection, hypochondriasis, phobias, depression, melancholy, obsessions, delusions, hallucinations, suicidal tendencies, delirium, stupor, and senility. Furthermore, when intestinal toxemia was treated, physical symptoms such as fatigue, nervousness, gastrointestinal conditions, impaired nutrition, skin manifestations, endocrine disturbances, headaches, sciatica, various other forms of low back pain, allergies, eye, ear, nose, throat, and sinus problems, and even cardiac irregularities were reversed.

This does not mean that bowel toxemia is the only cause of these problems, however, it is a factor that is often overlooked.

T R E A T M E N T

The most commonly used drugs for uncomplicated depression are the tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). TCAs and SSRIs work by blocking the reuptake of norepinephrine and serotonin into brain and nerve cells. Monoamine oxidase inhibitors (commonly known as MAO inhibitors) are another form of anti-depressants used in cases of atypical depression. Unfortunately drugs only serve to manage symptoms and rarely address the root cause. They also produce many undesirable side effects, often times with fatal consequences. Fortunately there are natural alternatives.

S-adenosyl methionine (SAMe), widely available as a dietary supplement, is one of the most studied non-drug antidepressants. It is critical for production of neurotransmitters and helps elevate mood quickly and safely.

Tryptophan and 5-hydroxytryptophan (5-HTP) are the building blocks for production of serotonin in the body. Ample evidence exists indicating that tryptophan depletion causes reduced synthesis of serotonin, which results in depression and other mood disorders.

Phenylalanine and tyrosine are other amino acids the body requires to produce neurotransmitters. These nutrients are used to manufacture dopamine, norepinephrine, and epinephrine, three neurotransmitters that influence and regulate mental and emotional states. Caution: Individuals with high blood pressure should only take phenylalanine under the close supervision of their primary health care provider. Phenylalanine should not be consumed by individuals suffering from phenylketonuria (PKU), melanoma, and those taking MAO inhibiting anti-depressants.

Studies show a relationship between symptoms of depression and a ratio of low omega-3 fatty acids to high omega-6 fatty acids in the diet. Supplementation with fish body oils containing EPA and DHA omega-3 fatty acids often improves mood and relieves depression within one to two weeks.

Vitamin B6 is required for the conversion of tryptophan to serotonin. Vitamin B6 deficiency may result in symptoms of anxiety and depression, due to decreased serotonin production. Numerous drugs can deplete B6, which can often lead to depression.

A vitamin B12 deficiency can result in depression with B12 deficiencies occurring much more frequently in the elderly.

Depressive symptoms are the most common neuropsychiatric signs of a folic acid deficiency. Folic acid supplementation has proven to significantly enhance recovery from psychiatric illness. The following classes of drugs are capable of depleting folic acid: antacids, anticonvulsants, biguanides, corticosteroids, aspirin and salicylates, non-steroidal anti-inflammatory agents, bile acid sequestrants, oral contraceptives, and the H-2 receptor antagonists.

St. John’s Wort is one of the world’s most popular herbal treatments for depression, thanks to its extensive use in Europe. Studies have shown St. John’s Wort to work effectively in mild to moderate depression; whether it works as well in severe depression has yet to be tested.

Ginkgo is among the oldest living species on earth and is considered a tonic for the circulatory system. It may increase blood flow in the brain, improve delivery of oxygen and nutrients to brain tissues, and assist with the elimination of cellular waste. Ginkgo has also been used to treat impotence, especially when associated with antidepressant therapy.

Rhodiola has long been used as an adaptogen – a herb that decreases fatigue and increases the body’s natural resistance to stress. Rhodiola seems to enhance the body's physical and mental work capacity and productivity, working to strengthen the nervous system, fight depression, enhance immunity, elevate the capacity for exercise, enhance memorization, improve energy levels, and possibly prolong the life span. The active ingredients of rhodiola, namely rosavin and salidroside, have been shown to enhance the transport of serotonin precursors tryptophan and 5-HTP into the brain in addition to decreasing the action of COMT (catechol-O-methyltransferase), an enzyme that breaks down serotonin in animal studies.

D I E T & L I F E S T Y L E

Sugar, caffeine, and alcohol should be eliminated from the diet. Food allergens should be identified and eliminated. Physical exercise is strongly recommended. Light therapy has proven effective. The reduction of stress is very important and can take the form of counseling, tai chi, yoga, meditation, and deep breathing to list some examples.

DISCLAIMER: THIS INFORMATION (AND ANY ACCOMPANYING PRINTED MATERIAL) IS NOT INTENDED TO REPLACE THE ATTENTION OR ADVICE OF A PHYSICIAN OR OTHER HEALTH CARE PROFESSIONAL. ANYONE WISHING TO EMBARK ON ANY DIETARY, HERBAL, SUPPLEMENTAL, DRUG, EXERCISE, OR OTHER LIFESTYLE CHANGE INTENDED TO PREVENT OR TREAT A SPECIFIC DISEASE OR CONDITION SHOULD FIRST CONSULT WITH AND SEEK CLEARANCE FROM A QUALIFIED HEALTH CARE PROFESSIONAL.