Depression now affects one in ten adults in the U.S. and is projected to be the second leading cause of disability in the world by the year 2020. Depression is also one of the leading causes of workplace healthcare expense, costing employers and employees billions of dollars in medical costs, absenteeism, and presenteeism. Attempts to find a medication to treat depression have been going on for over 50 years with surprisingly poor results. Some evidence indicates that response rates to the top medications are often as low as 17 percent and about 63 percent of patients experience side effects such as anxiety, insomnia, weight gain, sexual dysfunction and thoughts of suicide.

In 2013 there was a double-blind, placebo-controlled study comparing curcumin to Prozac and curcumin was just as effective, but without the potentially harmful side effects. Over time most prescription medications lose their effectiveness while producing ever-increasing negative side effects. Curcumin, on the other hand, has increasingly beneficial side effects including improved attentiveness, better sleep, emotions and learning. It accomplishes this through the increase of norepinephrine, serotonin and dopamine as well as the reduction of inflammation in the brain.

It should be noted that the curcumin used in the above mentioned study was a special form of curcumin called BCM-95. The form is seven times more bioavailable than any other form of curcumin.

There are some even more significant positive side effects or benefits to taking curcumin beyond its ability to improve brain function. Curcumin also suppresses the growth of inflammatory cells in our joints, thus helping to prevent and even reverse many cases of osteoarthritis. By preventing the breakdown of joint-lining cartilage curcumin has even been shown to provide significant relief for people with rheumatoid arthritis, a genetic and more difficult to treat disease.

And finally, curcumin may very well be one of the leading natural methods for the prevention and the treatment of cancer. Scientific evidence has shown the ability of curcumin to help in the following types of cancer: breast; uterine; cervical; prostate; brain; lung; throat; bladder; pancreas and gastrointestinal. Curcumin actually has been shown to intervene and disrupt cancer at virtually every stage of its development. It achieves this primarily through the suppression of inflammation, which is one of the major contributors to most forms of cancer. By preventing the proliferation, migration and thus the very survival of cancer, curcumin helps the body's natural defense mechanisms, as well as the conventional and the natural treatments that have been proven to kill cancer cells. This natural compound derived from the spice turmeric deserves serious consideration for the treatment of depression as well as the other chronic diseases mentioned here.

What makes one person depressed and another happy? Certain conditions are commonly associated with depression such as hypothyroidism, Crohn's disease or colitis, migraines, diabetes, chronic infections and cancer. Lifestyles such as drinking alcohol and smoking are correlated and the biggest secret of all is drug mugging! In my book Drug Muggers, I describe how drugs "mug" you of vital nutrients which you need to produce "happy" brain chemicals termed neurotransmitters. Today I'll teach you what popular drugs lead to depression just by the mere fact they mug you of vitamins. No amount of Zoloft replenishes the nutrient steal.

There are three primary neurotransmitters in your brain, serotonin, noradrenaline and dopamine. Serotonin is involved in emotion and mood control. Did you know that 95 percent of your serotonin is in your gastrointestinal tract, not your brain? Noradrenaline also known as "norepinephrine" is involved in your 'fight or flight' response. Dopamine is part of your inborn reward system which allows you to feel passion and pleasure. These three neurotransmitters are made in the body every second and they depend on adequate levels of B vitamins which you can get from eating right and keeping your gut healthy:

Thiamine or B1- The journal Neurology, showed a thiamine deficiency contributes to a decrease in serotonin which can lead to depression and anxiety, as well as weight gain. Drug muggers include antivirals, oral contraceptives and hormone replacement, raw oysters, antacids and antibiotics.

Niacin or B3- Tryptophan is metabolized in your brain into 5-HTP (5-Hydroxytryptophan) and goes on to form serotonin and dopamine. You need niacin for this biochemical reaction to occur. Acid blockers, antacids, cholestyramine and loop diuretics are drug muggers. Just so you know, serotonin is broken down at night to form melatonin, which makes you sleepy.

Pantothenic acid- This B vitamin makes for healthy adrenal glands; it's often low in people with hypoglycemia. Speaking of blood sugar, use your computer to tune in to a free online event www.DiabetesSummit.net where I am giving a free one hour interview along with 40 other experts. Blood sugar abnormalities cause mood swings. You need this B vitamin to make noradrenaline as well as your memory molecule acetylcholine. Deficiencies in vitamin B-5 are tied to decreased alertness, fatigue, memory problems and depression. Acid blockers, cholestyramine and antibiotics are drug muggers.

Pyridoxine or B6- Pyridoxine is found primarily in beans, legumes, meat, eggs, fish and bread but you can't eat enough to make adequate levels of serotonin and dopamine. By improving the production and function of serotonin and dopamine, you can reduce the severity of certain types of seizures, neuropathic pain and Parkinson's disease. Drug muggers are corticosteroids, oral contraceptives(estrogens), loop diuretics and antibiotics.

Folate or B9- This is folate not "folic acid" by the way. Up to 70 of depressed people have a genetic 'personality' such that they have what's called an "MTHFR" polymorphism or what we call a SNP (pronounced "snip"). This situation compromises your body's ability to turn folate from your foods into L-methylfolate which you need to make neurotransmitters, especially your passion hormone dopamine. Drug muggers include metformin, fluoxetine, warfarin, oral contraceptives and high doses of niacin.

Depression is an increasingly common issue in the United States. The Centers for Disease Control in 2010 estimated that 11.1 percent of the American population suffers from significant depression — a whopping 35 million individuals — and this figure seems to be steadily rising. Prescribed mood modifiers are everywhere, starting as early as elementary school and continuing on into old age. How successful are these pharmacologic approaches? Not very. Optimistic estimates maintain that such interventions are reasonably successful in only one half of those treated. Less optimistic observers note that in those currently taking an SSRI (selective serotonin reuptake inhibitor) antidepressant drugs such as Prozac, despite a host of side effects, most do not attain relief. Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy; they obtain better results with, for instance, tai chi.¹ For major depressive disorder, a condition for which one would think that pharmacological treatments would win out over nonpharmacological therapy, it turns out that nonpharmacological therapy not only is just as effective, but also involves far fewer adverse events.^2,3

The causes of depression and mood disorders remain an area of controversy. Human beings are prepared to react to vastly varied environmental factors. Not surprisingly, many biological and psychological factors cut in more than one direction. Metabolic factors (inflammation, insulin resistance, and oxidative stress) are not necessarily one-direction in terms of causation, for example, with regard to emotional and physical stress and the resulting stress hormones (glucocorticoids). Sex hormones (testosterone, estrogen), likewise, both influence and are influenced by emotional and physical factors.

Is Inflammation the Central Issue?
The concept of inflammation in the last few years has been stretched to cover more and more forms of illness and dysfunction. One reason is that inflammation is actually a set of responses that occur naturally all the time, yet each of which can itself escape proper regulation. You get a sense of this from the article on inflammation available online from Wikipedia: “Inflammation is a protective response that involves immune cells, blood vessels, and molecular mediators. The purpose of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.” Inflammation thus involves both destruction and repair.

A number of researchers are looking into the issue of neuroinflammation outside of the traditional medical areas of concern, such as stroke. For instance, psychological stress has been demonstrated to increase neuroinflammation in animal models.⁴ Similarly, there is evidence to support the position that links chronic depression to chronic brain inflammation and acute depression to stress-triggered neuronal microdamage.⁵ Another line of argument is that the “metabolic syndrome and its individual components induce a proinflammatory state that damages blood vessels. This condition of chronic inflammation may damage the vasculature of the brain or be directly neurotoxic.”⁶

Countering Depression without Drugs
Inflammation and the metabolic syndrome are closely linked in physiology and biochemistry. Therefore, it should not come as a surprise that studies on obesity, diet and exercise habits often turn up implications for preventing and treating depression. For example, a large study of 15,093 people published in 2015 indicated that depression could be linked with nutrient deficits. The best results were found with two essentially Mediterranean-style diets. These diets overlapped in terms of foods such as omega-3 fatty acids, vegetables, fruits, legumes, nuts and moderate alcohol intake. Another finding was that there apparently is a threshold effect, meaning that a certain level of protective foods needed to be in the diet, but that benefits in terms of reduced risk of depression plateaued after this threshold was passed.⁷

It is difficult to find many nutrients that can be given as dietary supplements that cross the blood-brain barrier. Many of the nutrients that are of use are from berries. Pterostilbene, but not resveratrol, is a potent neuromodulator in aging and Alzheimer’s disease.⁸ “Blueberry, strawberry, blackberry, grape and plum juices or extracts have been successfully tested in cognitively impaired rodents. Published trials of the benefits of grape and blueberry juice in the treatment of small numbers of cognitively impaired persons have recently appeared.”⁹ Another potentially useful item in this regard is the Chinese herb known as blue dogbane, Apocynum venetum. This interesting item, virtually unknown outside of Asia, exerts proven anti-depressant effects, in part, via brain monoamine levels and the dopaminergic system. The latter, again, is influenced by pterostilbene, but not resveratrol.¹⁰ Of importance regarding the impact of Apocynum venetum on inflammation is its high content of the potent antioxidant / anti-inflammatory, isoquercitrin.¹¹

A complementary option to the foregoing nutrients is to reduce the impact of stress. Phosphatidylserine (PS) supports the brain’s physiological processing of stress and promotes neuronal communication by its effect on cell membrane fluidity. It is a natural phospholipid that is an essential component of cell membranes. PS promotes brain function by increasing neuronal membrane fluidity (cell-to-cell communication), resulting in improved cognition. Also, PS protects against stress by mitigating the actions of cortisol (catabolic stress hormone.) Human research routinely demonstrates these benefits and suggests the usefulness of a combination with DHA, e.g., “The results demonstrate that consumption of 100 mg/day of PS-DHA might be associated with improving or maintaining cognitive status in elderly subjects with memory complaints.”¹²

Finally, there is the issue of the relation between Alzheimer’s and sugar consumption. In old age, there tends to be an increasingly significant association between forms of cognitive impairment and depression. Some believe there’s a connection between sugar intake and Alzheimer’s disease. There are a number of theories as to why this might be. One argument is that increased consumption of simple carbohydrates leads to blood brain barrier degradation and subsequently to damage to the hippocampus.¹³ A related argument is that increased consumption of simple carbohydrates leads to elevations of specific advanced glycation end products (AGEs), especially the neurotoxic methyl-glyoxal derivatives (MG). High levels of AGEs also are correlated with reduced insulin sensitivity in older human adults. These factors promote chronic oxidant stress and inflammation in the brain.¹⁴

Endnotes:

1. Lavretsky H, Alstein LL, Olmstead RE, Ercoli LM, Riparetti-Brown M, Cyr NS, Irwin MR. Complementary use of tai chi chih augments escitalopram treatment of geriatric depression: a randomized controlled trial. Am J Geriatr Psychiatry. 2011 Oct;19(10):839–50.
2. Gartlehner G, Gaynes BN, Amick HR, Asher G, Morgan LC, Coker- Schwimmer E, Forneris C, Boland E, Lux LJ, Gaylord S, Bann C, Pierl CB, Lohr KN. Nonpharmacological Versus Pharmacological Treatments for Adult Patients With Major Depressive Disorder [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Dec.
3. Gartlehner G, Gaynes BN, Amick HR, Asher GN, Morgan LC, Coker- Schwimmer E, Forneris C, Boland E, Lux LJ, Gaylord S, Bann C, Pierl CB, Lohr KN. Comparative Benefits and Harms of Antidepressants, Psychological, Complementary, and Exercise Treatments for Major Depression: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016 Feb 9. [Epub ahead of print]
4. Barnum CJ, Pace TW, Hu F, Neigh GN, Tansey MG. Psychological stress in adolescent and adult mice increases neuroinflammation and attenuates the response to LPS challenge. J Neuroinflammation. 2012 Jan 16;9:9.
5. Wager-Smith K, Markou A. Depression: a repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition? Neurosci Biobehav Rev. 2011 Jan;35(3):742–64.
6. Cherniack EP. A berry thought-provoking idea: the potential role of plant polyphenols in the treatment of age-related cognitive disorders. Br J Nutr. 2012 Sep;108(5):794–800.
7. Sánchez-Villegas A, Henríquez-Sánchez P, Ruiz-Canela M, Lahortiga F, Molero P, Toledo E, Martínez-González MA. A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. BMC Med. 2015 Sep 17;13:197.
8. Chang J, Rimando A, Pallas M, Camins A, Porquet D, Reeves J, Shukitt- Hale B, Smith MA, Joseph JA, Casadesus G. Low-dose pterostilbene, but not resveratrol, is a potent neuromodulator in aging and Alzheimer’s disease. Neurobiol Aging. 2012 Sep;33(9):2062–71.
9. Cherniack EP. A berry thought-provoking idea: the potential role of plant polyphenols in the treatment of age-related cognitive disorders. Br J Nutr. 2012 Sep;108(5):794–800.
10. Zheng M, Fan Y, Shi D, Liu C. Antidepressant-like effect of flavonoids extracted from Apocynum venetum leaves on brain monoamine levels and dopaminergic system. J Ethnopharmacol. 2013 May 2;147(1):108–13.
11. Butterweck V, Nishibe S, Sasaki T, Uchida M. Antidepressant effects of apocynum venetum leaves in a forced swimming test. Biol Pharm Bull. 2001 Jul;24(7):848–51.
12. Vakhapova V, Cohen T, Richter Y, Herzog Y, Kam Y, Korczyn AD. Phosphatidylserine containing omega-3 Fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints: results from an open-label extension study. Dement Geriatr Cogn Disord. 2014;38(1–2):39–45.
13. Hsu TM, Kanoski SE. Blood-brain barrier disruption: mechanistic links between Western diet consumption and dementia. Front Aging Neurosci. 2014 May 9;6:88.
14. Cai W, Uribarri J, Zhu L, Chen X, Swamy S, Zhao Z, Grosjean F, Simonaro C, Kuchel GA, Schnaider-Beeri M, Woodward M, Striker GE, Vlassara H. Oral glycotoxins are a modifiable cause of dementia and the metabolic syndrome in mice and humans. Proc Natl Acad Sci U S A. 2014 Apr 1;111(13):4940–5.

Depression could be described as a mood, a state of being, or energy level that includes lack of motivation, a sense of hopelessness, and often a lower level of physical energy. It is an emotional state that can result from many aspects of life. In standard medicine, most doctors label it, and prescribe one or more of a wide variety of anti-depressant drugs. However, in an integrated approach to medicine, we ask why a problem is present and look at all the factors that contribute to it in order to understand its existence and get to the cause. Then, we can correct and clear those areas that may be generating the difficulty. For depression, this could involve diet and substance intake, exercise activity, our biochemical and mental states, and how we feel about all areas of our life, such as job, relationships, and family.

The first important step involves determining if your depression is short term or chronic...and if it is mild, moderate, or severe. Do some careful self-analysis: how often do you feel depressed, and how significant is your debilitation? Most people experience some level of depression occasionally; it’s just part of our natural biorhythm of emotional and mental activity. If you are depressed right now, how long has this been going on? Is it linked to a stressful external cause—for example a life event, issues at work, or problems in a relationship? Or does the depression seem to follow you most of the time, like your own personal dark cloud? A state of constant depression may suggest persistent stress or a biochemical imbalance.

There are varying degrees of depression, from mild to severe, from acute to long term. Physicians often define a condition as chronic if it has persisted more than a month or two. In the case of depression, if you have experienced an ongoing low for more than three months, it is likely a chronic condition and definitely warrants a consultation with a capable, insightful psychiatrist or therapist (or a nutritionally-oriented practitioner if you wish to be guided in a natural approach). Anti-depressant drugs are clearly one solution and have been helpful to millions.

Depression has many causes as well. Western medicine categorizes depression as endogenous, coming from within, and exogenous, coming from outside influences. Exogenous depressions come from reactions to life events and daily stresses, such as loss of a loved one, job problems, or family crises. We also may experience depression from inner conflict, or we may feel overwhelmed by our responsibilities. Many drugs can cause low to mild levels of depression; these include blood pressure medications, estrogens in birth control pills, steroids, and antianxiety drugs, like the benzodiazepines (Valium, Xanax, or Ativan). The remedy for many cases of exogenous depression often involves clearing the causative factor, or doing some counseling to better integrate these life experiences.

Endogenous depression we could call biochemical depression. It tends to run in families, as in genetic factors, and is generated by brain chemistry and imbalances of serotonin (one of the “feel good” hormones that helps us sleep) or other neurotransmitters. Most of the anti-depressant medications prescribed currently are chemicals that maintain or improve serotonin levels. Even the natural approach that utilizes diet, herbs, and amino acids is geared toward raising serotonin levels.

For problems with depression, Western medicine doctors most often prescribe from a class of drugs called the SSRIs, abbreviation for Selective Serotonin Reuptake Inhibitors (help maintain serotonin levels), or those substances like Prozac, Paxil, Zoloft, Lexapro and Effexor. These medicines slow the breakdown and clearing of this important brain chemical, thus leaving more available to brain function. This then improves the mood and motivation of its consumer. The problem is that there are many possible, often likely, side effects of these drugs rather than the “side benefits” of a natural approach. Common side effects of the SSRI drugs include weight gain, loss of sexual energy, and bouts of anger or anxiety.

A hidden problem that contributes to depression is hypothyroidism, both the classically low thyroid function that any physician can discover and “sub-clinical hypothyroidism,” which is based on body/mind symptoms and body temperature. If you are sluggish, have a slow metabolism, feel cold all the time, and experience constipation, and some depression, you may have low thyroid function. Your thyroid numbers may be okay, but you could benefit from low-dose thyroid support, as some people who are stressed and fatigued feel much better as well as with adrenal support. (See the new book, Thyroid and Mental Health by Richard Shames, MD, and his wife Karilee and daughter Georjana.)

This approach to psychiatry, which incorporates the use of nutrients to rebalance brain chemistry, is described as orthomolecular therapy. Readers can obtain referrals to trained orthomolecular psychiatrists in the U.S. and Canada by calling Orthomolecular Health Medicine in San Francisco at 415-922-6462. Many physician members of ACAM (American College for the Advancement of Medicine) and most naturopathic practitioners also have training in the treatment of depression using nutritional supplements and herbs. ACAM referrals can be obtained by following the instructions at 800.532.3688.

SELF CARE
My general philosophy suggests that behavior involves motivation and attitude, both of which affect how we care for ourselves, such as whether we make healthy food choices or create and maintain a regular exercise program. My approach in medicine, and I think the highest calling of a physician (a philosopher-physician of the ancient Chinese tradition) is to inspire and educate patients to care for themselves—to live in a way that generates health rather than have a lifestyle that causes disease. Other aspects to depression support and treatment include:

• Self-image and self-love are important conscious and unconscious motivators that affect how we treat ourselves and whether we make the effort to maintain healthy habits.
• Meditation is a tool of ultimate and major significance. Practiced in moderation, meditation can be a meaningful adjunct to any medical regimen.
• Our inner dialogue is also important to our emotional health. (See Feeling Good by Burns, a classic book about the importance of maintaining positive self-talk and the applications of Cognitive Therapy.)
• Appreciation is another key to reestablishing joy. I encourage each of us to assess and appreciate what we have. At the same time, we can acknowledge the challenges we face and do everything in our power to identify and correct the medical and lifestyle approaches that decrease our depression.
• Self-image, how we view ourselves, has a lot to do with behavior and depression. If we feel unworthy of love, particularly of self-love, we may not treat ourselves with respect, or with healthy habits. If we can feel proud of who we are, and believe that we can improve and heal, and grow, we may be more able to rise out of the “blues.” It is common for people with depression to feel withdrawn and to look down, often with a hunched over back. Sit up, look up, and embrace life!

EXERCISE
Exercise activity is one way to prevent and chase away depression. Studies show that regular exercisers feel better and have a better mood and attitude toward life than those who don’t. Cleansing toxins from the blood and the body is one positive way that could help to reduce or shift depression. In addition, there are positive effects on the brain chemicals from exercise, such as an increase in the uplifting endorphins. Work toward a balanced combination of activities that includes aerobic exercise 3–5 times per week for 30–45 minutes, weight training to improve strength and tone, and stretching to insure flexibility. I know this takes an effort, even in organizing your time in the busyness and demands of modern life. However, it is surely worth it. I realize that it may be difficult to begin, especially if you feel depressed, but once your routine is established, it will build and potentially moderate some of the depressed state naturally over the course of a week or two.

Fatigue, and sometimes anxiety and insomnia, frequently accompany depression. In these cases, it will challenge your creativity to work exercise into your life. Yoga and Tai chi, taking classes or perhaps using a video, can be helpful and require less energy. Walking continues to be one of the forms of exercise found by patients, doctors, and research to be the most beneficial.

If you are too tired to exercise: Be sure to seek the care of a health care professional. Explore some form of sitting Qigong or Tai chi, such as that used by cancer patients in China with reported benefit, or explore simple yoga postures and deep breathing.

DIET
“Foods and moods” have been written about many times, and it is clear to me that individual foods as well as various types of diets contribute to how we feel. Food nutrients and chemicals (natural food and synthetic contaminants and additives) affect brain function and neurotransmitter levels, and this leads to experiences such as depression and anxiety, fatigue or insomnia. Food reactions, allergies and hypersensitivities, also affect energy levels, moods, and mental faculties. The False Fat Diet book (by myself and Cameron Stauth) describes a broad range of mechanisms involving food reactivity, which can clearly contribute to and alter mental, physical, and emotional states. Add to this The Detox Diet, an alkaline diet that also eliminates the SNACC habits of Sugar, Nicotine, Alcohol, Caffeine, and Chemicals, and we have The Purification Process. (See next month’s article.) Remember that sugars—especially refined sugars and sweet foods as with sodas and candies— alter the glycemic index and are often associated with rapid mood changes and depression.

• Get all the appropriate nutrients from wholesome foods and supplements
• Avoid chemicals and junk foods as much as possible
• Rotate your foods and avoid your reactive foods
• Watch your sugar and refined foods intake
• Eat adequate proteins along with fresh vegetables
• Consume fresh fruits and some nuts and seeds
• Eat whole grains and legumes and some sprouts

SUPPLEMENTS
There is a wide range of vitamins, minerals, amino acids, and herbs that can help alleviate depression. Many of them support brain function and specifically serotonin levels. Others support normal hormone balance, specifically of the thyroid and adrenal glands.

• Start with the B vitamins and some minerals. The most important is pyridoxine, vitamin B6. It assists many brain and neurotransmitter functions. Vitamin B12 along with folic acid supports nerve structure and functions, while pantothenic acid and vitamin C aid the adrenal glands and energy. Choline and inositol also aid the brain. Calcium and magnesium allow relaxation and better sleep when taken at night, and iodine supports normal thyroid function. Many of my patients use trace mineral liquids to support hydration and mineral function, which keep our cells electro-dynamically active. Also, for most people we suggest a good quality multi-vitamin/mineral product that is appropriate for their gender and age.
• Amino acid support may be a valuable key to clearing or reducing depression. Adequate protein in the diet is a good beginning for obtaining needed levels of amino acids. In addition, several specific ones may be helpful when taken in higher amounts as supplements. Phenylalanine seems to improve endorphin levels and reduce pain. Tyrosine is energizing and is needed for proper thyroid function; 500–1,000 mg can be taken in the morning and after lunch. Tryptophan is the most important since it directly makes serotonin, which seems to be low in testing for most people suffering from depression. Tryptophan is available or another serotonin precursor, namely 5-HTP (5-hydroxy-tryptophan), can be obtained at health food stores. The amount to start with is 50–100 mg (up to 200 mg) taken at night, as it aids sleep, with an additional 50–100 mg in the morning. The tryptophan dosage is basically ten times the 5-HTP amount in 500–1,000 mg at bed and sometimes in the morning for depression, although both these amino acids can cause drowsiness during the day (so, for people with anxiety and depression, it often works better than for those with fatigue). These amino acids are also helpful for those suffering from Fibromyalgia (as is magnesium malate or malic acid).
• There are also several herbs that may be helpful in improving depression. St John’s wort, with hypericum as the active ingredient, has been helpful in several research studies and in clinical practice as well. It needs to be taken consistently for a month to two to see the benefits and usually three times daily of 300 mg capsules of 0.3% hypericum. Other herbs can be used to handle other symptoms that go with depression. This might include valerian and hops for insomnia, and kava kava for anxiety (GABA also helps for this). Panax ginsengs can be used for energy and Siberian ginseng utilized more for stress. For women with PMS or menopause, or for men with libido changes, different herbal combinations might be beneficial. SAM-e (S-Adenosyl Methionine) has some benefits in the treatment of depression, with decreases in depression scores. However, some people have uncomfortable physical symptoms such as diarrhea and increased anxiety.

Review
With mild to moderate depression, consider an integrated approach drawing on the experience of a naturally-oriented physician who can help you sort out your options. You may be able to get acceptable results without the use of prescription drugs. Acupuncture can be helpful, as could the use of homeopathic remedies. Massage and relaxation therapies may likewise offer improvement. Meditation can be of great value, as can regular exercise. As with so many diseases, getting involved in your own program and finding a way to make things right, and to make them work for you (becoming your own best doctor) is likely the highest art in health care. In other words, get involved in your health and feel empowered. Seek wisdom and guidance from those trained to help you make the best decisions for you. For your long-term care, develop a working partnership with your practitioner. A multi-faceted approach typically holds the greatest promise.

Genetic Links to Depression
Research suggests possible indirect genetic links to depression. A study of the effects of exercise on depression and hormone output evaluated 82 healthy male volunteers (age 18 to 26 years old), who used an exercise bicycle to achieve maximum exertion. The volunteers were tested regarding their mood using the Beck Depression Inventory, an anxiety scale, stress scale, and self-efficacy scale. Blood samples were tested to measure growth hormone, cortisol, and testosterone.

Remember—genetics is not destiny. With the right guidance and health plan, you can delay your pre-dispositions to certain diseases, from heart disease and cancer to depression. Take care of yourself; it’s worth it!