Natural Approaches

 Center-For-Health-Science-Depression Depression IS NOT necessarily “all in your head”

Depression may be caused by purely psychological issues such as grief, loss, and fear; research tells us these types of issues themselves can bring about physical problems including elevations in homocysteine, decrease in thyroid function, and a host of other problems requiring nutritional intervention. Depressive symptoms may signal underlying physical disorders or may be a common side effect of a medicine you’ve been taking.

A fact that receives too little attention is that feelings of sadness, being out of control of our lives, anxiety and fatigue  are often triggered by purely physical causes. The Merck Manual for Healthcare Professionals acknowledges this, listing possible causes including diseases, endocrine imbalances, nutritional deficiencies, pathogens and endocrine issues. Unfortunately most conventional Western physicians ignore this advice and view depressive symptoms as a “mental disorder.” They try to suppress depressive feelings though drug treatments that for the most part create emotional numbness.

No one should suffer from unremitting depressive feelings. CHS recommends you see a qualified Psychologist as your first Mental Health Professional, and consider one of our natural support formulas, which are far safer than antidepressants and antipsychotics that are promoted on TV!

What can I do?

Western Medicine

Conventional Western Allopaths broadly consider depressive symptoms to be caused by a chemical imbalance, primarily involving serotonin. Antidepressants are seen as first line treatment (in the U.S. only), with increasing supplementation with antipsychotics such as Abilify. Both classes of drugs have a long list of common and often severe harmful effects. They have not been proven to work, and are known to worsen depression in up to 8% of recipients. CHS recommends you AVOID “anti”depressants and antipsychotic drugs. Research has shown them to be ineffective for all but the most severe cases of depression, and benefits even then are lacking adequate scientific justification. If you have been taking these chemicals routinely DO NOT stop without professional guidance; they cause “withdrawal” symptoms, a buzzword for their addictive properties and must be tapered SLOWLY. Seek help from a qualified Medical Psychologist who will work with your primary physician and psychiatrist in developing a treatment plan. Email  for a referral.

Western Naturopathy

The Western Naturopathic approach calls for identifying nutritional imbalances. Natural products are used to help the body return to normal functioning, rather than trying to trick the body into not reabsorbing serotonin as it was designed to do.  Adequate diagnostic testing and close examination of physical as well as psychological symptoms is a hallmark of natural, Functional Medicine. Please see the Protocol tab above for more information. Several natural substances have been shown to help with depression. Significant research has been published supporting effectiveness;  sample of some of these studies are referenced below. The following products may help your mood symptoms.*

5-HTP Instant Dissolve Tablets by Superior Source: 5-HTP supports the production of serotonin, an important substance for healthy nerve and brain function and the normal regulation of mood and normal sleep patterns.* The 5-HTP in this small tablet is absorbed quickly by placing it under the tongue, ideal for those who do not like swallowing pills. Available in 50 mg or 75 mg dosage.

Optimized Saffron® by Life Extension: Saffron has been used for generations as a natural mood treatment. Supported by research for insomnia, depression, PMS symptoms and dementia symptoms. Safe to use concurrently with pharmaceutical antidepressants.

Lithium Orotate by American Biologics: This low dose lithium is ready utilized by the body and safely supports mood. Safe to use concurrently with pharmaceutical antidepressants.

Super Fisol® by Nature’s Way: This enteric coated, high potency source of omega  fatty acids has the benefits of fish oil without the fish taste, smell or discomfort. The outer shell dissolves in the intestine to provide superior absorption. The EPA component of omega-3s has been found to be effective at depressive symptoms. Safe to use concurrently with pharmaceutical antidepressants.*

Traditional Chinese Medicine

Traditional Chinese Medicine approaches mental or emotional problems such as depression as an imbalance or blockage in one or more of the internal organs (Zang/Fu) and the energy pathways (meridians) that pertain to them. Some common patterns that can manifest as depression are Liver Chi Stagnation, Spleen Chi Deficiency, Kidney Essence Deficiency or Lung and Heart Meridian disorder. The appropriate remedies are chosen by the TCM practitioner based on patterns of symptoms.

Xiao Yao San by Evergreen Herbs: This is a traditional formula for treating mood symptoms. It does not contain St. John’s Wort and is safe to use on its own or in combination with other herbal products including Shine® or pharmaceutical antidepressants.*

Shine® by Evergreen Herbs: This Modern Chinese Formula is based on TCM principles and also contains St. John’s Wort, shown to improve mood, decrease anxiety and somatic symptoms, and decrease insomnia related to mild to severe major depression. This product should not be used concurrently with pharmaceutical antidepressants.*

Research

Lithium: Lithium has been shown to be effective for management of bipolar mania and depression (9) and is considered first line treatment by the APA (5). “Lithium alone or in combination with an atypical antipsychotic may reduce aggressive behaviors in children and adolescents with CD.” (10) The exact mechanism of action of lithium in psychological and behavioral disorders in humans is “unknown,” however it appears to affect dopamine and serotonin activity. Lithium might increase monoamine oxidase (MAO) activity. It also enhances folate and vitamin B12 transport into brain cells, which might affect mood (11). Reliable evidence demonstrates that a low level of lithium— trace levels found in many water supplies— is effective at reducing suicide rates (7) (12) (13) (14) (15) (16). Low dose lithium has been found to reduce rates of aggression in both humans and animals (7) (17). Lithium appears to work partially by inducing elevations in brain and erythrocyte glycine levels (18).

Although low dose lithium has not been promoted as useful in humans, veterinary science has embraced it for management of healthy animals; lithium is added to commercial pig, chicken and other feed. Low dose lithium has been found helpful for mild cognitive impairment and Alzheimer’s disease (19) (20) (21) (22). Lithium has been used for mania and depression since 1871 (23). It was used as a salt substitute in the 1940’s, although this was abandoned with emergence of dose dependent toxic effects. Lithium carbonate was listed as a controlled substance in 1970.

SAMe: S-Adenosyl methionine is produced naturally in the body and is made from adenosine triphosphate (ATP) and methionine. Several clinical studies show that taking SAMe is more effective than placebo and appears to be as effective as tricyclic antidepressants in trials lasting up to 42 days (26) (27) (28) (29). Rather than harming your liver, SAMe has been shown to combat liver disease as well as arthritis (30). Practice guidelines from the American Psychiatric Association suggest SAMe as a potential alternative to conventional antidepressants for patients with major depression who are interested in using alternative therapies (31).

St. John’s Wort: St. John’s Wort is a yellow-flowering perennial herb indigenous to Europe. It has been extensively studied and is commonly prescribed by psychiatrists in several countries The Cochrane Collaboration has found, “The available evidence suggests that the Hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; and c) have fewer side-effects than standard antidepressants.” (32) St. John’s wort extracts are more effective than placebo for depression (33) (34) (35). Taking St. John’s wort extracts has been shown to improve mood, decrease anxiety and somatic symptoms, and decrease insomnia related to mild to severe major depression (36).

5-HTP: 5-Hydroxytryptophan (5-HTP) is a naturally occurring amino acid and precursor to serotonin and melatonin. It is used for sleep disorders, depression, anxiety, migraine and tension-type headaches, fibromyalgia, binge eating associated with obesity, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), attention deficit-hyperactive disorder (ADHD), cerebellar ataxia, Ramsey-Hunt syndrome, Down syndrome, insomnia, and as adjunctive therapy in seizure disorder and Parkinson’s disease.

5-HTP readily crosses the blood-brain barrier and increases central nervous system synthesis of serotonin (37). There is good evidence for use for depression (37) (38) including treatment resistant depression (39). Taking 5-HTP orally appears to improve symptoms of primary fibromyalgia syndrome (PFS), including pain severity, morning stiffness, and sleeplessness (40) (41) (42). Preliminary evidence supports the use of 5-HTP for anxiety disorders (43) and cerebellar ataxia (44). Preliminary evidence suggests that taking 5-HTP orally might help reduce appetite, caloric intake, and weight in obese patients (45).

Omega-3 Fatty Acids: Three types of omega-3 fatty acids involved in human physiology are ALA (found in plant oils), EPA, and DHA (both commonly found in marine oils). Common sources of animal omega-3 EPA and DHA fatty acids include fish oils and krill oil. Significant research shows that fish oil can reduce triglyceride levels by 20% to 50% (46). The prescription form, Lovanza, is FDA approved for treating hypertriglyceridemia (47).

The EPA component of omega-3s has been found to be effective at depressive symptoms (48) (49) (50). Some clinical research shows that taking a fish oil supplement orally might reduce the risk of progression from sub-threshold psychosis to full-blown psychotic disorders (51). Taking EPA orally provides modest improvement in aggressive behavior and depression in women with moderately severe borderline personality disorder (52). EPA modestly improves the mental state in patients with schizophrenia compared to placebo (53).

EPA 500 mg orally, three times daily, provides modest, but significant reduction in the frequency of hot flashes compared to placebo (54). Limited evidence supports fish oil use for prevention of restenosis following angioplasy (55). Cochrane found benefit for asthma in children (56). Omega 3’s help with atherosclerosis (57), diabetic neuropathy (58), dysmenorrhea (59), hypertension (60), and rheumatoid arthritis stiffness (61).

Saffron: Saffron is derived from the flower of Crocus sativus, a native of Greece or Southwest Asia. Saffron is used for insomnia, depression, Alzheimer’s disease, fright, shock, asthma, cough, pertussis, and as an expectorant. Women use saffron for menstrual cramps and premenstrual syndrome (PMS). Men use it to prevent (premature ejaculation. Saffron is also used as an aphrodisiac and to induce sweating.

Clinical research shows that taking saffron orally seems to improve symptoms of major depression after 6 weeks of treatment (62) (63). It has shown similar efficacy to fluoxetine 10 mg twice daily in patients with mild-to-moderate depression after 6 weeks of treatment (64) (65).

Some clinical research shows that patients 55 years and older with dementia and probable Alzheimer’s disease treated with saffron orally have comparable cognitive and clinical outcomes to patients receiving conventional therapy with donepezil (Aricept®) 10 mg/day orally after 22 weeks of treatment (66). Saffron significantly improves symptoms of PMS after two menstrual cycles (67).

DHEA: DHEA is endogenously produced in the adrenal glands and in the liver. In men, DHEA is also secreted by the testes. Additionally, the neurons and glial cells in the brain synthesize minute quantities. DHEA and its sulfate ester, dehydroepiandrosterone sulfate (DHEA-S), are interconvertible. DHEA-S is the storage form of DHEA.

Taking DHEA orally might improve symptoms of depression and dysthymia (68) (69) (70). “DHEA treatment may have significant antidepressant effects in some patients with major depression.” (71) “We find DHEA to be an effective treatment for midlife-onset major and minor depression.” (72) “DHEA was superior in the intent-to-treat analysis, where the response rate was 56% (43 of 77) for the DHEA group versus 31% (21 of 68) for the placebo group.” (73)

Taking DHEA orally seems to improve both negative and positive symptoms in patients with schizophrenia (74) (75).  Limited evidence indicates DHEA may be effective for erectile dysfunction, lupus (SLE), Addison’s, Chronic fatigue Syndrome and aging skin.

*Statements contained herein have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat and cure or prevent disease. Information provided by CHS is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Any information given is only intended as a sharing of knowledge and information from scientific world literature. You are encouraged to make your own health care decisions based upon your own research of the subject and in partnership with a qualified health care professional.

Protocol

The Western Naturopathic approach to depression calls for adequate diagnostic testing and close examination of physical as well as psychological symptoms. Treatment of underlying physical issues is critical; correcting nutritional deficiencies, supporting key body systems and eliminating pathogens and environmental toxins is accomplished using phytonutrients, vitamins, minerals and amino acids. Emotional issues are also explored through psychotherapy and other alternatives. Several natural substances have been found to help with depressive symptoms, particularly SAMe, St. john’s Wort and serotonin precursors such as 5-HTP.

Traditional Chinese Medicine approaches mental or emotional problems such as depression as an imbalance or blockage in one or more of the internal organs (Zang/Fu) and the energy pathways (meridians) that pertain to them. Some common patterns that can manifest as depression are Liver Chi Stagnation, Spleen Chi Deficiency, Kidney Essence Deficiency or Lung and Heart Meridian disorder. The appropriate remedies are chosen by the TCM practitioner based on patterns of symptoms.

 

The CHS Depression Protocol

CHS recommends 3 steps in your approach to feelings of sadness and depression:

1. IDENTIFY: A written, well organized summary of your symptoms and health history is an important first step in reaching and attaining optimal health. This formal approach is especially important with mood issues, which very often are linked to other health problems. Be sure to bring a copy of your health history when you visit your Healthcare Professional.

2. TEST: Specific tests should be ordered to help find physical causes. Depression is very often the result of a low functioning thyroid, but may also be a signal of problems with adrenal, pituitary or parathyroid glands, deficiencies of vitamins B12 and folate, iron, copper, B6, riboflavin, vitamin E, and vitamin C, infections such as Lyme disease, cardiovascular disorders, autoimmune disorders such as Lupus and polymyositis and liver, kidney and blood sugar issues. You may need to be very directive (“pushy”) to get the correct tests. Alternately, you can purchase labs through our affiliate, MDLabTests.com. MDLabTests.com offers a convenient, confidential, reliable and affordable way for consumers to take control of their health care costs and provide them complete access to their health information.

Click the banner to visit their site:

Recommended tests for depressive symptoms: (Clicking the links below will take you to the MDLabTests.com website if you wish to order)

CBC (Complete Blood Count)

CMP (Comprehensive Metabolic Panel)

Thyroid Labs:

TSH (Thyroid Stimulating Hormone)

Free T3

Reverse T3

C-reactive Protein (CRP)

Cortisol

Homocysteine

Methylmalonic acid

Antinuclear antibody (ANA)

3. Act on your symptoms! Ask to be referred or seek out a competent Psychologist. Psychologists are trained to LISTEN.  Psychiatrists are trained to PRESCRIBE. Select a natural Product that addresses your beliefs, physical issues and symptoms. See the Natural Approaches, above.

Conventional medicine does not have all the answers about depression. Doctors of Orthomolecular Medicine, Oriental Medicine, Ayurveda, Herbalists and other healthcare experts have successfully used natural depression treatments based on science and often based on hundreds to thousands of years of experience. Recent research is finding increasing value on these “alternative” natural depression treatments, and many are starting to be used by conventional physicians. Please click on the “Options in Depression Treatment” tab above to learn the facts.

Unsure what to order? Dr. Reinhardt is a Board Certified Medical Psychologist and Functional Medicine Specialist. If you, or your Physician, Psychologist, Psychiatrist or other Healthcare Professional would like to discuss treatment options please call us at 714-886-9026, or email us at . Please be sure to leave your phone number and we will contact you.


Can drugs help?

AVOID “anti”depressants and antipsychotic drugs. Recent research has largely discredited these harmful chemicals for use in all but the most severe cases of depression, and benefits even then are lacking adequate scientific justification. All have “depression worsening” and many physical harms as a known adverse effects. If you have been taking these chemicals routinely DO NOT stop without professional guidance. Seek help from a qualified Medical Psychologist who will work with your primary physician and psychiatrist in developing a treatment plan. Email  for a referral.

Statements contained herein have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat and cure or prevent disease. Information provided by CHS is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Any information given is only intended as a sharing of knowledge and information from scientific world literature. You are encouraged to make your own health care decisions based upon your own research of the subject and in partnership with a qualified health care professional.

Symptoms Checklist

Symptom Checklist

Name: _________________________________   Date: ___________________

Print out, complete, take to your healthcare professional

Click Here for Printer Friendly Version

Frequency: 1- occasionally, 2- nearly every day, 3 most of the day, nearly every day

Severity- 1- mild 2- disrupts normal activities 3- Debilitating

How long:  1- one or 2 weeks 2- one to 3 months 3- One or more years

Symptom Frequency (1-3) Severity (1-3) How Long (1-3)
Cognitive:
Fatigue
Anxiety, Fearfulness, Irritability
Sleeping Difficulty
Sleeping Excess
Brain Fog, Slowed Thinking
Anger, Aggressive Behavior
Behavior or Personality Changes
Mood Swings, Lability
Apathy, Reduced Interests
Hallucinations, Delusions
Frequent Sadness, Crying
Easily Distracted
Memory Loss
Changes in Appetite
Unplanned Weight Changes
Confusion
Immune Process:
Asthma, Cough, Breathing Trouble
Frequent Yeast Infections
Allergies
Frequent Flu Symptoms
Immunity Depressed, Frequent Illness
Heart, Blood, Circulation:
Blood Pressure High/Low
High Cholesterol
Heart Palpitation, Rhythm Abnormality
Nervous System:
Carpal Tunnell Syndrome
Restless Leg Syndrome
Numbness or Tingling Extremities
Difficulty Walking, Poor Balance
Spasm, Muscle Tics, Trembling
Senses:
Dizziness
Vision Changes, Blurred Vision
Light Sensitivity
Tinnitus, Ringing, Ear Sounds
Cold Sensitivity, Cold Extremities
Excessive Sweating, Night Sweats
GI System:
Abdominal Pain
Abdominal Swelling
Colic
Frequent Constipation or Diarrhea
Excessive Thirst
Indigestion, Heartburn, Gas
Weight Gain
Nausea
Weight Loss or Poor Appetite
Ulcers
Frequent or Decreased Urination
Reproductive System:
Absence of Menstruation
Irregular Periods
Breast Pain, Tenderness
Infertility
Painful Intercourse, Dryness
Hot Flashes
Loss of Libido
Erectile Dysfunction
Pain:
Migraines, Headaches
Bone, Back or Leg Pain (skeletal)
Joint Pain
Muscle Pain
Achiness
Muscle Cramps
Muscle Weakness
Skin, Hair, Nails:
Mouth Ulcers, Canker Sores
Sores in Corners of Mouth
Dry, Brittle Hair
Hair Loss
Dry or Itchy Skin
Tender or Bleeding Gums
Acne
Eczema
Pale Skin
Skin Rash
Edema, Swelling
Please List Any Additional Symptoms:
Diagnoses received in past 2 years (include chronic conditions): 
List all medications used in last 2 years
List dosage size (mg), frequency, how long taken (months)
How did the medication affect you? (good and bad)
List all supplements used in last 2 years
List dosage size (mg), frequency, how long taken (months)
How did the supplements affect you? (good and bad)
Family: List illnesses experienced by family members in last 2 years, or if deceased, in last 2 years of life

Natural ADHD Treatment Offers Many Advantages

While they offer a wide variety of herbal supplements to meet the needs of a variety of individuals, many people consider the natural ADHD treatment from Center of Health Science (CHS) a great alternative ADHD treatment. If you or a family member has symptoms of ADHD such as a lack of ability to focus, inattention, lack of concentration, forgetfulness, fidgeting, hyperactivity or are impulsive, or if there has already been a diagnosis of ADHD, CHS can help by providing natural ADHD remedies that are proven effective but which don’t have the serious side effects caused by drugs. There are many things that can cause or worsen ADHD symptoms including allergies and food intolerances, reactions to certain chemical adulterants in food, and from bacterial, viral and parasitic infections and other physical problems. Read more about how a natural ADHD treatment from CHS can help alleviate your problems with ADHD.

As many as 20% of children and adults may be diagnosed with ADHD but few of those receive a proper medical “work-up” to rule out any of the physical causes listed here. Natural ADHD treatments are available to help you manage the ADHD symptoms and for treating underlying causes. These treatments offer much of the same level of symptom relief as drugs but are non-addicting and do not have the dangerous side effects of pharmaceuticals. CHS offers the best natural ADHD medication that comes from Western Naturopathics, Traditional Chinese and Ayurvedic Medicine.

Before making the decision to try a natural ADD treatment for symptoms that you think might mean you have ADHD, have a complete physical and the specific tests needed to identify causes. CHS offers medical lab tests to explore the causes of your ADHD symptoms in addition to the natural ADHD supplements that have been scientifically proven to improve these symptoms and treat their underlying causes.

One of the things that CHS has learned from research is that there is a strong correlation between ADHD symptoms and hypersensitivities. That means you should check labels and eliminate all artificial ingredients including preservatives, colorings, conditions, enhancers and processed foods from your diet. Consider a rotation diet to eliminate foods individually so you can determine which ones you are sensitive to.

CHS offers the best natural ADHD treatment options to help you increase concentration and reduce distractibility. Their CHS Wellness Package contains key ingredients needed to maintain good health, including critical B vitamins, Vitamin D, Magnesium, Calcium, Zinc and Omega 3 fatty acids. They also offer ADHD Support by Herbal Extracts Plus which is a Western Herbal formula that has been shown to improve mental clarity, relieve minor anxiety, help with sleep and improve concentration. This product works as a natural ADHD treatment for adults and children alike.

Other natural ADHD treatment options from CHS include their MindCare Jr. by Himalaya and Calm by Evergreen as well as Enhance Memory by Evergreen. Go to www.bobteachesart.com to learn more about their natural ADHD remedies and which ones have been shown to be most effective for which symptoms. You do have another choice besides harmful drugs when you or a loved one is diagnosed or experiencing symptoms of ADHD. A naturalADHD treatment can provide you with the right solutions without the dangerous side effects.

Options in Depression Treatment

Options in Depression Treatment

By David Reinhardt, Ph.D. MSP.Pharm, ABMP

Several meta-analyses indicate pharmaceutical depression drugs work no better than a jelly bean (1) (2) (3). They all have harmful effects and even cause or worsen depression in 4% (admitted in company provided prescribing information) to 8% (European experience, according to the EMA).

A recent study by Read, Cartwright and Gibson found, “Eight of the 20 adverse effects studied were reported by over half the participants; most frequently Sexual Difficulties (62%) and Feeling Emotionally Numb (60%). Percentages for other effects included: Feeling Not Like Myself – 52%, Reduction In Positive Feelings – 42%, Caring Less About Others – 39%, Suicidality – 39% and Withdrawal Effects – 55%. Total Adverse Effect scores were related to younger age, lower education and income, and type of antidepressant, but not to level of depression prior to taking antidepressants. The adverse effects of antidepressants may be more frequent than previously reported, and include emotional and interpersonal effects.” (4)

Despite the obvious failure of these chemicals, they continue to be prescribed in massive numbers, either by well-meaning but poorly informed physicians or by those who believe the benefit of the placebo effect outweighs the negatives.

Do “natural” alternatives offer better help, with fewer negative effects? According to a new study by Rakofsky and Dunlop, no. “The findings of this review do not support the routine use of nutritional supplements in the treatment or prophylaxis of BD depression.” (5)  This report presents a rather limited view of natural treatments for depression. The authors limited their data search to “bipolar depression”, eliminating any studies on mania, major depressive disorder, or dysthymia. This is a curious choice, given that antidepressants have a poor record when used with bipolar disorder, with even the American Psychiatric Association recommending antidepressants only as a last resort in severe depressive episodes (5) (6).

The study authors did admit that “Despite the inadequacy of the existing data, clinicians should remain open to the value of nutritional supplements: after all, lithium is a mineral too.” This is an interesting concession. Lithium as been shown to be effective and absolutely safe at trace levels in the few studies that have found their way to funding and publication (7).

Don’t expect many clinical trials. Nature has provided the pharmaceutical industry with the raw materials to develop the majority of their products. Many natural substances have a long history of use for depression, with records of hundreds and even thousands of years of safe and effective use. This history is largely ignored by allopathic physicians, with some justification, in favor of chemicals derived from nature that have been shown to be “not inferior” (FDA requirement). Large clinical trials are expensive and hard to design. How do you test a depression treatment without doing psychotherapy as even the “placebo” condition, when the very act of diagnosing requires all of the feature of talk therapy?

Clinical trials are expensive, and are funded by those who hope to profit from them. Natural substances cannot be patented (although the chemical industry occasionally finds ways such as with Lovaza®, a slightly altered form of fish oil that is actually less effective than OTC fish oil, yet prescribed at a typical price of $236.87 per month) (8).

Do alternatives work? With all of this noise, what is the best approach to using substances to treat psychological conditions? Several natural substances have been shown to help depressive symptoms. It is likely that at least some of this benefit comes from correcting underlying nutritional deficiencies. Many of these substances may owe effectiveness to their powerfully antibacterial, antiviral and antiparasitic qualities. Readers know of my functional medicine emphasis on treating the underlying conditions which may have sadness and ennui as symptoms. Finally, many of these substances may work by their offering of hope— as a placebo.

Ultimately, prescribers need to weigh the costs and benefits of choosing a treatment. In the case of pharmaceuticals, the costs can be quite high—in terms of monetary costs for the drug and the follow up psychiatry visits, in terms of the expected negative effects (such as nearly 100% rate of sexual effects), and even risk of permanent disability or death (including brain stem strokes from induced hyponatremia ). According to the preponderance of evidence, benefit is limited to placebo effect and stockholder benefit.

Natural substances must also be examined on a cost benefit basis. Costs include product cost (lithium aspartate costs about $2.15 per month, the cheapest fish oil about $5.40 per month) and risk of adverse effects, in most cases practically nonexistent. Benefit may be real, or at worst, placebo.

What may help?

Lithium: Lithium has been shown to be effective for management of bipolar mania and depression (9) and is considered first line treatment by the APA (5). “Lithium alone or in combination with an atypical antipsychotic may reduce aggressive behaviors in children and adolescents with CD.” (10) The exact mechanism of action of lithium in psychological and behavioral disorders in humans is “unknown,” however it appears to affect dopamine and serotonin activity. Lithium might increase monoamine oxidase (MAO) activity. It also enhances folate and vitamin B12 transport into brain cells, which might affect mood (11). Reliable evidence demonstrates that a low level of lithium— trace levels found in many water supplies— is effective at reducing suicide rates (7) (12) (13) (14) (15) (16). Low dose lithium has been found to reduce rates of aggression in both humans and animals (7) (17). Lithium appears to work partially by inducing elevations in brain and erythrocyte glycine levels (18).

Although low dose lithium has not been promoted as useful in humans, veterinary science has embraced it for management of healthy animals; lithium is added to commercial pig, chicken and other feed.

Low dose lithium has been found helpful for mild cognitive impairment and Alzheimer’s disease (19) (20) (21) (22).

Lithium has been used for mania and depression since 1871 (23). It was used as a salt substitute in the 1940’s, although this was abandoned with emergence of dose dependent toxic effects. Lithium carbonate was listed as a controlled substance in 1970.

Lithium orotate and lithium aspartate are available over-the-counter and low, very safe doses, costing about $1.50 per month.

SAMe: S-Adenosyl methionine is produced naturally in the body and is made from adenosine triphosphate (ATP) and methionine. Several clinical studies show that taking SAMe is more effective than placebo and appears to be as effective as tricyclic antidepressants in trials lasting up to 42 days (26) (27) (28) (29). Rather than harming your liver, SAMe has been shown to combat liver disease as well as arthritis (30). Practice guidelines from the American Psychiatric Association suggest SAMe as a potential alternative to conventional antidepressants for patients with major depression who are interested in using alternative therapies (31).

Typical dosage of SAMe is 200-400 mg bid. It is available over the counter for about $30.22 per month.

St. John’s Wort: St. John’s Wort is a yellow-flowering perennial herb indigenous to Europe. It has been extensively studied and is commonly prescribed by psychiatrists in several countries The Cochrane Collaboration has found, “The available evidence suggests that the Hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; and c) have fewer side-effects than standard antidepressants.” (32) St. John’s wort extracts are more effective than placebo for depression (33) (34) (35). Taking St. John’s wort extracts has been shown to improve mood, decrease anxiety and somatic symptoms, and decrease insomnia related to mild to severe major depression (36).

Typical dosage of St. John’s Wort is 450 mg, available over the counter and costing about $1.50 per month.

5-HTP: 5-Hydroxytryptophan (5-HTP) is a naturally occurring amino acid and precursor to serotonin and melatonin. It is used for sleep disorders, depression, anxiety, migraine and tension-type headaches, fibromyalgia, binge eating associated with obesity, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), attention deficit-hyperactive disorder (ADHD), cerebellar ataxia, Ramsey-Hunt syndrome, Down syndrome, insomnia, and as adjunctive therapy in seizure disorder and Parkinson’s disease.

5-HTP readily crosses the blood-brain barrier and increases central nervous system synthesis of serotonin (37). There is good evidence for use for depression (37) (38) including treatment resistant depression (39). Taking 5-HTP orally appears to improve symptoms of primary fibromyalgia syndrome (PFS), including pain severity, morning stiffness, and sleeplessness (40) (41) (42). Preliminary evidence supports the use of 5-HTP for anxiety disorders (43) and cerebellar ataxia (44). Preliminary evidence suggests that taking 5-HTP orally might help reduce appetite, caloric intake, and weight in obese patients (45).

The typical dose of 5-HTP for depression is 150-300 mg/day. It is sold over the counter and costs about $8.00 per month.

Omega-3 Fatty Acids: Three types of omega-3 fatty acids involved in human physiology are ALA (found in plant oils), EPA, and DHA (both commonly found in marine oils). Common sources of animal omega-3 EPA and DHA fatty acids include fish oils and krill oil. Significant research shows that fish oil can reduce triglyceride levels by 20% to 50% (46). The prescription form, Lovanza, is FDA approved for treating hypertriglyceridemia (47).

The EPA component of omega-3s has been found to be effective at depressive symptoms (48) (49) (50). Some clinical research shows that taking a fish oil supplement orally might reduce the risk of progression from sub-threshold psychosis to full-blown psychotic disorders (51). Taking EPA orally provides modest improvement in aggressive behavior and depression in women with moderately severe borderline personality disorder (52). EPA modestly improves the mental state in patients with schizophrenia compared to placebo (53).

EPA 500 mg orally, three times daily, provides modest, but significant reduction in the frequency of hot flashes compared to placebo (54). Limited evidence supports fish oil use for prevention of restenosis following angioplasy (55). Cochrane found benefit for asthma in children (56). Omega 3’s help with atherosclerosis (57), diabetic neuropathy (58), dysmenorrhea (59), hypertension (60), and rheumatoid arthritis stiffness (61).

The prescription form of fish oil, Lovanza, costs $236.87 per month, although an equally effective, identical dose is available over the counter for as little as $11.15 per month.

Saffron: Saffron is derived from the flower of Crocus sativus, a native of Greece or Southwest Asia. Saffron is used for insomnia, depression, Alzheimer’s disease, fright, shock, asthma, cough, pertussis, and as an expectorant. Women use saffron for menstrual cramps and premenstrual syndrome (PMS). Men use it to prevent premature ejaculation. Saffron is also used as an aphrodisiac and to induce sweating.

Clinical research shows that taking saffron orally seems to improve symptoms of major depression after 6 weeks of treatment (62) (63). It has shown similar efficacy to fluoxetine 10 mg twice daily in patients with mild-to-moderate depression after 6 weeks of treatment (64) (65).

Some clinical research shows that patients 55 years and older with dementia and probable Alzheimer’s disease treated with saffron orally have comparable cognitive and clinical outcomes to patients receiving conventional therapy with donepezil (Aricept®) 10 mg/day orally after 22 weeks of treatment (66). Saffron significantly improves symptoms of PMS after two menstrual cycles (67).

Saffron is available over the counter and costs about $27.00 per month.

DHEA: DHEA is endogenously produced in the adrenal glands and in the liver. In men, DHEA is also secreted by the testes. Additionally, the neurons and glial cells in the brain synthesize minute quantities. DHEA and its sulfate ester, dehydroepiandrosterone sulfate (DHEA-S), are interconvertible. DHEA-S is the storage form of DHEA.

Taking DHEA orally might improve symptoms of depression and dysthymia (68) (69) (70). “DHEA treatment may have significant antidepressant effects in some patients with major depression.” (71) “We find DHEA to be an effective treatment for midlife-onset major and minor depression.” (72) “DHEA was superior in the intent-to-treat analysis, where the response rate was 56% (43 of 77) for the DHEA group versus 31% (21 of 68) for the placebo group.” (73)

Taking DHEA orally seems to improve both negative and positive symptoms in patients with schizophrenia (74) (75).

Limited evidence indicates DHEA may be effective for erectile dysfunction, lupus (SLE), Addison’s, Chronic fatigue Syndrome and aging skin.

DHEA is available over the counter. Dosage should be under the direction of a healthcare professional. A typical 25 mg per day dose costs about $2.15 per month.

Other substances that need more research

Preliminary evidence suggests several other natural substances offer benefit for depression. Studies are needed to understand if these benefits are due to a direct action on mood or if they are effective because they mitigate nutritional issues. The following substances have preliminary evidence of effectiveness:

Rhodiola (76)

Inositol (77)

Acetyl-L-carnitine (78) (79)

Chromium (80)

L-tryptophan (81)

L-phenylalanine (82)

Phosphatidylserine (83)

Vitamin C (84)

Other Healing Systems

The above discussion examined potentially antidepressant natural substances for a Western Science perspective, as used in Allopathic Medicine and in Western Herbology. Ayurveda and traditional Chinese medicine recognize the symptoms of depression but do not label it as a specific disease for which we must search for a magic pill or elixir.

Ayurveda is an alternative healing system developed over thousands of years and practiced primarily on the Indian subcontinent. From an Ayurvedic perspective, we are at our core healthy, whole, and happy by nature. We should engage in habits and practices that support the emergence of the essential nature and that bring balance to mind, body, and spirit. Ayurvedic medicine may prescribe yoga, breathing, and lifestyle techniques, in addition to using herbal remedies to address imbalance.

Symptoms of depression and anxiety are triggered by excessive mental and physical stress, or disruptions of natural biological rhythms. According to Ayurveda, psychological problems start when fundamental imbalances develop in the biological intelligence that controls all bodily processes. Depression and anxiety can be influenced by many factors, such as diet, digestion, toxin accumulation, stress, exercise levels and daily routine, Ayurveda treatments attempt to balance many physiological functions simultaneously. Ayurvedic formulas for depressive symptoms include 2 substances with limited human research of effectiveness (although several rat studies have been published):

Bacopa monnieri (Brahmi): Brahmi has been shown in many rat studies and a limited number of human studies to help with symptoms of depression (85) (86) (87).

Brahmi has been shown effective for measures of verbal learning, memory, and information processing in healthy men and women (88). It is used for the symptoms of ADHD (89).

Brahmi is available over the counter and costs about $3.12 per month.

Ashwagandha: Ashwagandha is used a part of treatment for arthritis, anxiety, insomnia, tumors, tuberculosis, and chronic liver disease. Ashwagandha is also used as an “adaptogen” to increase resistance to environmental stress. It is also used for improving cognitive function, decreasing inflammation, preventing the effects of aging, for menstrual disorders, fibromyalgia, and asthma. Studies have shown benefit for treating depression, particularly in the elderly (90) (91)

Ashwagandha is available over the counter and costs about $5.25 per month.

Traditional Chinese Medicine (TCM) is a broad range of medicine practices developed over more than 2000 years. TCM’s view of the body places little emphasis on anatomical structures, but is mainly concerned with the identification of functional entities (which regulate digestion, breathing, aging etc.). While health is perceived as harmonious interaction of these entities and the outside world, disease is interpreted as a disharmony in interaction. TCM diagnosis aims to trace symptoms to patterns of an underlying disharmony, by measuring the pulse, inspecting the tongue, skin, and eyes, and looking at the eating and sleeping habits of the person as well as many other things. Plant elements are by far the most commonly, but not solely, used substances; animal, human, and mineral products are also utilized. Complex formulas are tailored to the individual in treatment. Depression, according to TCM, is a disease caused by prolonged stagnation of qi, blood, dampness, or food. The treatment protocol is to break up all stagnation and moisten the internal organs.

Xiao Yao San: Xiao Yao San is a typical TCM depression formula with moderate evidence of effectiveness (92) (93). Xiao Yao San is made up of Bupleurum root (Bupleuri Radix), Chinese peony root (Paeoniae Radix), Chinese Angelica root (Angelicae Radix), White Atractylodes rhizome (Atractylodis Rhizoma), Tuckahoe mushroom (Poria), fresh ginger rhizome (Zingiberis Rhizoma), Chinese licorice root (Glycyrrhizae Radix), and wild mint herb (Menthae Herba). This formula in contraindicated during pregnancy and nursing. It does not contain St. John’s Wort and may be used concurrently with antidepressants or Shine®.

Xiao Yao San is available over the counter and is available from CHS for $20.00 for 100 capsules, a 1 month supply.

Evergreen Shine®: Evergreen makes high quality, modern Chinese formulas based on traditional prinicples and updated using Western standards of research. This formula contains St. John’s Wort, called Guan Ye Lian Qiao in TCM, which has been shown to be effective for depression (see references for St. John’s Wort, above). St. John’s Wort has similar action to Western antidepressants, and inhibits reuptake of serotonin. Because of this Guan Ye Lian Qiao should not be taken concurrently with antidepressant pharmaceuticals. This herb is used in Chinese medicine to clear heat, treat urinary tract and other infections and reduce inflammation. Evergreen Shine® is available from CHS for about $26.00 fper month

Depressive symptoms respond to natural treatments at least as well as pharmaceuticals, and in many cases better. Few if any adverse effects can be expected. They have the advantage of low cost, and freedom from seeing a psychiatrist monthly for monitoring.

Certain facts that are undeniable:

-None of these natural approaches increases depression by 8% (European antidepressant studies) or 4% (American studies, with us being “exceptional,” of course!)

-None of these natural approaches decreases libido

-None of these natural approaches cause serotonin syndrome, Stevens Johnson syndrome or other life threatening effects

-None of these natural approaches require the patient to see a psychiatrist once each month!

-None of these approaches cost $250-800 per month to try.

Although herbal approaches are much safer to try than highly concentrated pharmaceuticals, selection and use should be guided by a healthcare professional that is knowledgeable about interactions and contraindications.

About the author:

Dr. Reinhardt is a Medical Psychologist and head of the Center for Health Science in Long Beach, California. He is on the executive board and a founding member of NAPPP, the National Alliance of Professional Psychology Providers and a Fellow of the Academy of Medical Psychology. Dr. Reinhardt’s special training and passion is in uncovering the roots of poor mental and physical health and finding natural treatments that are both safe and effective. His education includes degrees in Clinical Psychology, Psychopharmacology, Holistic Health, Western Herbology and Engineering. For read more of his work visit his website and blog at CenterforHealthScience.com

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