As the season shifts further from sunshine and summer to cool temperatures and dampness, many West Coast residents notice a shift in their moods. Seasonal Affected Disorder (SAD) can be one of the main reasons for this and thanks to more attention and discussion of SAD, prevention with Vitamin D supplementation and natural light lamps has become common practice. When non-SAD associated depression is diagnosed, working with a trained therapist can be very beneficial to help bring light to events or lifestyles that contribute to depressive tendencies. In addition, looking inward at other biomedical contributing factors of depression often leads to findings of nutrient deficiencies and hormone and neurotransmitter imbalances.
When asked to help a patient determine the root cause of depression, I bring out my checklist of nutrient levels to assess that could be low and therefore cause a low mood. Vitamin D, Vitamin B12 and iron are simple to test by blood and are relatively simple to treat when deficient. The goal is to bring blood measures to an optimal level which is different than assessing if nutrient levels are in the reference range. For example, the reference range for serum B12 is 150- 650 units and patients are quite commonly told by their family doctor that they are at healthy levels in the 200 unit range. In practice, most people feel their best when at serum B12 levels of above 600 – 800 units.
Hormone imbalances such as undiagnosed or subclinical hypothyroidism and low testosterone, estrogen or progesterone can also be the root cause of depression. When our stress hormone cortisol is too low there is an association to feeling down and depressed. Clues about the balance of hormones can be assessed based on discussion of symptoms related to menstrual cycles, body changes such as hair loss, weight gain, body temperature (eg always cold or always hot), sleep patterns and stress. Diagnostic testing can confirm hormone levels either by blood, saliva or urine. As a naturopathic physician, I have the knowledge and scope of practice to address hormone imbalances by many different approaches – herbs, diet and nutrition, acupuncture, supplementation and bio-identical hormone replacement therapies.
Another part of my check-list to determining the root cause of depression involves neurotransmitter levels. Neurotransmitters (NTs) are the chemical messengers that allow for communication between brain cells. The two most common NTs that can factor into depression are serotonin and dopamine. Although questionnaires are available to help give clues about levels, testing is preferred. The Organic Acid Test (OAT) is an excellent assessment of both NT levels and nutrient levels as well as other important biological markers.
The best chance of recovering from depression comes when looking at all aspects of health and wellness. Lifestyle factors such as proper sleep patterns, regular exercise and nutrient dense meals will optimize mood. Keep earching! The root cause is out there!