By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr
If you ever wonder why so many people are suffering from ‘treatment resistant’ depression it is because mainstream medicine and psychology can offer only ‘palliative’ remedies. They mostly treat symptoms only and not causes. Depression is usually triggered by a stressful event, which is then often mistaken for the cause of depression. The biggest obstacle in the treatment of mood disorders is the generally held assumption – perpetuated by many “professionals” in the field – that depression is a “mental” illness confusing symptoms with causes and thereby ignoring the underlying biochemical factors mostly responsible for these “mental” symptoms.
True, environmental stresses can cause emotional disorders, but once the environmental circumstances are dealt with, an otherwise healthy and well-functioning person will soon recover. However, if stress reactions continue to affect a person’s well-being long after resolution of the environmental situation, we may have to look at possible underlying biological factors that could account for his present emotional experiences.
Depression can often cause problems in significant relationships, triggering a partner to withdraw emotionally from the other, or even seeking “love” elsewhere under the delusion that his/her unhappiness is caused by a break-down in the bond that initially drew the couple together. It is natural for a depressed person not understanding why he is depressed, to believe that his unexplainable sadness is caused by that very relationship, that is expected to bring happiness. The unaffected partner in a relationship often comes to believe that the depressed person has stopped loving him/her or that he/she may be responsible for the depression.
Drug therapy – legal or illegal – can only suppress the symptoms of depression, but does nothing to address the underlying biochemical abnormality that is responsible for depression. Once a patient is on the drug band wagon, they usually go on the merry-go-round from one drug to another for maybe the rest of their lives. Several studies have shown that drug therapy and/or psychotherapy may leave about 70 per cent of patients with treatment resistant depression.
Similarly, mainstream psychologists believe that talk therapy can alleviate the symptoms of depression. They assume that our irrational thoughts, unpleasant childhood experiences or ‘bad parents’ – hidden in a mythical ‘subconscious mind’ – have caused us to be depressed. They have us believe that by changing our attitudes and beliefs (for instance by RCBT) we can overcome the underlying biochemical disorder. They truly believe that psychology is a question of ‘mind-over-matter’. We only have to bring these ‘unconscious’ thoughts into consciousness and voila we become better. Many psychologists assume that depression is caused by cognitive processes, such as a low self-esteem, making the mistake of confusing symptoms with causes. In fact, they may be mere delusions. This is ‘palliative treatment’ without addressing the underlying biochemical disorder. A low self-esteem is simply a symptom of depression and not its cause. See Psychological Projection and Hypoglycemia.
True, when we experience a stressful situation in life – such as divorce, bereavement, rejection by a loved-one or any other trauma – stress hormones interfere with the synthesis of our feel-good neurotransmitters and we become depressed. This is called ‘environmental’ depression, where a person is fully aware of the external source of stress. Here the production of stress hormones helps us to find a solution. See Strickland PL et als. (2002). Sometimes such person can be helped by changing their coping skills or lack of self-esteem that could be at the root of their problems.
And, when the source of stress is removed people soon start to produce the happy hormones again and life resumes.
Unfortunately, many depressed people do not fall into that category, because after the removal of the external trauma, they continue to feel depressed and often cannot understand why, which brings them into the hands of a therapist. This may explain the development of Post Traumatic Stress Disorder, when a person fails to produce serotonin following a traumatic experience in a person’s life, long after the event. See PTSD and Hypoglycemia.
The majority of people seeking advice and information at this web site are people with ‘endogenous’ depression; that is to say that their depression is due primarily to a chemical imbalance in the brain. Mainstream medicine and psychology often fail to help these people, because they have no proper explanation as to the causes ‘endogenous’ depression. Consequently, they are not in a position to help depressed people.
Moreover, mainstream medicine and psychology are kept in ignorance of alternative scientific approaches by a seemingly deliberate omission to publish articles in the NIMH from such sources such as the Journals of Orthomolecular Medicine, reflecting their bias against nutritional biochemistry as a non-pharmaceutical model for treatment. This contempt for evidence-based science will keep the established professions in the dark as to more effective treatments in mental health. This is often aggravated by the fact that many clients themselves are unaware or even reluctant to consider a connection between depression and nutrition.
Thus we need a different interpretation of endogenous depression as an alternative to the prevailing narrow drugs and/or psychotherapy model: AND which is based on scientific knowledge.
I will propose the psycho-nutritional model which says that depression – and for that matter any other non-psychotic mental illness – is a disease of energy production. See also here.
Modern research in clinical nutritional points to the fact that if you are deficient in certain nutritional precursors to feel-good neurotransmitters a person is at risk of developing depression or any of the many mood disorders that goes under the name of “mental illness”. Many studies show that many nutrient components such as amino acids, Vitamin D, B12, B6 or generally the B-complex vitamins, minerals such as chromium, zinc and manganese or magnesium are essential in the production of feel-good bio-chemicals. One major factor may be any of a number digestive disorders that interfere with the absorption of essential nutrients.
More importantly, for the brain to change one molecule into another – as in the conversion of tryptophan into serotonin – it needs a sufficient amount of biological energy called Adenosine Triphosphate (ATP). That energy is derived mainly from the sugars in our food in the form of glucose. It is transformed into biological energy as a result of a complex biochemical pathway, called glycolysis.
The brain although 2 per cent of the body requires about 60-70 percent of all available energy, whether we are asleep or awake. A normal healthy cell requires about 2 million molecules of energy (ATP) per second to fuel biochemical reactions inside the cell. This is all derived from glucose in our food. See here.
Thus if the brain is deprived of that energy, it cannot synthesize the feel-good neurotransmitters such as serotonin, norepinephrine, dopamine or acetylcholine, to make us feel happy and relaxed when we normally should. One immediate consequence is that the body is inundated with stress hormones, which will undermine one’s self-esteem. This is often mistakenly interpreted to mean that a negative self-image is the cause of depression.
Without serotonin the body cannot produce melatonin – the sleeping neuro-chemical that makes us sleep – and so we see that depression is usually associated with insomnia. Because serotonin is also associated with the appetite mechanism, depression is often accompanied with weight problems. Unabsorbed sugars in the diet are stored in the body as fat cells, hence the association between depression and obesity. See also: Connection between obesity and depression. Not only energy, but a host of other nutrients are required to bring about these biochemical reactions in the brain. They could well be deficient.
If the universal source of energy is derived from glucose in our food, one may wonder why it is, that in a high sugar consuming society in the Western world, people would suffer from energy starvation? Could this be responsible for the exponential increase in depression and mental illness?
Excessive sugar consumption, when converted to glucose, can expose the body to free radical attack upon the immune system and DNA. Glucose is easily oxidized into peroxides and other toxins. The body has a defense mechanism against excess sugar consumption: it shuts down receptors for insulin that controls the amount of glucose (and other nutrients) getting across cell membranes into cells. This is called Insulin Resistance, which may result in hypoglycemic symptoms. There are many studies showing a significant association between depression and insulin resistance. See here.
With insulin resistance blood sugar levels tend to rise, triggering more release of insulin – called hyperinsulinism – and this may provoke a sudden descent in blood sugar level called hypoglycemia. Thus the brain tends to be exposed to wildly fluctuating blood sugar levels, responsible for many ‘psychological’ symptoms. See graph here. Unfortunately, mainstream medicine does not yet recognize hypoglycemia as a separate disease, and cannot as yet test for it as an illness that is the precursor to diabetes. See Test for Hypoglycemia by Dr George Samra below. Hence most traditional treatments for depression miss a common underlying biochemical factor that is responsible for depression and other mood disorders.
When the brain is starved of energy it could lead to the death of brain cells in a matter of minutes. In reaction to this threat, the brain triggers the release of stress hormones – such as adrenaline and cortisol – that function to convert sugar stores in the body (glycogen and amino acids) back into glucose so as to feed the brain again. (See image) See also Rita Elkins et al.
But these stress hormones, generated within the body are also responsible for the varied symptoms of mental illness, from depression, anxiety attacks, phobias, delusions ,insomnia, compulsive behaviours and thoughts, alcoholism, drug addiction, sex addiction, violence, hypochondria, PTSD, OCD and so on and on.
Thus hypoglycemia is characterized by unstable blood sugar levels feeding the brain, causing excess stress hormones to flood the system and is one of the major factors playing a role in depression (references). In his studies of twelve hundred hypoglycemic patients, Stephen Gyland, M.D., found that 86 percent were depressed. Source. This has been confirmed with our own tests for hypoglycemia as designed by Dr George Samra.
However traditional psychotherapy (talk-herapy) can still be useful, provided the biochemical imbalance has been treated FIRST before considering “psychological” aspects.
The non-drug treatment for hypoglycemia is the adoption of the Hypoglycemic Diet – a virtual panacea for depression – which is a natural diet expected to contain all the necessary amino acids, vitamins and minerals – and specifically designed to regulate blood sugar levels, stress hormones and insulin levels. One should not be surprised to find that the medico-pharmaceutical industrial complex would be strenuously opposed to the treatment of mood disorders without resort to drugs. Somehow it is profitable to be ignorant of nutritional medicine.
Thus depression is in fact a NUTRITIONAL DISORDER.
This concept is difficult to accepts for those who have believed for so many years that mental illnesses is one of ‘mind over matter’. This perception is still held by the majority of practitioners in the field. But scientific truth is not very democratic and is not determined by majority rule. This misconception is reinforced by the common conviction that ” I am on a healthy diet, therefore it does not apply to me”.
This disorder can be medically tested with a special Glucose Tolerance Test for Hypoglycemia (GTTH) designed by Dr George Samra of Kogarah (Australia) and as described at our web site at:
The scientific basis of this new nutritional approach is supported by numerous scientific studies, that have shown a significant association between Depression and Insulin Resistance.
Of course, mental illness is a multifactorial problem. Although hypoglycemia is a major factor, other illnesses may contribute or be responsible for mood disorders. These have discussed at:
The first step in treatment is going on a hypoglycemic diet, with the appropriate supplements such as B-complex vitamins including vitamin B3 (niacin), B6 (Pyridoxine), B12 (ask your doctor for injections), Vitamin D and folic acid, zinc, magnesium, chromium picolinate, cinnamon, glycerine, high doses of EPA fishoil, Rhodiola rosea (Amoryn), Seredyn, Try out Olive Leaf Extract, Coconut Oil and others. Experiment with combining the Hypoglycemic Diet with Herbal Remedies for Mood Disorders, such as Camu-Camu, Damiana, Ginseng, Hops, Kanna (reduces cravings for cigarettes), Lavender, Passion Flower, Rhodiola, St John’s Wort, Vervain, with the help of a herbalist or a health care professional. Remember herbal remedies may interact with psychotropic medications. Generally, herbal remedies and AD medications do not mix.
Glycerine: One way of overcoming withdrawal symptoms is taking one tablespoon of glycerine (obtainable from a health food store) in a glass of water, with a dash of lemon juice, to improve taste, about three time a day. It will also help reduce anxiety, improve sleeping, calming you down when faced with a strenuous situation, such as exams, job interviews and so on.
Follow this up with a thorough assessment of possible allergies and food sensitivities by systematically recording a food diary as per Finding your Allergies or better still getting a referral to a nutritional doctor. If possible, have a hair analysis done to detect abnormal mineral levels.
If you are presently on medication for any mood disorder, the best strategy is to remain on any medication and prepare your body to produce the right neurotransmitters and hormones by nutritional therapy. This should be done in consultation with your doctor. This may take some time (perhaps up to a year), but as soon as you start to feel better you could then gradually withdraw from your medication, under doctor’s supervision, whilst being on the hypoglycemic and anti-allergenic diet or other nutritional therapy. (See also here) If you strike any problem It is suggested that you be referred to a Nutritional Doctor, Clinical Nutritionist or Nutritional Psychologist. See: Looking for Nutritional Therapists.
Thus patients do have a choice, if mainstream medicine and psychology have failed to help them.
Upon completion of the biological treatment of mood disorders, one should follow this up with a course of self-help psychotherapy course as explained at: Summary of Psychotherapy Course.
Please discuss this article with your health care worker, doctor or nutritional doctor or therapist
“An active cell requires more than 2 million ATP molecules per second. The store of ATP in a human body is sufficient to satisfy a person’s needs for only a few seconds, therefore, the store needs to be continuously replenished.” Source and here.
“Blood tests reveal that 75 percent of hyperactive, learning disabled children have hypoglycemia and/or allergies.” “Some studies had even shown that up to 75 percent of depressed people were not able to metabolize sugars properly. Dr Harvey Ross,MD believes that hypoglycemia is so prevalent that it is mandatory to consider the possibility of this disorder whenever a patient complains of depression” Hypoglycemia by Rita Elkins et al., 13
About 82 articles in the Journal of Orthomolecular Medicine (JOM) link hypoglycemia with “mental illness”. See: Archive of Journal of Orthomolecular Medicine
See also research at:
Depression and Insulin resistance
Conquering Anxiety, Depression and Fatigue Without Drugs – the Role of Hypoglycemia
Other treatments for Depression