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Depression – A Nutritional Disorder

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:

Testing for Hypoglycemia and How your Doctor can help”.

We also have a paper-and-pencil test called the NBI  that can indicate a metabolic disorder if you score high on that test. Another home test can be found at:  Hypoglycemia Questionnaire.

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:

Silent Diseases and Mood Disorders

Treatment

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

References

“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

 

More References for Mood Disorders and Hypoglycemia

See also research at:

Index to Specific Topics and Research

References to Mood Disorders and Nutrition

Research Evidence for Hypoglycemia

Brain/Sugar Interaction

Depression and Insulin resistance

Depression and Genes

Diabetic gene

Glucose/ATP requirement of the brain

Glycerine

Insomnia and Hypoglycemia and Melatonin

Obesity references

Post Traumatic Stress Disorder (PTSD)

Schizophrenia and Hypoglycemia

Seasonal Affective Disorder (SAD)

Shoplifting

Stress and Immune System

Zinc and picolinic acid, tryptophan

Alternative Treatments for Depression

Other articles:

What is Hypoglycemia?

The Serotonin Connection

Depression – a Disease of Energy Production

Silent Diseases and Mood Disorders

Nutritional Aspects of Depression

Hit or Miss Supplements for Depression

PTSD and Hypoglycemia

Hypoglycemia: is it a cure-all for mental illness?

The Hypoglycemic Diet

Allergies; the Food and Disease Paradigm

How to find your allergies

Conquering Anxiety, Depression and Fatigue Without Drugs – the Role of Hypoglycemia

by Professor Joel H. Levitt

 

Other treatments for Depression


17 Responses

  1. Grace says:

    I just can’t stop reading article after article in this newly discovered website! Thank you for your efforts!

    “Thus depression is in fact a NUTRITIONAL DISORDER” – I like this so much:)

  2. BoneYard says:

    There is some merit within this.
    I would like to point out that the
    paper pencil tests are set up specifically
    (if answered honestly) to skew the
    results in favor of the diagnosis.

    Nutritional disorders can be tested for
    quite easily. Furthermore throwing out
    the possibility of natural chemical
    imbalances that are not nutritionally
    related is quite absurd. That would be
    akin to one trying to treat high cholesterol
    levels with nothing more than diet.

    The fact is compartmentalizing things like
    this is not advantageous for anyone. That
    is the primary reason why it has been
    disregarded by most all medical professionals.

    • Jurriaan Plesman says:

      Hi Bondyard,
      If you think the questionnaires are skewed, then ask for a GTT.  Medical tests are naturally more accurate, but fairly expensive. The questionnaires are designed to avoid unnecessary medical expenses and are found to be fairly accurate. See for instance the NBI, where the results of the GTT group were compared to the questionnaire group. 

      If you are interested in other diseases, apart from hypoglycemia, or nutritional disorders have a look at
      SILENT DISEASES AND MOOD DISORDERS. 

      It is difficult to see what you mean by “compartmentalizing”, and how this differs from other branches of medicine or science. Classifying is an important feature of science. 

  3. Jurriaan Plesman says:

    THE CREATION OF A NEW PROFESSION

    Reflecting on the necessity of having nutritional psychotherapy recognized in our society, I believe this can only be achieved if prospective nutritional psychotherapists can obtain proper qualification in this new profession. 
    I believe there is a need and great interest among young Probation and Parole Officers, Nurses, Social Workers, Psychologists, Alcohol and Drug Counsellors. Family Counsellors and so on, to obtain qualifications for this new profession. 

    This new profession should be separate and distinct from either psychiatry and/or psychology, although in a cooperative relationship.
    There  is a multiplicity of factors influencing mood disorders involving many allied professions. 

    It is envisioned that Nutritional Psychotherapists will contribute to the challenge facing the epidemic of “mental illness” as part of team with other professionals. 

    Its recognition as a separate profession should be based on it’s success rate in helping people overcome mood disorders by statistical evidence. 

    Let’s hope that some institution or organization will soon create a distance learning course that would enable the.next generation of young people to obtain Post Graduate Qualifications in Nutritional Psychotherapy. 

    Most of the study material is already available on the internet. 
     
    One of the many sources would be at this very Hypoglycemic Web Site. 

  4. Aaron says:

    All I can say is thank you. I have been preaching the same information here in Ireland for the last few years and thus far it has fallen upon deaf ears. I have been suffering with anxiety and depression for the last eight years and through trial and error I have discovered most of the solutions above bar a few, which I am now going to incorporate into my routine to test the benefits.

    I can tell you 100% that this works and that it is the right way to go. I have been bounced from one medication to another and if your persistent enough to try and stick with the docs they will have you try every medication on the market. Eventually one day I decided enough was enough and developed a healthier lifestyle. I first discovered that caffeine was a main trigger for me, but I always thought it was an allergy or intolerance; it then made sense how my blood sugar would bounce along with all of the other refined sugars that are in every processed food we eat today.

    I cannot stress enough how the B vitamins and Magnesium helped me recover as they control the release of energy for our bodies. I also try to eat 5-6 small meals per day rich in protein slow releasing carbs and good fats. I also discovered from having my hair tested that I had a wheat intollerance so I cut it out of my diet and the difference was night and day, I lost around 12 kilos and my digestive system reeped the benefits. I also discovered as a result of the reduced flow in my digestive system by body was full of toxins because of stagination.

    Anyhow without rambling so much I just wanted to say thank you for all of your information and confirming all of the above, I think it is great what you are doing and in support I am going to create a website in Ireland for people who suffer with anxiety and depression and post the same information with links to your site. Many many thanks.

    Kind regards
    Aaron

    • Jurriaan Plesman says:

      Thanks for responding. If enough people like yourself join us, Nutritional Psychotherapy will become soon normal practice.

  5. Jurriaan Plesman says:

    AMORYN:
     St Johns Wort is a well-known herbal remedy for depression. A major component, HYPERFORIN  in this plant has been shown to be responsible for it’s antidepressant activity. 
    http://www.amoryn.com/

  6. Cara says:

    I recently read the article from your website about depression being a nutritional disorder and I want to say thank you as well. After going to doctor after doctor after doctor over here in the United States, and being told the same thing: to go see a psychiatrist so they can put you on anti-depressants, something inside of me told me that this isn’t the way to go; I’ve been on anti-depressants before and they didn’t feel right to me. The goal of health and well-being isn’t to stare blankly ahead with a distant gaze because some medication is numbing you out in order to relieve your symptoms. The key to health and life is to be vibrant and full of energy, full of life.

    The doctors recently found out that my blood sugar was low and I started doing some research into metabolism, how the body absorbs nutrients, and how deficiencies of some vitamins and minerals can lead to the SYMPTOMS of depression, anxiety, etc. I’m just beginning my new “treatment” right now, all of which I’m having to fight for; I cut back on a lot of the processed foods and sugars that I had been eating my whole life, and I recently began getting acupuncture. The first thing that the acupuncturist said after I described my symptoms was that I have a digestive imbalance. Keep in mind that Traditional Chinese Medicine has been used for thousands of years. Not one doctor over here in the States has suggested that I could have a nutritional imbalance, not one.

    After reading Aaron, from Ireland’s reply, I’m encouraged to get a hair analysis done and I plan on finding a nutritionist; a very far cry from having pills thrown at me. I know various other people who feel the same way, that the pills aren’t working and they don’t know why. My parents always said that once I find my way, there will be no stopping me, and I’m finding it. I plan to go back to school for nutrition in the Fall of 2013 and I want to place an emphasis on Nutritional Psychology. It may be a few years, but I hope to join the fight, not just for myself, but for all of those people who are wrongly put on medications that are more harmful than helpful to their bodies, to mask the real problem. You are an inspiration to me and I just want to encourage you to NEVER give up the fight; I know I’m not going to. My deepest gratitude for everything you are doing and continue to do.

    Namaste,
    Cara

    • Jurriaan Plesman says:

      Hi Cara, Your experience with psychiatrists is not uncommon, but you seem to be on the right track now.We strongly believe that going on an a hypoglycemic diet (look up in our web site) is the step in treatment.
      Yes, as patients get more educated an alternative to the traditional and inefficient drug and/or talk therapy model will be replaced wit a more effective treatment over time. Please join our facebook page and let us know how you are going.

  7. shelley says:

    I have PTSD and Major Depression and have struggled for years with eating disorder that involves sugar,chocolate, ice cream addiction. I can say for sure that all my symptoms are relieved when I am abstinent from sugar and am eating balanced regular meals. The longest I have done this is for 3 months. One problem is that I have intestinal worm/candida which complicates things and my PTSD triggers plus that intestinal issue has made it very difficult to maintain. Not to mention lack of support and understanding by doctors etc. I dissociate from the sugar intake or to the numb the PTSD and get into a zombie state of feeding on sugar. I wish there was a nutritional oriented treatment centre with this type of understanding.

  8. James says:

    Sorry got disagree with comments. Although there are other ways to treat depression your diet is going to have little impact. I have met weight lifters who have a clean and sugar free diet to overweight people who all suffer from depression. The cause is modern life and the stress it can put on you to conform to a certain way. To say it’s duet is ignorance and will have little impact. If you can change the way you live first. Then keep a diary.

  9. Julie Ruiz says:

    Although I have read a lot of articles online, I have never responded to one until today. I am so grateful to you for researching and writing this article. I am currently a nurse and I am studying to be a health coach at the Institute for Integrative Nutrition. While I have been training, I have been sort of “searching” for my niche and trying to figure out what is the most important type of work that I want to do. I feel like I have found “my calling” so to speak after reading your article. At the nutrition school, I have learned how to eat properly and removed all of the bad sugars from my diet. I have never felt better. I am going to start researching everything I can about the correlation between diet/hypoglycemia and mental illness. When I become a health coach, I hope to use this information to help my clients. I would really like to focus on the mental illness aspect and give lectures on the subject. I think I can help a lot of people. I wish that you could be a speaker at my school!

    Thank you for opening my eyes,
    Julie

    • Jurriaan Plesman says:

      Hello Julie Rutz,

      This is very exciting to hear. We desperately need what I call Nutritional Psychotherapists (http://psychonutrition.proboards.com/index.cgi?action=display&board=general&thread=32&page=1) as a separate and additionally recognized profession working with psychiatrists and psychologists. The latter are mostly unaware about the nutritional aspects of mood disorders, because they have not studied nutritional biochemistry as part of their training. About 60% of patients receiving conventional treatment by medications and/or psychotherapy finish up being “treatment resistant patients” for he rest of their life.
      See:

      Antidepressant Medications are ineffective
      http://www.hypoglycemia.asn.au/2011/research-evidence-for-hypoglycemia/#SSRIs

      You will find that your chosen goals will be a very satisfactory career. Nutritional psychotherapy has a great success rate and may be the answer in the near future, with people like you undertaking these studies. I hope when you have completed your studies that you will teach many other aspirants into this new profession.

      Cheers Jur

  10. H says:

    I am so thankful to have stumbled upon this site. I feel that I was supposed to see this. I have been battling major depression for a while and have never got on meds because of the dear of what they would do to me. No reason to be depressed it just happens during my supposed to be “happiest times”. I love the nutritional disorder title of it. I have never eaten the way I’m supposed to with vegetables and have always known that was one of my main reasons for zero energy. Although I have zero motivation at this point with my depression I will make myself flow some of this diet. I have hope in it and that’s what I needed. I just don’t understand why some
    People that even eat worse than me don’t feel this way? That’s my only skepticism with this. I know
    People that just constantly eat fast food and I rarely do that. I truly hope this helps give me relief from depression and I can spread my testimony with this finding.

    • Jurriaan Plesman says:

      The reason why some people seem to be more tolerant to carbohydrates than others may be a mystery. It all depends on the amount and the time. But ultimately they put themselves at risk for inulin resistance —> diabetes and perhaps mood disorders. You are lucky to have found the reason for your mood disorders.

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