8 Things Everyone Needs to Know Before Taking Antidepressants

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Sadness, feeling down in the dumps, or general depression is a normal part of human emotion. Everyone experiences these feelings on occasion. Feeling depressed over a long period of time however can be an indication of something out of the ordinary. It’s estimated that over 300 million globally live with depression. It’s not just adults that are affected, severe depression for young people is on the rise. (1, 2)

As we begin to understand more about the human mind and body, we expand our knowledge base of healthcare by acknowledging the brain-gut connection and psychoneuroimmunology. Psychoneuroimmunology includes a broad spectrum of research including a range spanning cellular disruptions to personal relationships and how immunological activity can impact the brain. (3)

Did They Get Depression All Wrong?

Science and the medical profession base their theories and treatments on what is known at that particular point in time. A common theory for depression is “chemical imbalance”. The theory suggests that depression can be the result of too little or too much of a particular chemical in the body. While it may logically make sense to some, it also oversimplifies the multiple causes of depression, such as health issues, medication side effects, poor diet, genetic vulnerability, physical vulnerability or stressful life events such as the death of a spouse or child. (4)

For example, this small study of 24 women, displayed a history of depression and on average the hippocampus was 9% to 13% smaller in depressed women compared with those who did not display episodes of depression. Stress plays a role in depression and may actually be a significant key to depression, as experts believe that stress can actually suppress the production of new neurons in this part of the brain. (4, 5)

A Holistic Approach to Depression

While therapy and prescription medicines are common options for depression, it’s important to consider a whole body approach to determine your best options. If your therapist believes that medication is necessary, it is worth taking that into consideration. It’s also important to do your research and get additional opinions and information until you feel comfortable with making a decision.

1) Addressing the Gut

Although the concept of gut health being related to your mood isn’t new, there is a resurgence of interest in the relationship between bacterial imbalance and behavioral issues. Two major factors that can influence gut microbiomes are diet and immune system health. (6, 7)

Your gut is connected to your brain by the vagus nerve, which extends from the brain stem, down the neck, thorax and abdomen. The vagus nerve supplies motor parasympathetic fibers to all organs except adrenal glands, all the way from the neck down to the second segment of the transverse colon. It helps to transmit information for a wide variety of sites, including the heart, lungs, speech, sweating, and various gastrointestinal functions. (8, 9)

Evidence is mounting that stress has a far greater impact on our health than previously known. Stress can increase gut permeability by allowing bacteria and bacterial antigens to cross the epithelial barrier and activate a mucosal immune response, which in turn alters the composition of the microbiome. (10)

2) Good Fats / Fish Oil

Fish oil appears most effective in individuals with a diagnosis of MDD (Major Depressive Disorder). It does not show potent results in individuals with minor depression. (11)

EPA oil (eicosapentaenoic acid) shows the most promise at a supplementation dosage of 1g. It is possible that the reason for the effectiveness of fish oil is due to its ability to augment antidepressants, as many of the studies noted that most trials conducted in major depression or disease were also taking standard antidepressant drugs (such as lithium). (12)

3) Mindfulness

Some people use the term mindfulness and meditation interchangeably. They really aren’t the same thing. Mindfulness is about awareness of the moment. Being aware of everything….how you feel, your surroundings, paying attention to your behavior, thoughts, actions, words.

There are many forms of mediations, some are about letting go and clearing your mind, some are aimed at focusing your mind such as “clear mind” meditation, while others such as open heart meditation are focused on altruistic states such as forgiveness or compassion.

Mindfulness is a practice that can help you be in tune with your surroundings, but also with your body and how you feel. So whether you choose meditation or mindfulness, you’ll be encouraged to know that both can offer stress relief, lower blood pressure and can improve pain levels. (13)

4) Addressing Your Nutrition

Whole foods will provide your body with a daily balance of vitamins and minerals that are critical for your overall health. Nutrients like magnesium, B12, B6, folate, Vitamin D, Zinc and adequate protein are found in fresh whole foods, not in a box. What you eat matters, not only for your physical body, but for your mental well health as well. So what are the basics of healthy gut brain relationship?

Avoid Processed Foods- These foods are not nourishing for your body. The added sugars, preservatives, colors and flavors are linked to numerous health conditions ranging from diabetes, obesity to cancer.
Eat Healthy Fats-The body, especially your brain needs healthy fats for optimal function. Wonderful options for healthy fats include avocado, olive oil and nuts.

Avoid GMOs-Genetically modified foods are not nourishing foods and in fact do more harm than good.
Skip Nightshades-Nightshades or foods that contain solanine should be limited or avoided altogether. They can trigger inflammation in your body, which is also linked to numerous chronic diseases.

Probiotics-Fermented foods such as kimchi, sauerkraut or dairy free yogurts are great ways to re-establish and build up the good bacteria in your gut.

Go gluten free- Gluten free foods are easier on your digestive tract and less likely to cause inflammation.
Add nuts-Aside from being a healthier fat option, nuts such as almonds, cashews and walnuts are rich in serotonin, which some individuals with depression may be low in. Serotonin not only makes you feel happier, it decreases hunger and it also improves heart health. (14)

Mushrooms- Mushrooms like shitake are high in B6. Higher B6 levels are linked to reduced stress levels and can help with mild depression. (15, 16)

5) Mind-Body Connection

A mind body approach to healing, while not yet considered part of conventional medical approaches offers numerous health benefits. A mind body complementary health approach referred to as CHA, encompasses many practices such as: acupuncture, breathing exercises, guided imagery, healing touch, hypnotherapy, meditation, movement therapies, massage, progressive muscle relaxation, spinal manipulation, t’ai chi or qigong and yoga. (17, 18)

All of these methods can offer stress and pain relief, which can contribute to depression. Decreasing your physical and emotional stress is important to improving your overall health and well-being

6) Your Sleep

You may be surprised to learn that inadequate sleep can contribute to depression. According to the U.S. Centers for Disease Control and Prevention, more than one third of American adults are chronically sleep deprived. (19, 20)
What do researchers mean by inadequate sleep? Irregular sleep patterns such as sleeping 5 hours one night, 10 the next and so on, going to bed at irregular bed times, irregular wake up times, waking up during the night.

Our body likes rhythm and consistency especially when it comes to sleep. What researchers have found is that any sleep disturbance which affect stress hormones and neuro transmitters can simply create havoc in the brain, which can lead to impaired thinking and emotional regulation.

It is recommended by The American Academy of Sleep Medicine and the Sleep Research Society that adults sleep at least 7 hours nightly. Sleeping less than 7 hours a night is not linked only to an increased risk of depression, but to other chronic health issues such as diabetes, obesity, heart disease and high blood pressure. (20)
It turns out that going to bed by 10 o’clock may be the perfect time, as the deepest and most regenerative sleep for your body happens between 10 and 2. The basic truth is that most people do best when they fall asleep within three to four hours after the sun sets and waking naturally when the sun rises. (21)
In addition, regular aerobic exercise or activities help people to fall asleep sooner, spend more time in a deeper sleep state, and to sleep more soundly through the night. (19)

7) Exercise

Depression can hinder your desire to exercise. Since exercise requires motivation, hauling yourself off to your local gym for a spin or aerobics class may be low on your list.

Consider committing to something smaller, go for a walk in your neighborhood with a friend, watch your favorite music video on TV and dance. Take a drive to your closest nature trail and enjoy a leisurely stroll in nature. A game of Frisbee in the park with your dog is a great way to spend some time outdoors. It really doesn’t matter what you do, as long as you start small and commit to that time.

8) Find Your “Tribe”

When you feel depressed, the word no, can become a mainstay in your vocabulary. It needs to be tossed out the window. Don’t isolate yourself. Say yes to meeting with friends, even if you’re not in the mood. Get outside your comfort zone and build your community.

Don’t know where to start? Begin by doing things you enjoy and find likeminded people to share that interest with you. Take classes at your local community center, art gallery or local special interest clubs. I guarantee, if you sit at home and do nothing, nothing exciting will happen.

Can’t find a group you like? Start your own. Whatever your interests, book club, bicycling, quilting, cooking, other people will also share that interest and you will be developing your tribe, your community. The community you build is a place where you can find connection, acceptance and friends to offer support and encouragement in lifes journey.

Depression Can Be Overcome

Everyone experiences depression from time to time. Experiencing depression on a more consistent basis can be an indication of something out of the ordinary. While many people’s first thought of alleviating depression may be of therapy or prescription meds, it’s not the only option.

Consider looking at other factors that can impact your health such as diet, sleep, environmental factors exercise and nutritional deficiencies.

If you are medication, talk with your healthcare provider about additional options that may be beneficial for you.

You don’t have to let depression rule your life. You can take proactive steps to improve your quality of life.
Build your tribe. Find like-minded individuals who share your interests or beliefs.

1. Depression. (n.d.). Retrieved October 23, 2018, from http://www.who.int/news-room/fact-sheets/detail/depression
2. The State of Mental Health in America. (2018, August 01). Retrieved October 23, 2018, from http://www.mentalhealthamerica.net/issues/state-mental-health-america
3. Psychoneuroimmunology. (n.d.). Retrieved October 23, 2018, from https://www.sciencedirect.com/topics/neuroscience/psychoneuroimmunology
4. Harvard Health Publishing. (n.d.). What causes depression? Retrieved October 23, 2018, from https://www.health.harvard.edu/mind-and-mood/what-causes-depression
5. Sheline, Y. I., Mintun, M. A., Gado, M. H., & Milan Sanghavi. (1999, June 15). Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression. Retrieved October 23, 2018, from http://www.jneurosci.org/content/19/12/5034
6. Dash, S., Clarke, G., Berk, M., & Jacka, F. N. (2015, January). The gut microbiome and diet in psychiatry: Focus on depression. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/25415497
7. Belkaid, Y., & Hand, T. (2014, March 27). Role of the Microbiota in Immunity and inflammation. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056765/
8. Vagus Nerve. (n.d.). Retrieved October 23, 2018, from http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/h_n/cn/cn1/cn10.htm
9. Vagus Nerve. (n.d.). Retrieved October 23, 2018, from https://www.sciencedirect.com/topics/medicine-and-dentistry/vagus-nerve
10. Dinan, T. G., & Cryan, J. F. (2012, September). Regulation of the stress response by the gut microbiota: Implications for psychoneuroendocrinology. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/22483040
11. Grosso, G., Pajak, A., Marventano, S., Castellano, S., Galvano, F., Bucolo, C., . . . Caraci, F. (2014). Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013121/
12. Martins, J. G. (2009, October). EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: Evidence from a meta-analysis of randomized controlled trials. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/20439549
13. Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., . . . Haythornthwaite, J. A. (2014, March). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/24395196
14. Benefits of nut consumption for people with abdominal obesity, high blood sugar, high blood pressure. (2011, November 10). Retrieved October 23, 2018, from https://www.sciencedaily.com/releases/2011/11/111102125348.htm
15. McCarty, M. F. (2000, May). High-dose pyridoxine as an ‘anti-stress’ strategy. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/10859691
16. Hartvig, P., Lindner, K. J., Bjurling, P., Laengstrom, B., & Tedroff, J. (1995). Pyridoxine effect on synthesis rate of serotonin in the monkey brain measured with positron emission tomography. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/8748674
17. Sun, H., Zhao, H., Ma, C., Bao, F., Zhang, J., Wang, D. H., . . . He, W. (2013, September). Effects of electroacupuncture on depression and the production of glial cell line-derived neurotrophic factor compared with fluoxetine: A randomized controlled pilot study. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/23647408
18. Burnett-Zeigler, I., Schuette, S., Victorson, D., & Wisner, K. L. (2016, February 01). Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review. Retrieved October 23, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761814/
19. Harvard Health Publishing. (n.d.). Sleep and mental health. Retrieved October 23, 2018, from https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health
20. CDC Newsroom. (n.d.). Retrieved October 23, 2018, from https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
21. Sleep and Longevity. (n.d.). Retrieved October 23, 2018, from https://www.doctoroz.com/blog/kulreet-chaudhary-md/sleep-and-longevity

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