Functional Medicine for Anxiety and DepressionAug 27, 2013 11:16PM ● By Richard Chen, MD
The Anxiety and Depression Association of America reports that 18 percent of adults are affected by anxiety, while The World Health Organization has stated that 19 percent of Americans will suffer from depression in their lifetime. Fortunately, functional medicine provides treatment options for these mood disorders that allow people to be active in their own recovery.
Causes of Depression and Anxiety
Depression can vary from a long-term condition to that which is temporarily triggered by a specific life event. From a diagnostic standpoint, depression consists of having low mood, low self-esteem and the loss of pleasure in normally enjoyable activities. Anxiety becomes a disorder when it begins to change a person’s life. From a functional medicine perspective, one person’s depression or anxiety may be very different from another’s. The factors involved in depression and anxiety are psychological, cultural, genetic and related to lifestyle choices, diet and environment. While people often think that they’re depressed or anxious because of life events, more times than not biochemical issues within the body precede the negative external event. Imbalanced biochemistry affects a person’s view of life and their reactions to events. In many cases the cause of depression or anxiety is an internal, biological concern. Food sensitivities are an unrecognized factor in mood disorders, and research suggests that up to half of all Americans are affected. The most common food sensitivities are gluten and dairy. People with food sensitivities have a delayed reaction to food, which may present itself as heartburn, joint aches, fatigue or other symptoms. They may also feel depressed from eating food that puts stress on their system. Similarly, food sensitivities may cause anxiety because of the stress on the body.
The Role of Serotonin
Serotonin is a neurotransmitter in the brain responsible for a sense of peace. A person lacking serotonin may feel fearful and anxious, suffer sleep challenges and crave carbohydrates or other foods, based on the emotional environment in which they grew up. Some people have genetic issues that predispose them to making less serotonin. Family of personal histories of cancers (especially prostate, breast and endometrial cancers), depression, anxiety, alcoholism, early heart attacks, strokes or recurrent miscarriages flag the possibility of genetic issues that could affect serotonin levels. Physicians can test for the methylenetetrahydrofolate reductase (MTHFR) gene and, based on results, recommend supplements and dietary changes that support the body in making more serotonin. Another neurotransmitter that calms the body is Gamma-Aminobutryic acid (GABA). Low GABA levels can lead to a racing brain and anxiety.
Other Causes of Mood Disorders
Hormone imbalances can also be behind depression symptoms. For instance, abnormal levels of estrogen in women and testosterone in men can trigger depression or anxiety. Problems with other endocrine glands, such as depleted adrenals, can cause mood disorders. Chronic stress in a patient’s life can deplete the adrenals to the point where they feel depressed. Additionally, an underactive thyroid may result in symptoms of depression.
Treating Depression and Anxiety with Medication
Functional medicine physicians view each mood disorder as unique and treatable. If medication is warranted, many patients do well with selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Celexa, Zoloft, Paxil and Lexapro. SSRI medications, which work by blocking the breakdown of serotonin, can be effective for both depression and anxiety. Some studies suggest that these drugs lose effectiveness if used for more than one or two years. They may also bring on such side effects as weight gain, sexual dysfunction and drowsiness. Medications for curbing acute anxiety include Ativan, Valium, Xanax and Klonopin. These drugs can become addictive, however, and withdrawal from them must be medically monitored.
Supplements for Mood
One alternative to medications is the use of supplements, including 5-hydroxytryptophan (5htp), which helps the body make serotonin. This supplement should not be used by patients taking medications that affect serotonin, such as SSRIs, unless their healthcare provider is knowledgeable in 5htp usage. Because ongoing stress can deplete magnesium, a mineral that’s helpful for reducing muscle tension, supplementation can be effective. A good form to take is magnesium glycinate, which is well absorbed and doesn’t cause uncomfortable bowel symptoms. If zinc-copper imbalances are the issue, zinc supplements can help when used with the supervision of a healthcare provider knowledgeable about zinc-copper issues.
Diet, Exercise and Bodywork Approaches
Because all neurotransmitters are made from protein, nutrition can be used to improve mood. Foods high in the protein tryptophan, which turns to serotonin in the body, include avocado, pork, chicken, eggs and turkey. Eating foods high in zinc such as red meats, chicken, and eggs, while decreasing foods high in copper such as nuts, chocolate, soy, shrimp, lobster and sunflower or sesame seeds can help the body raise zinc and GABA levels to calm the brain. It is best to consult with a doctor to determine which foods are the best form of medicine for an individual’s particular health issue. Physical activities that can help with mood include any form of exercise that a person enjoys. Other options include acupuncture, yoga therapy, craniosacral therapy and other types of bodywork. While some people prefer doing relaxation therapy on their own, others benefit from a therapeutic touch. Considering all of the possible treatment options, a functional medicine physician can help to determine which approach is best, based on a patient’s needs and preferences.
Dr. Richard Chen is a board-certified family medicine doctor available for both primary care and functional medicine consultations at Visions HealthCare, 910 Washington St., Dedham. For more information, call 781- 431-1333 or visit VisionsHealthCare. com.