Depression
62 Case Studies
55 Member Stories
2352 Research

Functional medicine takes a systems biology approach and offers new treatment ideas for mental illness. The focus is on the underlying causes of the disease rather than the symptoms. 

What is depresssion?

Depression is a mood disorder that causes a persistent feeling of sadness and lack of interest. Also called a major depressive disorder or clinical depression, it affects how you feel, believe and behave and can cause various emotional and physical issues. You might have trouble doing normal day-to-day activities, and sometimes you may feel as if life is not worth living.

More than just an episode of the blues, depression is not a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But do not get discouraged. Most people with depression feel better with medication, psychotherapy or both.

Conventional treatments available today like antidepressants don’t cure the disease; they just mask the symptoms. And continuing such medications for a long period of time can make things worse while making you prone to side effects, or at best can provide partial relief. A more effective way and healing functional medicine for anxiety and depression at the root cause is the one that focuses on repairing and healing the body's biological processes and rebalancing the neurological system helping in the remission of depression. 

See: Ashwagandha benefits for anxiety

How does Functional Medicine view Depression?

Functional Medicine is a systems biology-based approach that concentrates on identifying and addressing the root cause of disease. Each symptom or differential diagnosis might be one of many contributing to an individual's illness.

A diagnosis may be the consequence of more than one cause. As an example, depression can be brought on by many different things, including inflammation. Likewise, a cause like inflammation may result in a lot of different diagnoses, including depression. The precise manifestation of every trigger is dependent upon the person's genes, environment, and lifestyle, and only remedies that address the ideal trigger will have lasting benefit beyond symptom reduction.

The Functional Medicine model highlights a multi-pronged approach to wellness and health, engaging patients in a therapeutic partnership that recognizes the current conventional paradigm doesn't optimally address the needs of patients with cerebral symptoms. A functional medicine doctor might unravel the main cause of depression by looking at several factors, such as vitamin D and other vitamins, amino acids, and minerals--and the gut microbiome.

Epidemiological studies suggest there is an association between diet and mental health. A 2019 study found that long-term adherence to a healthful diet can offer protection against recurrent gastrointestinal symptoms. Analyses were conducted on a sample of 4,949 people, and diet scores were calculated using data gathered from food frequency questionnaires repeated over 11 decades of exposure. Higher scores on the Choice Healthy Eating Index-2010, Dietary Approaches to Stop Hypertension, and the altered Mediterranean diet has been associated with a lower risk of recurrent gastrointestinal symptoms. Evidence suggests that dietary or supplemented intake of other nutrients can be protective or decrease depressive symptoms.

See: DASH Diet Treatment for High Blood Pressure

How does Functional Medicine heal depression?

Recent literature demonstrates that depression is a multifactorial syndrome, co-morbid with many chronic diseases, by virtue of common biological mechanisms. There's a bidirectional connection between depression and chronic medical disorders. The negative health risk behaviors and psychobiological changes associated with depression increase the risk for chronic medical disorders, and biological changes and complications related to chronic medical disorders may precipitate depressive episodes. Comorbid depression is associated with increased medical symptom burden, functional impairment, medical expenses, inadequate adherence to self-care regimens, and increased risk of morbidity and mortality in patients with chronic medical ailments.

See: Health benefits of yoga

Depression may worsen the course of health disorders due to its impact on pro-inflammatory factors, hypothalamic-pituitary axis, autonomic nervous system, and metabolic variables, as well as being associated with a greater risk of obesity, sedentary lifestyle, smoking, and poor adherence to medical regimens. Both evidence-based psychotherapies and antidepressant drugs are efficacious treatments for depression. Collaborative depression care was shown to be an efficient means to deliver these treatments to large main care populations with depression and chronic medical conditions.

 The functional medicine approach in treating depression and anxiety is very simple, where you just need to identify the cause and eliminate or balance those things in order to regain good health conditions. A person may be facing a lot of problems like dietary intolerance or allergies, nutritional deficiencies, abnormalities of the gut microbiome, toxicity, and disturbance in the body’s neuroendocrine and immune systems. Functional medicine for depression constitutes a variety of disciplines that can help patients go back to the source of the depression. It focuses on diagnosing the problems or imbalances and addressing these with focused nutritional support and supplements. 

Functional medicine approaches include everything from diet and exercise to mental conditioning and lifestyle changes.  Some of the functional medicine approaches for depression are listed below:

a. Regulate your cortisol levels

Growing evidence indicates that there is an intermediate link between stress exposure and depressive symptoms, where stress can cause increased circulating levels of hormones such as adrenocorticotropic hormone (ACTH) and cortisol/corticosterone which are considered to be the important biomarkers of the stress response.

Increased levels of cortisol, in turn, activate various neurotransmitters and neuropeptides, as well as novel immune and inflammatory mediators, which exert their effects on the multiple aspects of brain function such as survival of neurons, neurogenesis, and emotional events. It's important to combat your stress and regulate your cortisol levels by getting enough sleep, exercising regularly, eating a healthy diet, taking occasional vacations or regular breaks from work and finding a relaxing hobby.

 See: How to lower high cortisol levels naturally

b. Consume a healthy diet

Good food can cause the release of hormones in the body. Optimum Nutrition levels maintained through your diet can activate various hormones, neurotransmitters and signaling pathways in the gut which help modulate brain functions like sleep, appetite, cognitive function, energy intake, neurogenesis, and mood. Foods like refined food, sweetened beverages, fried food, processed meat, and high fat intake, have been shown to be associated with an increased risk of depression. 

Consuming an anti-inflammatory diet that is nutrient-dense, like a whole food diet, and nourishing your gut by probiotics and prebiotics are considered as practices of healthy eating. Apart from this, maintaining a healthy lifestyle can be an effective remedy for depressive symptoms which include exercise, sleeping for at least 8 hours, early morning walk, yoga, and meditation.  

 

 c. Supplement your body with essential nutrients

Numerous researches conducted in the past years support the use of nutritional supplements for the prevention of depressive symptoms in healthy subjects. They have the ability to reduce depressive symptoms by altering brain chemistry in a milder way with fewer side effects. They can also be used either alone or in combination with conventional treatment. Some of the essential supplements and its functions are described below:

- Omega-3 fatty acids

 Ω-3 fatty acid supplements that are found to be rich in EPA and DHA when taken in adequate amounts can favor the fluidity of cell membranes; promote the correct functioning of neurotransmission by regulating various cellular pathways like promoting the calcium flow through the calcium channels. Evidence-based studies also indicate that a supplement with ω-3 and ω-6 can act as an antidepressant treatment because it inhibits the secretion of proinflammatory cytokines, resulting in decreased levels of cortisol by the adrenal gland, which is known to be associated with mood changes. Good sources of  Ω-3 and Ω-6 fatty acids include Flax seeds and fish liver oil.

- Group B vitamins

 Group B vitamins like folic acid, vitamin B12, and B6 deficiency can be related to depressive symptoms. Research has shown that folic acid plays an important role in the synthesis of various neurotransmitters in the CNS like serotonin, dopamine, and norepinephrine which plays an important role in mood regulation. Furthermore, patients with depressive symptoms are found to respond minimally to the antidepressant treatment due to low levels of folates and have a greater likelihood of relapse. 

Group B vitamin supplements and L-methyl folate is recommended as an antidepressant therapy in patients with depression.

- Tryptophan

Tryptophan and tyrosine are two important amino acids that play an important role in regulating mood and emotions. Tryptophan is an essential amino acid that is known to be an important precursor in the synthesis of neurotransmitters like serotonin, dopamine, epinephrine, and norepinephrine respectively. According to the monoamine hypothesis of depression, the depletion of tryptophan and other amino acids like tyrosine, phenylalanine could lead to the insufficient synthesis of neurotransmitters which ultimately results in a depressive mood state.

Spinach, seeds, nuts, salmon, green leafy vegetables are good sources of tryptophan that can help boost levels of serotonin in the body.

- Magnesium

 Magnesium acts as a cofactor in multiple enzymatic reactions and a significant decrease in magnesium blood levels can cause depression. Magnesium is involved in regulating the cardiovascular,  osteoarticular, endocrine, and nervous systems functioning. Magnesium helps attenuate neuronal damage by participating in the oxidative and nitrosative stress and scavenging those free radicals that lead to neuronal cell damage.

Sources of Magnesium –  Whole wheat, spinach, nuts, seeds, quinoa, avocado, black beans.

- Zinc

Zinc influences brain homeostasis, causing alterations in the learning processes and behavior especially in regards to mental health and depressive states. Zinc deficiency can affect cell survival and increases the levels of lipid peroxidation in depressed patients when compared to healthy ones.

Source- Meat, legumes, seeds, nuts, dairy, eggs, whole grains.

- Chromium

Research has shown that chromium plays a crucial role in the synthesis of serotonin, norepinephrine, and melatonin. All of which are essential in promoting mood and antagonizing depressive symptoms. 

Source-  vegetables such as broccoli, green beans, and potatoes, Whole-grain products, meat, fruits, milk, and dairy products.

- Prebiotics and probiotics

Consumption of probiotics and prebiotics is known to influence the development of neurotransmitters in brain systems and modulate affective and stress-related disorders. It directly influences intestinal microbiota and results in lowering the cortisol levels at awakening and improved attention to positive stimuli in an emotional recognition task.

 

See: Why Magnesium is important for your diet

Studies in Functional Medicine for Depression

Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers.[4]

 

The study included forty-five healthy volunteers who were studied to understand the effects of Prebiotics in reducing the waking cortisol levels and emotional bias. The volunteers were randomly divided into three groups where each group included 15 individuals. The first group received prebiotic treatment fructooligosaccharides and the second group was treated with Bimuno®-galactooligosaccharides while the third group received placebo treatment with maltodextrin daily. The duration of the treatment was for 3 weeks. 

The results showed significantly lower levels of salivary cortisol awakening response and decreased attentional vigilance after B-GOS intake compared with the placebo group. However, No effects were found after the administration of FOS.

See: How To Lower High Cortisol Levels Naturally

Summary

There is increasing evidence about the role of functional medicine in promoting mental health. Functional medicine that focuses on adequate intake of nutrients contributes to better overall health and mental health in particular. Major depression is a severe mental illness with a high prevalence for which effective treatments exist but not in all cases the patient’s remission is achieved.  Whereas, functional medicine increasingly aims at optimizing the supply of nutrients necessary for adequate brain functioning as adjunctive therapy to antidepressant treatment in depressive disorders. 


See: Potential of Disease Prevention with Panchakarma Therapy

References

1.https://www.upmc.com/-/media/upmc/services/integrative-medicine/documents/upmc-cim-newsletter-winter-2019.pdf?la=en&hash=615E724422EE0C3E15663B1E01F04E84E1855283

2.        Lang U.E.a · Beglinger C.b · Schweinfurth N.a · Walter M.a · Borgwardt S.a. Nutritional Aspects of Depression.

3.       Mónica Martínez-Cengotitabengoa1,2,3 Ana González-Pinto. Nutritional supplements in depressive disorders.

4.      Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers.

5. Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci. 2011;13(1):7–23.

6. Milaneschi Y, Simmons WK, van Rossum EFC, Penninx BW, Mol Psychiatry. Depression and obesity: evidence of shared biological mechanisms., 2019 Jan;24(1):18-33. doi: 10.1038/s41380-018-0017-5. Epub 2018 Feb 16.

7. IFM, https://www.ifm.org/functional-medicine/what-is-functional-medicine/


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