A Functional Medicine Approach to Depression
Major depressive disorder affects approximately 17.3 million American adults, or about 7.1% of the U.S. population age 18 and older, in a given year. (National Institute of Mental Health “Major Depression”, 2017) , and even more will experience depressive moods, low energy and lack of motivation. Depression is extremely common, especially in climates where winters are long and dark (like Ohio!). The lack of vitamin d, limited time in nature, and social isolation plays a role. A life with depression can feel hopeless, and leave us with very little energy to work, take care of our families, or ourselves. I am going to show you that there is hope and much we can do to affect our moods in a positive way, so let’s get started!
Functional medicine treats the root cause – not just the symptoms. From a functional perspective, depression is viewed as a symptom, not a diagnosis. Your traditional doctor may diagnose you with depression and then reach for a prescription medication, but that’s not the end of the line. We need to go one step further into looking for the cause of the depression.
Depression is traditionally treated with medications like SSRIs (Selective serotonin reuptake inhibitors- paxil, prozac, lexapro, celexa etc), but medication is not fixing the root cause and is often accompanied by significant side effects. Although medication is often helpful for a bit and can be lifesaving, we also want to address the root cause and allow the mood to improve naturally.
Some of the main root causes of depression include: gut imbalances, poor diet, vitamin deficiencies, toxins, sleep disturbances, trauma, media, and disconnection from nature and others. Let’s go through these factors and how we address them from a functional medicine perspective.
Gut Imbalance. By now, a lot of us have heard that the gut is our “second brain.” About 90% of our serotonin is produced in the gut. If you recall, common antidepressants target our serotonin, so you know it’s a key player! Our “happy” neurotransmitters, like serotonin, need a balanced gut to be properly balanced. These chemical messengers are responsible for happiness, wellbeing, cognition, memory and mood, all of which fend off feelings of depression.
When there is an overgrowth of certain types of bacteria, or not enough of certain types, these imbalances take a toll on our physical and mental health. Also, if your gut is inflamed it’s hard to absorb all the amino acids we need to make neurotransmitters. Amino acids come from the protein that you eat and are the building blocks of serotonin and other neurotransmitters. So in short – happy gut, happy mind! There are many things that influence gut health, including stress, diet, deficiencies, food allergies, sleep, the list goes on.
To start, try adding fermented foods to add good bacteria, prebiotics to fuel the good bacteria, and lower your intake of sugary foods – bad bacteria and yeast love to eat sugar! Inflammation in our gut = inflammation in our brain = depression.
Diet. The food we eat has a direct impact on the way our bodies function, how genes are expressed, and how we feel day after day. Diet is one of the most powerful tools not only for treating depression, but improving our health across the board.
I like to follow an 80/20 rule. 80% of the time, you aim to eat healthy, whole foods (preferably cooked at home!). Focusing on getting a wide variety of fruits and vegetables, with healthy fats and protein included in each meal. The other 20% of the time, you can be more flexible! This allows us to go out to eat, have our favorite snacks, and have dessert occasionally without feeling guilty.
Foods that are heavily processed are highly inflammatory. And as I said above, inflammation can affect the brain and directly cause depression. If you are struggling with depression, avoiding highly processed foods, fast foods and sugar will help you out. Can you swap out a sugary protein bar for a homemade protein smoothie? Or swap out soda for green tea? Little changes throughout the day make a huge impact over time.
Vitamin Deficiencies. Despite our best efforts, gaps in our diet exist. Lacking key nutrients can worsen or even trigger depression. Unfortunately, the typical American diet doesn’t fill all of the nutritional needs we have, and supplementation is often necessary for optimal health.
Vitamin D and magnesium are two that a majority of Americans are found to be deficient in, and both are important for hundreds of processes in the body. I always recommend that adults living in Ohio supplement their vitamin D, especially in the winter.
Other key nutrients for mood include B vitamins and Omega 3s. Lower levels of both have been correlated with higher levels of depression.
If you’d like to know more about the supplements I suggest for the average adult, you can visit here.
Toxins. Toxins are in our food, in our water, and in the air we breathe. These toxins have been shown to directly damage our receptors for neurotransmitters in our brain. So even if you have enough serotonin, it can’t do its thing. Limiting toxins is a difficult task, but lifestyle changes can help. Replacing household cleaning products and personal care products are a great place to start. I always recommend downloading the EWG Healthy Living App, which rates products by their sustainability and toxicity. Laundry detergent, makeup, skin care, shampoo, soap, and cleaning products can all contain harsh chemicals. Try to replace one product at a time, opting for a cleaner version approved by the EWG.
If you’re interested in detoxification, I have a whole online course about it you can view here.
Sleep Disturbances & Circadian Rhythm. Our bodies follow a biological clock that regulates processes like sleep, metabolism, and energy. (if you’d like to read more in depth about this, check out my blog on circadian rhythms here.) When our circadian rhythm is off, we aren’t getting quality sleep and likely feel like our energy is off. Our bodies love rhythm and predictability. Disruptions in our natural rhythm are disruptive to our mood, and can lead to depression.
Sleep is the cheapest medicine there is, so prioritize it! Many of us stay up late into the night staring at a device and ignoring our body’s need for sleep. I suggest aiming for 8–9 hours of quality sleep per night, with plenty of wind down time before bed. And trying to maintain an approximate bedtime and wake time each day without varying by more than 30 minutes, will help your body know when sleep is coming and make the most of it!
Trauma and Disconnection. Humans are social creatures, meant to interact, collaborate, and connect with each other. The events of the past 3 years have left us more isolated than ever. We have never been so connected, yet disconnected at the same time. We are connected to people on social media or information coming to us through the news, but disconnected from personal interaction and connection with those in our family or community. We are longing for true connection.
It’s nearly impossible to hold yourself accountable, make positive and healthy decisions, and support yourself if you don’t have people supporting you. Trauma and isolation can feel like a weight, holding you back from the health you deserve. Even if you are doing everything you can on your diet, sleep, and exercise, these factors can leave you stagnant.
If you’re feeling isolated or alone, consider seeking a counselor or joining a group. Starting an exercise class, picking up a new hobby, or joining an art class are all ways we can meet and connect with others. Wellness cannot be achieved completely alone! We offer a wonderful community for connection in the Wild Collective. You can find more information here.
Also, many people grew up in an unsafe environment or have past trauma and are carrying the trauma of that in their body. If you are carrying the unprocessed trauma of your past, you deserve some support to process this and allow your body to heal. I strongly encourage you to find a trained counselor or therapist to guide you on this journey. You can start by reaching out to your primary care physician for a referral or call your insurance company to see who is covered.
Going about your regular life with depression can be very difficult, and if you’re struggling right now – know there is hope! Depression can be treated from many angles, and seeking help demonstrates care for yourself. I hope this list provides you with a starting point. If you or anyone you know is struggling with depression, help is out there. If you’re looking to be treated with a more holistic approach, reach out to us and schedule a free 15 minute discovery call.