Beyond Medication: Effective Natural Relief for Depression & Anxiety
By Jigsaw Health’s Research and Writing Staff
An estimated 60 million Americans suffer from an anxiety disorder or a depressive disorder, and in some cases both.
We live at a frenzied pace, work long hours, eat unhealthy food, breathe environmental pollutants, and deal with financial and family pressures much more than we did in previous generations. So it’s not hard to understand why so many are affected and no surprise that the use of prescription antidepressants has skyrocketed.
Fortunately, expensive prescription medications — and their potentially harmful side-effects — are not the only way to combat feelings of depression or anxiety. Though it’s unlikely you will ever hear that from your doctor.
What is Anxiety Disorder?
Anxiety is a normal reaction to stress. It helps us deal with a tense situation in the office, study harder for an exam, or keep focused on an important speech. In general, it helps us cope and is perfectly natural. But when anxiety becomes an excessive, irrational dread of everyday situations, it becomes a disabling disorder.
Anxiety disorders, according to the National Institute for Mental Health (NIMH), are the most common forms of mental illness. These disorders include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder, and phobias. And while both sexes are equally affected by OCD and social phobia, women are more prone to generalized anxiety and panic disorders.
What is Depressive Disorder?
A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.
Both stress and depression can impact your health in other, more serious ways including eating disorders, obesity, diabetes, heart disease, hypertension, sexual disorders, osteoporosis, weakened immune system, and sleep disorders.
Conventional Methods of Treatment
Total sales of pharmaceuticals that treat depression and anxiety are in the billions of dollars. Antidepressants — like Zoloft®, Paxil®, and Prozac® — may provide immediate relief, particularly for more severe forms of depression. But antidepressants also carry some potentially serious side effects. Long-term use is controversial and withdrawing from them can be as difficult as the disorder itself.
A Holistic Approach to Combating Depression and Anxiety
Recovering from depression and anxiety requires an integrated approach including dietary and lifestyle changes. Using pharmaceuticals, as prescribed by your doctor, to ease your symptoms is a personal choice and may be very useful in severe cases. However, rarely do conventional medications address or solve the root cause of the problem, they only ease the symptoms.
Ask yourself, whose best interest is served when you are told to rely on a continuous prescription of expensive pharmaceutical drugs? A thriving industry that spends billions of dollars each year wooing doctors? Or you, one of the millions of suffering people forced to fill the pockets of the pharmaceutical companies with your hard earned money, just to feel better?
A much better solution is to find the root of the problem and work to regain your mental and emotional well-being.
The Role of Serotonin
Serotonin is a neurotransmitter that regulates multiple functions of the central nervous system including anger, aggression, mood, sleep, sexuality, and appetite. Low levels of serotonin have been associated with several disorders, namely increases in aggressive and angry behaviors, clinical depression, obsessive-compulsive disorder (OCD), migraines, irritable bowel syndrome, tinnitus, fibromyalgia, bipolar disorder, and anxiety disorders.
Maintaining Healthy Levels of Serotonin
The food you eat has the potential to temporarily raise or lower your serotonin levels. That’s why the ingredients of a meal can have an impact on the way you feel after you eat it. To understand this relationship you need to know a little more about an amino acid called tryptophan (pronounced trip-toe-fan).
Your body can’t make serotonin without the help of tryptophan. If you were to eat pure tryptophan, it would be absorbed into the blood stream through the digestive tract, metabolize into a form (5-HTP) that would allow it to cross the blood-brain barrier, flow into the brain, and stimulate the production of serotonin.
Unfortunately, eating foods with tryptophan does not significantly increase serotonin levels. Here’s why: Tryptophan requires the use of a transport molecule to cross the blood-brain barrier. Unfortunately, several other amino acids “compete” for this same transport molecule. The presence of these competing amino acids (tyrosine, phenylalanine, valine, leucine and isoleucine) can, and do, inhibit the transportation of tryptophan into your brain. According to some estimates, as little as one percent of the tryptophan in your diet actually crosses the blood-brain barrier.
How Can 5-HTP Supplements Help Depression & Anxiety?
5-Hydroxytryptophan (5-HTP) is a metabolite of tryptophan that naturally increases production of serotonin in your body. Unlike tryptophan, which competes with other amino acids to get to the brain, 5-HTP is absorbed directly into the brain. In other words, you get all the great benefits of tryptophan that are associated with increasing your serotonin levels but with far smaller and more effective doses.
5-HTP is found in trace amounts within some foods, such as, turkey and cheese. However, it is most commonly sold as an over-the-counter therapeutic supplement, which is typically derived from the seeds of the Griffonia simplicifolia, a West African medicinal plant. However, because 5-HTP has a very short life-span in the body, a sustained release 5-HTP formula greatly increases absorption, and usually reduces the necessary dose per day.
5-HTP performs much like the antidepressants often prescribed for generalized forms of depression and anxiety, yet without the potentially harmful and unpleasant side-effects. It may help you to manage stress more effectively, improve your quality of sleep, overcome depression and anxiety, maintain mental and emotional well-being and even lose weight. It can be used alone or, in some cases, as a supplement to a pharmaceutical regimen.
Warning: Always check with your doctor prior to taking 5-HTP in combination with any SSRI antidepressant drugs.
The Scientific Research Supporting 5-HTP
5-HTP, a naturally occurring substance that converts to and raises serotonin levels, has been closely studied as a potential treatment for depression and anxiety.
- A 6-week study found equal benefit between using 300 mg of 5-HTP per day vs. 150 mg per day of fluvoxamine, a common antidepressant in the Prozac family. But 5-HTP caused fewer and less severe side effects than the drug.4
- In a review of two separate trials, researchers determined that both 5-HTP and tryptophan were more effective than placebo for alleviating depression, although the evidence was not conclusive.5
- Another research review concluded that neurotransmitter precursors, such as 5-HTP, can be helpful in patients with mild or moderate depression.6
- A Maastricht University study found that 5-HTP significantly reduced the reaction to the panic challenge in panic disorder patients by regulating serotonin levels.7
Clearly, 5-HTP can affect serotonin levels and may improve symptoms of anxiety and depression.
Other Nutritional Options for Anxiety and Depression
1. Essential fatty acids (EFAs). Of the omega-3 EFAs, eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) have been extensively studied for use in mental wellness. In fact, a University of Alaska study found that changing the omega-3 EFA-rich diet of native peoples to more processed foods and Western dietary habits not only increased the rate of cardiovascular disease, obesity, and diabetes, but resulted in an increase in depression and anxiety.24 And a Harvard Medical School study showed that a combination of EPA and DHA helped improve symptoms of bipolar disorder.25
But EPA and DHA each has its own link to mental wellness. A research review concluded that geographic areas with high DHA consumption showed decreased rates of depression, indicating that using DHA to treat minor depression should be considered.26
Similarly, EPA can positively impact depression. In one study, patients with persistent depression—who were taking a standard antidepressant along with EPA—showed significant improvement in depressive symptoms.27 Another study found that EPA was superior to a placebo in diminishing aggression as well as the severity of depressive symptoms in patients with borderline personality disorder.28
2. L-Theanine. Known for its calming effects is an amino acid commonly found in green tea. However, since just 1-2% of the dry weight of tea leaves contains theanine, it’s extremely difficult and time-consuming — not to mention expensive — to extract it from tea leaves particularly without losing purity. Fortunately, a patented enzymatic process known as Suntheanine® helps synthesize 100% pure L-theanine.
Suntheanine goes directly to the brain where it helps promote relaxation, ease restlessness, and reduce the anxiety that comes with stress and fatigue. And its effects are immediate, often within 30-40 minutes of taking it.
3. Melatonin. A pineal hormone that regulates the circadian rhythm, melatonin may be closely linked to mood. After all, melatonin is normally released in higher amounts at night and lower amounts in the morning to coincide with the sleep-wake cycle. Changes in this pattern have been found in those with seasonal affective disorder (SAD), bulimia, schizophrenia, panic disorder, and OCD.16
In patients with major depression, successful treatment with antidepressants also included melatonin, and in women with bulimia or neuralgia in addition to fibromyalgia, melatonin replacement reduced pain, sleeping disorders and depression.17
Other researchers have found that melatonin may help reduce anxiety.18,19
4. B vitamins. The B vitamins have been the subject of a number of studies because B-vitamin deficiencies can sometimes mimic symptoms of depression and anxiety.
- For example, pyroxidine (vitamin B-6) helps convert tryptophan to serotonin and a deficiency in this important vitamin can result in lowered levels of serotonin.
- Similarly, cobalamin (vitamin B-12) deficiency may also be linked to depression and mood disorders. Duke University researchers found that bereaved men who were cobalamin deficient reported increased overall levels of distress, depression, anxiety, and confusion.20 And in research done by the National Institute on Aging, elderly patients with cobalamin deficiency are two times more likely to be severely depressed than non-deficient patients.21
- Folate (vitamin B-9) levels have also been shown to be low in depressed individuals. A Cochrane Database System review of trials involving folate and antidepressants concluded that folate may be useful in supplementing other treatments for depression.22
- And inositol, which affects cell membrane health and nerve transmission, may help ease anxiety. Researchers have found 18g per day reduced the number of panic attacks just as well as the use of the pharmaceutical fluvoxamine.23
5. L-Tryptophan. One of the essential amino acids, L-tryptophan is an earlier precursor to serotonin. Unlike 5-HTP, tryptophan is available in diet through protein foods (turkey being the most notable of these). However, it must first be converted to 5-HTP, which is then converted to serotonin. While 70% of 5-HTP actually gets converted to serotonin, that number drops off drastically for tryptophan: just 5% is converted to serotonin. However, some people find benefits in using both. In some cases, L-tryptophan can provide more effective support for the insomnia related to depression and anxiety when taken at bedtime.
6. Minerals. Deficiencies in chromium and selenium may produce symptoms of depression and anxiety which can be eased by replenishing them.
- Chromium has been found to improve depressive symptoms in those with atypical depression where low serotonin levels may be linked to insulin sensitivity.29,30
- And a recent research review concluded that selenium deficiency may adversely affect psychological conditions because of its role in thyroid function. Patients who showed a combination of depression, hypothyroidism, and increased susceptibility to viral infections may be at risk for selenium deficiency.31
7. Magnesium. Depression and anxiety are both known to be among the many symptoms of magnesium deficiency, something which experts estimate that 2 out of 3 Americans have. So clearly, magnesium is a very important nutrient to remember when trying to alleviate depression and anxiety. Inadequate brain magnesium appears to reduce serotonin levels, and several studies have shown that supplementing with magnesium can be effective in relieving both depression and anxiety, either on its own or in combination with other treatments.
In A Nutshell…
While pharmaceutical therapies may be necessary to treat more serious and clinically-diagnosed mental health issues, most people will find that a healthy diet, exercise, and a high quality supplement regimen will improve symptoms of anxiety and depression. Plus, with these alternatives, you may be able to avoid the need for pharmaceutical therapies altogether, which can have serious side effects and long-term use issues.
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- Cohen JH, et al. “Psychological distress is associated with unhealthful dietary practices.” J Am Diet Assoc, 102(5):699-703, 2002. www.eatright.org/journal
- Rodriguez-Jimenez J, Rodriguez JR, Gonzalez MJ. “Indicators of anxiety and depression in subjects with different kinds of diet: vegetarians and omnivores.” Bol Asoc Med PR, 90(4-6):58-68, 1998
- Poldinger W, Calanchini B, Schwarz W. “A functional-dimensional approach to depression: Serotonin deficiency as a target syndrome in a comparison of 5-hydroxytryptophan and fluvoxamine.” Psychopathology, 24:53–81, 1991.
- Shaw K, Turner J, Del Mar C. “Tryptophan and 5-hydroxytryptophan for depression.” Cochane Database System Review, 1:CD003198, 2002. www.cochrane.org
- Meyers S. “Use of neurotransmitter precursors for treatment of depression.” Alternative Medicine Review, 5(1):64-71, 2000. www.thorne.com/altmedrev
- Schuers K, et al. “Acute L-5-hydroxytryptophan administration inhibits carbon dioxide induced panic in panic disorder patients.” Psychiatry Res, 113( 3):237-243, 2002. www.sciencedirect.com/science/journal/09254927
- Caruso I, Sarzi Puttini P, Cazzola M, et al. “Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome.” J Int Med Res, 18:201–209, 1990.
- Titus F, Davalos A, Alom J, et al. “5-hydroxytryptophan versus methysergide in the prophylaxis of migraine.” Randomized clinical trial. Eur Neurol, 25:327–329, 1986.
- Bono G, Criscuoli M, Martignoni E, et al. “Serotonin precursors in migraine prophylaxis.” Adv Neuro, 33:357–363, 1982.
- Ribeiro CAF. “L-5-Hydroxytryptophan in the prophylaxis of chronic tension-type headache: a double-blind, randomized, placebo-controlled study.” Headache, 40:451-456, 2000.
- Ceci F, Cangiano C, Cairella M, et al. “The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects.” J Neural Transm, 76:109–117, 1989.
- Cangiano C, Ceci F, Cascino A, et al. “Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan.” Am J Clin Nutr, 56:863–867, 1992.
- Cangiano C, Ceci F, Cairella M, et al. “Effects of 5-Hydroxytryptophan on eating behavior and adherence to dietary prescriptions in obese adult subjects.” Adv Exp Med Biol, 294:591–593, 1991.
- Cangiano C, Laviano A, Del Ben M, et al. “Effects of oral 5-hydroxy-tryptophan on energy intake and macronutrient selection in non-insulin dependent diabetic patients.” Int J Obes Relat Metab Disord, 22:648–654, 1998.
- Pacchierotti C, et al. “Melatonin in psychiatric disorders: a review on the melatonin involvement in psychiatry.” Front Neuroendocrinol, 22(1):18-32, 2001.
- Rohr UD, Herold J. “Melatonin deficiencies in women.” Maturitas, 41(Suppl 1):85-104, 2002.
- Raghavendra V, Kaur G, Kulkarni SK. “Anti-depressant action of melatonin in chronic forced swimming-induced behavioral despair in mice, role of peripheral benzodiazepine receptor modulation.” Eur Neuropsychopharmacol, 10(6):473-481, 2000. www.sciencedirect.com
- Naca F, Carta G. “Melatonin reduces anxiety induced by lipopolysaccharide in the rat.” Neurosci Lett, 307(1):57-60, 2001. www.elsevier.com
- Baldewicz TT, et al. “Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(-) homosexual men.” J Psychsom Res, 48(2):177-185, 2000.
- Penninx BW, et al. “Vitamin B12 deficiency and depression in physically disabled older women: epidemiologic evidence from the Women’s Health and Aging Study.” Am J Psychiatry, 157(5):715-721, 2000.
- Taylor MJ, et al. “Folate for depressive disorders.” Cochrane Database Syst Rev, 2:CD003390, 2003.
- Palatnik A, et al. “Double blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder.” J Clin Psychopharmacol, 21(3):335-339, 2001.
- McGrath-Hanna K, et al. “Diet and mental health in the Arctic: is diet an important risk factor for mental health in circumpolar people?—a review.” Int J Circumpolar Health, 62(3):228-241, 2003.
- Stoll AL, et al. “Omega-3 fatty acids and bipolar disorders: a review.” Prostaglandins Leukot Essent Fatty Acids, 60:329-337, 1999.
- Mischoulon D, Fava M. “Docosahexanoic acid and omega-3 fatty acids in depression.” Psychiatr Clin North Am, 23(4):785-794, 2000.
- Peet M, Horrobin DF. “A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs.” Arch Gen Psychiatry, 59(10):913-919, 2002.
- Zanarini MC, Frankenburg FR. “Omega-3 fatty acid treatment of women with borderline personality disorder: a double blind, placebo-controlled pilot study.” Am J Psychiatry, 160(1):167-169, 2003.
- McLeod MN, et al. “Chromium potentiation of antidepressant pharmacotheraphy for dysthymic disorder in 5 patients.” J Clin Psychiatry, 60(4):237-240, 1999.