Recommended Lifestyle and Supplement Protocol for Mild Depression
Always make sure you have the basics covered: good dietary habits; regular exercise; rejuvenating sleep; alcohol, caffeine and tobacco avoided or in moderation. Taking a very complete six-a-day multivitamin/mineral is essential. Men over 40 should consider human growth hormone (hgh) secretagogues and testosterone precursors, as these hormones tend to restore a more youthful, confident, and optimistic state of mind. Women over 40 may want to enhance natural progesterone (not synthetic progestins), especially if their symptoms are premenstrual. Progesterone is a natural antidepressant. Women at or past the "change of life" should consider hgh and natural triple estrogen plus progesterone replacement therapy. Estrogen is thought to be very protective of the mind, so unless there is strong breast cancer concern or risk, or other estrogen contraindications (liver/gall bladder disease, phlebitis, cervical precancerous lesions etc.), natural HRT (hormone replacement therapy) should be strongly considered.
The other basic is deep sleep. Exercise, avoiding caffeine after noon, dark rooms, white noise, cool bedrooms and hot baths are all helpful. The herbs valerian, passion flower and kava kava, hops, and the minerals calcium and magnesium are indicated for adults of any age. It may take two weeks for the effects to be noticed by some. Melatonin is more indicated the more above 40 you are. Also, night workers, those travelling across time zones, and women with hot flashes, often do well with melatonin. Salivary "sleep profile" melatonin tests are now readily available. 5-HTP is the other great natural sleep inducer. It is also an antidepressant, anti-anxiolytic, and tends to curb carbohydrate and chocolate craves. Therefore, if your depression is strongly related to poor and difficult sleep, 5-HTP is to be strongly considered. 5-HTP is presented more fully below.
Please keep in mind that many common prescription medications cause tiredness, loss of libido and flattening of emotions. So always consult your doctor.
If you have been following the above recommendations for several months and still feel in low spirits, supplementation specific for mood elevation is likely indicated. How to Start Your Mood
How to Start Your Mood Wellness Program
The following nutritional and herbal supplements have proved very useful for easing and preventing mild-to-moderate depression. Some of these supplements aid in the production of neurotransmitters (low levels of these chemicals in the brain have been linked to depression). Other supplements have a soothing effect on nerves. Others protect the brain from the damage of stress.
Most people struggling with depression, even those on prescription anti-depressants, can benefit from the nutrients listed here. Supplements like gingko biloba, St. John's wort and 5-HTP can be added to a high quality mega-multi-vitamin/mineral, but should not be used without your doctor's consent if you are taking an antidepressant medication. Most importantly, never stop taking an antidepressant or any other prescription drug without first talking to your doctor.
If indicated, consider the following supplements to support your mood. However, severe depression, or moderate depression that is worsening rapidly, demands immediate professional attention.
Before starting, be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and you're taking medications. Always advise your health care provider about all your supplemental choices.
Finding exactly the right combination of supplements that work best for you may take some time and a bit of trial and error. And your choices may well be determined by time and money. It will be worth the trouble, however, if you can avoid taking more potent prescription medications.
Over 50
If you're over age 50, starting with an hgh secretagogue, a mega-multi vitamin/mineral and gingko biloba. Gingko biloba improves circulation to the aging brain, lifting mood and protecting the memory. Ginkgo extract improves the brain's use of oxygen and enhances neurotransmitter activity, the chemicals that enable brain and nervous system functions. Ginkgo improves memory, enhances mental alertness, and also increases mental energy. It is being recommended to treat tinnitis; dizziness; cataracts; macular degeneration; diabetic neuropathy; senility; Alzheimer's disease; and depression. Gingko is an antioxidant and a natural anti-stroke blood thinner containing PAF, platelet anti-aggregation factor. Indeed it should not be taken with other blood thinners without your prescribing doctor's OK. Also, let your doctor and dentist know before any surgeries!
Gingko also increases circulation to the extremities. As such, it is used for intermittent claudicating and Raynaud's disease. Ginkgo is specific for erectile dysfunction if the cause is vascular, as it most commonly is. Interestingly, Gingko appears to be even more sexually stimulating to women than men. Ginkgo extract has been found to be 84 percent effective in treating sexual dysfunction due to depression. Ginkgo also is effective in enhancing all four phases of sexual arousal.
Gingko should always be standardized, containing at least 24% glycosides and 6% terpenes.
Gingko is usually taken at 60 mg twice a day, though more stubborn or advanced problems call for 120 mg twice a day. Generally, ginkgo is considered safe for long-term use in recommended dosages, but higher doses (above 240 mg a day) can lead to intoxication or disorientation.
In rare cases, ginkgo may cause headache, irritability, restlessness, diarrhea, headache, nausea, vomiting, dizziness, or vertigo. These effects are usually mild and transient.
After three to five weeks, re-assess your feelings. If you are doing well, continue. If not, then try St. John's wort fortified with folic acid and B-12 and/or 5-HTP instead of gingko biloba, as explained below.
Serotonin Enhancers
Much depression is related to dysregulation of the neurotransmitter serotonin. This major brain messenger provides feelings of competence, calmness, satiation and satisfaction. Many common anti-depressant drugs, such as MOA inhibitors and SSRIs, are designed to increase serotonin. Mono-amine oxide inhibitors inhibit an enzyme that breaks down serotonin. Selective serotonin re-uptake inhibitors prevent serotonin from being re-absorbed thus again increasing brain levels. Eating carbohydrates can raise serotonin, which explains many a late night raid of the refrigerator and cookie jar. St. John's wort and 5-HTP are two natural products that increase serotonin levels as well, and with much fewer side effects.
If gingko was not successful or you are under 50, a good place to start (and the most economical one) is by using a mega-multi vitamin/mineral (iron free) and standardized St. John's wort fortified with extra folic acid and B-12. Extra folic acid and B12 are the precursors (building blocks) to SAMe (S-adenosylmethionine), a new but very expensive natural mood elevator from Europe. They are often deficient, especially in the geriatric population. Take one tablet, containing 450 mg of standardized St. John's wort fortified with B9 and B12, morning and night.
Men over 40 and women at or past the "change-of-life" may add an hgh enhancer and sex hormones as explained above. Understand, however, that you have to be patient with St. John's wort, because it does take three to five weeks for the maximum effect of this herbal plus vitamin formula to be felt.
If you need something that takes effect more rapidly and can handle the extra expense, you can choose 5-HTP. 5-HTP is particularly indicated in those with low mood combined with poor quality sleep and carbohydrate and sweet cravings. Start with 50 mg early a.m. and late p.m. For some people, 5-HTP's mild tranquilizing effect is not desirable during the day. A viable alternative is to take St John's wort in the day and one 5-HTP at night. Some people may need up to 100 mg of 5 HTP three times a day to get the desired effect.
After three to five weeks, again re-assess your feelings.
If you are still not having success, or your depression is related to large amounts of anxiety causing stress, worry and tension, and especially if marked by failing memory, consider the combination of phosphatidylserine, DHEA and pregnenolone. These products are nootropics (smart nutrients), which improve learning and memory, reduce fatty deposits in aging nerve cells (lipofuscin), and even support nerve and memory regeneration while relieving stress caused depression. An Adrenal Stress Index (ASI) is a salivary hormone test that will pin point the supplementation protocol that is best for the stage of stress you are suffering.
John Maher,DC,ABAAHP
San Diego, California
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