The Neuro-Protective Lifestyle

Depression can be difficult to treat.

Even with the most effective medications, a sixty percent response rate is considered exceptional. Worse yet for most people, continued treatment revolves around minimizing side-effects rather than aggressively addressing the circumstances that allowed the depression to develop in the first place.

To confound matters even more, recent studies suggest that for moderately depressed patients, new-generation anti-depressant medications function primarily as a placebo and clinically significant medication effects are reserved for only the most severely depressed.

Like most physicians, I have watched select patients benefit from SSRI and dopaminergic-type medications and marveled at their relatively rapid onset and ease of use. And, like most physicians, I’ve watched as patients gain weight, develop sexual side-effects and after prolonged drug therapy become less engaged and more dispassionate about life in general.

They are no longer sad — but they’re not happy either.

Now, recent studies in neuropsychopharmacology and nutritional neuroscience may help restore the chemical and informational imbalance that characterizes the current approach to anti-depressant therapy.

For example, from the Journal of Neuropsychopharmacology, scientists reveal how DHEA levels in the mesolimbic system of the brain up-regulate GABA receptors resulting in a pronounced anti-anxiety and anti-depressant effect.

In another study researchers at Boston University School of Medicine (BUSM) discovered that practicing yoga, in addition to it’s behavioral benefits is capable of elevating GABA (gamma aminobutyric acid) levels in the brain.

GABA is the brain’s primary inhibitory neurotransmitter and is thought to be the final common pathway for most anti-depressant, sedative and anesthetic-type medications. The GABA neurotransmitter system possesses the ability to counterbalance the action of excitatory neurotransmitters contributing to an overall calming effect. If yoga is just not your thing, GABA is available in capsule form without a prescription and the recommended dosage is 600-700 mg, 1-2 per day.

Nutritional neuroscience has also peered into the “mood-stabilizing” properties of omega-3 fatty acids. Epidemiological studies have confirmed that, the lower the intake of omega-3 fatty acids in a given population, the higher the incidence of major depressive disorders. The exact mechanism behind the mood stabilizing properties of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is unknown. Their effectiveness however, remains unquestioned. The recommended dosage is approximately 1.5 to 2 grams of EPA per day and less is more in this case since larger amounts have not been shown to be any more effective.

Not surprisingly, other nutritional deficiencies have been linked to depression, including folic acid and magnesium. Randomized, controlled trials have been conducted confirming the benefit of B12 and folic acid supplementation in the treatment of depression. While not as powerful, case studies in which patients received magnesium (glycinate or taurate) supplementation resulted in rapid resolution of major depression.

To sum it up - - if you “suddenly” find yourself on the Paxil, Prozac or Zoloft super-highway, remember you didn’t get there suddenly. This is the perfect time to introduce stress-management skills such as yoga to your daily routine. Ask your doctor about adding omega-3 fatty acid supplementation especially if you have a triglyceride disorder. DHEA is generally safe but may increase hormone levels if you are already taking estrogen or testosterone.

Finally, consider giving magnesium a try. Use it at bedtime for its sleep-inducing “side-effect” and wake up to a brighter day!

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