Depression varies in severity from light to harsh. There can be momentary episodes of unhappiness or continual depression in a person. Clinical-depression is the term for major and continual kind of depression. It is also known as major depressive disorder.

Clinical Depression Symptoms

The common symptoms of clinical depression are:

Minimal interest in ordinary everyday activities
Loss of interest in activities that one used to take pleasure in formerly
Prolonged feelings of misery
Trouble in concentrating
Tiredness and fatigue
Inability to sleep or sleep related disorders

How Long Does It Last?

If it is left untreated, clinical depression will probably last for several months. It very well could last even up to 1 year. Throughout depression, the sufferer will feel as if this problem may not go away. Great news is that in a lot of cases it could go away even by itself.

Nevertheless, we also need to try and come out of our clinical-depression by engaging in healthy habits. If we isolate our-selves, avoid company of others, do not keep ourselves engaged in constructive work then we might not be able to come out of depression so effortlessly.

Physical exercise, meeting people and keeping your mind occupied are a few of the key steps you can take to treat clinical depression.

How to Treat Depression

First of all you ought to gain a good understanding of precisely what is depression. When you know the nature of the beast you are dealing with, it becomes simpler. Next, you have to make some considerable efforts to tackle depression.

Control your sleep patterns. Go to bed early at night and get out of bed early in the morning. Try to get up prior to 8 AM in the mornings and go to sleep by 10 or 11 PM at night.

Have regular sleep timings. You may find it difficult in the beginning, yet carry on with this. In due time it should become a habit. Right after waking up, go outside for a short time in order to expose yourself to the early morning sunshine and breathe fresh air.

Take steps to keep your brain occupied. An empty mind is a devil’s workshop and it will continue going over problems and depressing emotions. Participate in some productive work.

Lastly mingle with people. Have fun and revel in the company of others. Do not keep to yourself. You may wish to remain alone when depressed, but overcome this urge.

Try meditation, relaxation exercises or other such mind-calming techniques. Invest 10-20 minutes daily in these pursuits which help you cope better with stress and negative emotions.

What Exactly is Clinical Depression? Depression varies in severity from light to harsh. There can be momentary episodes of unhappiness or continual depression in a person. Clinical-depression is the term for major and continual kind of depression. It is also known as major depressive disorder. Clinical Depression Symptoms The common symptoms of clinical depression are: Minimal interest in ordinary everyday activities Loss of interest in activities that one used to take pleasure in formerly Prolonged feelings of misery Trouble in concentrating Tiredness and fatigue Inability to sleep or sleep related disorders How Long Does It Last? If it is left untreated, clinical depression will probably last for several months. It very well could last even up to 1 year. Throughout depression, the sufferer will feel as if this problem may not go away. Great news is that in a lot of cases it could go away even by itself. Nevertheless, we also need to try and come out of our clinical-depression by engaging in healthy habits. If we isolate our-selves, avoid company of others, do not keep ourselves engaged in constructive work then we might not be able to come out of depression so effortlessly. Physical exercise, meeting people and keeping your mind occupied are a few of the key steps you can take to treat clinical depression. How to Treat Depression First of all you ought to gain a good understanding of precisely what is depression. When you know the nature of the beast you are dealing with, it becomes simpler. Next, you have to make some considerable efforts to tackle depression. Control your sleep patterns. Go to bed early at night and get out of bed early in the morning. Try to get up prior to 8 AM in the mornings and go to sleep by 10 or 11 PM at night. Have regular sleep timings. You may find it difficult in the beginning, yet carry on with this. In due time it should become a habit. Right after waking up, go outside for a short time in order to expose yourself to the early morning sunshine and breathe fresh air. Take steps to keep your brain occupied. An empty mind is a devil’s workshop and it will continue going over problems and depressing emotions. Participate in some productive work. Lastly mingle with people. Have fun and revel in the company of others. Do not keep to yourself. You may wish to remain alone when depressed, but overcome this urge. Try meditation, relaxation exercises or other such mind-calming techniques. Invest 10-20 minutes daily in these pursuits which help you cope better with stress and negative emotions.

Moodgym – www.moodgym.anu.edu.au ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ More information www.beyondblue.org.au http www.mentalhealth.org.uk http www.sph.umich.edu www.who.int ~~~~~~~~~~~~~~~~~~~~~~~~~ 24-hr Counselling services in Australia: Lifeline – www.lifeline.org.au 13 11 14 Kids Help Line – http 1800 55 1800 (won’t show up on phone bills from landline telephone calls) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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Gather the information about the depression symptoms according to the type of depression of an individual.

People suffering with depression and anxiety feel that they are in danger or bad things will happen to them or to their close ones. They become paranoid and live in constant fear. They develop negative thinking.

Apart from some of these common depression symptoms people suffering from depression can have dry mouth, fatigues and faint. Many a times they shiver, have a fast heart beat, muscle aces, sweat and usually have cold and moist hands.

People suffering with major depression could show up some of these types of depression symptoms such as low energy, low mood and also loss their interest in their favorite activities. They have trouble in sleeping like they can wake up early in the morning or wake up in night repeatedly. You can also observe that people suffering with major depression start feeling guilty, loss confidence and self-esteem. It is hard for them to concentrate on their work and therefore their performance drops. They think about suicide or can attempt to do so.

Bipolar depression is another type of depression which could be defined as mood swing and fluctuation in mood of a person. Bipolar depression has two phases one is manic and other one is depressive disorder. Both of these phases have different symptoms. Each one have its own symptoms and signs such as a person suffering from manic can show symptoms like he has increased energy, becomes aggressive and irritable, speaks faster than he used to, have increased sexual drive, restlessness, unable to stick to decisions and lose self-confidence.

Just as people suffering with depressive disorder have a feeling of hopeless and worthlessness, they either have over sleep or can face problems in sleep. They even become physically ill and lose interest in activities. They can even attempt suicide.

Most of the time women get depressed in pregnancy which is known as postpartum depression. It extends after depression also may be for a year after delivery. You can observe the depression symptoms like they lack in energy, loses appetite, a sudden increase or decrease in weight, continuous crying and anxiety and a lot of mood swing can also be noticed. They become paranoid about themselves and baby feeling someone will harm their baby or something bad will happen.

These are the depression symptoms according to the depression types in adults.

If you notice some of these symptoms in you, then you need a doctor or psychiatrist. They will help you to understand the situation and improve your thinking and behavior with the help of medication, psychotherapies, antidepressants, depression natural remedy and acupuncture.

Exercise and Depression Help

Exercise will likely produce results more quickly than any other treatment option. Physical activity naturally releases endorphins, or mood-altering chemicals, into the brain; and this causes a heightened feeling of well-being. It’s arguably the easiest non-medical way to escape the “funk” that is a hallmark of depression. Running, walking, weightlifting, cycling, or playing sports are all good ways to exercise the body and improve one’s mood.

Yoga and Depression Help

This activity combines some of the mood-altering effects of physical activity with breathing and relaxation techniques. It is especially helpful for people who are unable to engage in traditional exercise due to physical or spatial limitations. Not only does yoga stretch the muscles of the body, but it also helps to relax and renew the mind and spirit, which can help stave off feelings of hopelessness and negativity associated with depression.

Relaxation Techniques and Depression Help

Relaxation can help beat back the anxiety and irritability that often accompanies depression. Some relaxation techniques are as simple as breathing exercises and visualization training. Scheduling regular massages can help relieve tension that builds up inside the body over time. Even acupuncture has been shown to have a positive effect on people suffering from depression.

Stress Management and Depression Help

Since many types of depression are caused or fueled by stress, it’s important to learn techniques to manage that stress. Some of these methods include breathing exercises, altering routines, or confronting outstanding issues. Identifying and addressing stress triggers can go a long way toward effective depression management. In other words, removing the stressors helps get rid of depression.

Sleep and Depression Help

It’s something everyone does, but many people don’t do it enough. When people suffer from a lack of sleep, their moods deteriorate — which can make it harder to fight off depression. Getting the right amount of sleep (eight to ten hours a night, depending on a person’s age) is more than just going to bed earlier. It’s also making sure the bedroom is quiet and dark, the air temperature is suitable, and the slumber is uninterrupted. Proper sleep helps shield a person from depression’s dark urges.

Healthy Lifestyle and Depression Help

A healthy body and a healthy mind go hand in hand. This can be achieved by eating a well-balanced diet, getting the right amounts of vitamins and other nutrients, staying away from fatty and sugary snacks, and avoiding caffeine. Eliminating smoking, drug abuse, and alcohol consumption can also have a significant effect on a body’s health. These and other obstacles spawned by unhealthy lifestyle choices can impede the recovery process in a depressed individual.

Therapy and Depression Help

Though it requires more of a time commitment, therapy is one of the most effective ways to manage almost all kinds of depression. Psychologists, psychiatrists, and counselors are trained to help people express their feelings, explore their troublesome thoughts and responses, and change their self-destructive behavior. A therapist can also teach patients coping skills and cognitive strategies so they can arm themselves in the battle against depression. These tools can be useful long after a therapy regimen has been completed.

Support and Depression Help

Depressed people are often tempted to reject invitations and outreach from others, but getting support can be a key component of mitigating the condition. Whether the support is formal (as in a group therapy session or online chat room) or informal (as with family, friends, co-workers, or church members), social interaction and the encouragement that comes with it, can be an excellent source of external reinforcement during times when depression may feel too tough to overcome. The hardest part for the depression sufferer may be to ask for the support he or she needs.

If these depression treatments are not obtaining the desired outcomes, medication may be another option. Physicians can dispense a number of different antidepressants that have achieved impressive results in staving off depression. Remember that medication alone is not typically considered an effective method of depression management. It’s important to work with a doctor to find a sustainable, holistic approach.

Whatever path is chosen, keep in mind that you may not see results immediately. A trial and error process may be needed to determine a specific combination that works best. With this in mind, depression sufferers must remain patient and stay the course on their treatment plan. The biggest thing to keep in mind is that depression is not the “default state” of mankind, even though it may feel that way sometimes. People who are depressed can and do get better — and they become stronger individuals because of it.

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Hyla Cass, M.D.

Postpartum depression (PPD) Postpartum Anxiety (PPA) have become a national epidemic in the United States, affecting 15%-20% of all new mothers, or about 600,000-800,000 women annually. (1) It is now estimated that over 30 million Americans are on antidepressant or anti-anxiety medications. (2) The majority of this 30 million are women who have one or more children. The chance of suffering from PPD increases with each successive child. (3)

The most common medical treatment for postpartum depression is SSRI (selective serotonin reuptake inhibitors) antidepressant drugs. Postpartum Anxiety Disorder is most commonly treated by the benzodiazepine family of drugs like Valium, Ativan, Xanax, and Klonopin. Combination reuptake inhibitors for both serotonin and norepinephrine (SNRIs) are also commonly used in postpartum depression. In the case of postpartum psychosis, antipsychotic drugs are used and are immediately necessary. Many women are now given samples of SSRIs as they are leaving the maternity ward. Most medical sources believe that PPD is caused by an imbalance of brain chemistry and that pharmaceutical intervention is the treatment of choice. While a certain percentage of women suffering from PPD do need pharmaceutical assistance, these are far fewer than are actually receiving them. Recent Meta-studies show this to be true.  While it is clear that some women with PPD do need and benefit from pharmaceutical intervention, it is our experience that an integrative approach yields the best results.

Postpartum Anxiety Disorder is mostly treated

The most common Postpartum Depression symptoms  include the following:

1. Persistent feelings of despair and/or anxiety;
2. Loss of energy and low levels of daily functioning;
3. Sleep and eating disturbances;
4. Inability to focus, concentrate or make decisions;
5. Feelings of worthlessness, shame and guilt;
6. Feelings of indifference and/or resentment towards the baby;
7. Intrusive negative thoughts and/or obsessive worries–in the most serious cases, this includes thoughts of harming oneself or the baby;
8. Reduced sex drive;
9. Loss of joy and appreciation for life;
10. Irritability or excessive anger.

The literature generally outlines several types of postpartum disorders that have special features beyond the typical symptoms of depression. These include:

1. Postpartum Anxiety Disorder (PPA). Here, the primary symptoms are excessive nervousness, hyper-vigilance, racing thoughts and in some cases outright panic. Panic attacks are especially frightening–sufferers often believe they are dying, as they experience shortness of breath, dizziness and a pounding chest.

2. Postpartum Obsessive-Compulsive Disorder. Most often, this takes the form of obsessive thoughts or worries about the baby and may be accompanied by compulsive behaviors such as constantly checking if the baby is breathing, constantly washing to protect the baby from germs, etc. The most disturbing type of obsessive thoughts are those in which the mother envisions harming her baby in some way. These thoughts are unwanted, intrusive and terrifying to the mother. It is important to emphasize that, except in extremely rare instance of psychosis (see below), these thoughts are not accompanied by any actions. Nonetheless, the mother may be so frightened by her own thoughts that she avoids the baby and consequently neglects her. It is terribly difficult for new mothers to acknowledge having such thoughts, and as a result, many suffer in isolation.

3. Post-traumatic Stress Disorder. PTSD can occur in response to a real or perceived traumatic childbirth or because of unresolved past trauma–sometimes sexual in nature–triggered during childbirth. A woman who experiences PTSD is likely to have recurring, memories, dreams or even flashbacks of the traumatic labor/birth. She will be hyper-vigilant and startle easily, and will likely suffer from sleeplessness, irritability, poor concentration and apathy. Women who have experienced a particularly traumatic childbirth often show symptoms of both PTSD and PPD.

4. Postpartum Psychosis. This is the most extreme and rarest of all postpartum disorders. When it occurs, the mother loses touch with reality and her symptoms may include extreme disorientation (e.g., not knowing who she is), delusional or paranoid thinking, and visual or auditory hallucinations. The few, tragic cases where mothers have harmed their children while in a psychotic state have received enormous media attention. As a result, many people inaccurately associate PPD with psychotic symptoms and dangerous behavior. This constitutes yet another reason why women fail to get help–they want to avoid being labeled with such a stigmatized disorder.

Article Premise: Fully Replenishing a New Mother’s Postpartum Nutritional Reserves Has Been Largely Ignored and Should  be An Integral Part of Treating Postpartum Depression.

Foundations of A Nutritional Approach to PPD
The human body is entirely formed from nutrients. Every muscle, organ, gland, bone, cell, and fluid is composed entirely of nutrients (environmental toxins notwithstanding). All of the neurotransmitters, hormones, biochemical structures, and metabolic pathways are formed from nutrients.

No other normal physiological process uses up and drains more vital nutrients from a postnatal woman’s body than the process of being pregnant, giving birth, and caring for a new infant which may include breastfeeding. The fact that a mother’s body donates all the nutrients required to form her baby’s body is too often overlooked when it comes to the medical treatment of PPD. Not only does the placenta literally rob the mother’s body of all the key nutrients required to make a baby’s body, but the placenta itself is formed from nutrients taken from the mother’s body. This is the main reason that many postpartum women become nutritional drained and this nutrient depletion syndrome can lead to postpartum depression and anxiety disorder.

Other factors that may contribute to a drain of a new mother’s nutrient reserves are loss of blood during the birth process, sleep deprivation, breastfeeding, returning to work too soon, and the immense extra energy required to take care of a new infant with intense needs. If a pregnant woman’s or new mother’s nutrient reserves are too low, she is much more vulnerable to experiencing PPD and PPA because all of the body’s normal metabolic processes are entirely dependent upon nutrients. The preponderance of extremely poor quality pharmaceutical prenatal vitamins significantly adds to the tendency of nutrient depletion.

Rarely is there is any mention that the body’s production of neurotransmitters is completely dependent upon their nutritional precursors. (4) Nor are the causes of these nutritional precursor deficiencies discussed. Additionally, the interdependent relationship between hormones and neurotransmitters is rarely taken into consideration by most physicians when considering treatment for PPD and PPA. The nutritional requirements of mitochondrial function, the importance of liver function from Western and Eastern perspectives, and some individual nutrients like Omega 3 fish oils, pharmaGABA, L-theanine, SAMe, inositol, magnesium, and the herb St. John’s Wort can also be of great assistance in treating PPD and PPA. These will be briefly discussed.

An integrative approach to treating PPD may include nutritional therapies, bio-identical hormone replacement, moderate exercise, a nutrient dense diet, proper rest, psychological counseling/support, stress reduction techniques, elimination of caffeine, alcohol and other addictive drugs, and if needed, pharmaceutical intervention.

Neurotransmitter Nutritional Precursors

Serotonin and Tryptophan

The amino acid L-Tryptophan is required for the body to produce serotonin. Ninety-five percent of the serotonin in the human body is produced in the intestinal tract. Approximately five percent is produced in the brain. The serotonin produced in the intestinal tract is unavailable to the brain because serotonin cannot pass through the blood- brain barrier. L-Tryptophan also does not easily pass through the blood-brain barrier and requires a carrier protein to ferry it into the brain. The consumption of simple sugars changes brain neuron cell membrane amino acid selectivity, allowing tryptophan to enter the brain more easily. Hence, the craving of sweets is often a sign of serotonin deficiency.

Serotonin has been referred to as the brain’s mood elevating and tranquilizing chemical. Inadequate serotonin levels are linked with depression, anxiety, insomnia, irritability, and weight gain. Serotonin mediated depression usually contains an element of anxiety. Serotonin is considered an inhibitory neurotransmitter. Its functions include:

- Inhibiting Glutamate excitability over diverse regions of the CNS
-Stimulating its own receptors on GABA neurons prompting GABA to perform its inhibitory function
- Inhibiting the release of the Catecholamines: Dopamine, Norepinephrine, and Epinephrine.

A comparison of the effects of optimal serotonin levels to low serotonin levels to reveals the following contrasts:

1) Hopeful/optimistic—————-Depressed
2) Calm—————————Anxious
3) Good-natured——————–Irritable
4) Patient————————–Impatient
5) Reflective/ thoughtful————–Impulsive/Reactive
6) Loving /Caring——————–Abusive
7) Able to concentrate—————-Short attention span
Creative/focused——————Blocked/scattered
9) Moderate carbohydrate intake——–Excessive carbohydrate intake
10) Good sleep and dream recall——–Insomnia and poor dream recall

Tryptophan is converted to its metabolite, 5- Hydroxy-Tryptophan (5-HTP) which is then converted to serotonin. Niacin, iron, and folic acid are required for L-Tryptophan to be converted into 5-HTP. The body also requires pyridoxal-5-phosphate along with 5-HTP in order to produce serotonin. Magnesium and riboflavin (B2) are required for the conversion of pyridoxine (B6) into pyridoxal-5-phosphate. Deficiencies in any of these nutrients can limit the production of serotonin. Numerous double-blind studies have shown 5-HTP to be as effective as antidepressant drugs with fewer and milder side effects and most times better tolerated. (5-11)

From Martin Hintz, M.D. –Neuro Research

 A number of significant factors contribute to low L-Tryptophan levels in many people, especially postpartum women whose bodies are providing the proteins needed to form another human body, these include excessive levels of cortisol, epinephrine, norepinephrine, and dopamine. The ratio of L-tryptophan to other amino acids available in most foods is quite low.

An overabundance of the adrenal gland hormone cortisol (a very common occurrence in stressful psychological and physiologic states) adversely affects serotonin production and sensitivity in four different ways:

1. Excess cortisol significantly decreases the number of serotonin (5-HT1A) receptor sites. (12)
2. Excess cortisol suppresses serotonin receptors. (13, 14)
3. Excess cortisol increases serotonin reuptake. (15)
4. Excess cortisol, causes tryptophan oxygenase (TO) to metabolize tryptophan into kynurenine, leaving less tryptophan to become serotonin. (15,16)

If cortisol levels are too low in the amygdala, serotonin no longer has an Inhibitory effect on Glutamatergic activity, suggesting that cortisol plays a key role in maintaining Serotonergic-mediated modulation. (16,17) This may be another factor involving insomnia in PPD.

Added to the reasons that serotonin deficiencies are growing more common and contributing to PPD is a stress-related overabundance of the catecholamines. Epinephrine, norepinephrine, and dopamine also deplete serotonin because the inhibitory monoamine neurotransmitter serotonin is supposed to balance these three excitatory monoamine neurotransmitters. The more stress a person experiences, the more the body increases the production of the catecholamines in an attempt to respond to this stress. This requires a postpartum body to produce even more serotonin – though deficiencies in nutrient precursors may interfere with its production.

The use of 5-HTP as a nutritional precursor to serotonin has significant advantages over tryptophan. 5-HTP easily passes directly through the blood-brain barrier without the need for a carrier protein, allowing for an easier conversion into serotonin in the brain. Sublingual forms of 5-HTP work more quickly. Dosage varies from 25 mg per day to 300 mg per day or more.

A deficiency of vitamin B6 (pyridoxine), which is required for serotonin synthesis, is often found in premenopausal female patients with depression. (18) Replacing B6 in cases of deficiency is an important aspect of PPD treatment that may enhance serotonin production in the brain. (19) The use of the vitamin B6 metabolite, pyridoxal-5-phosphate, instead of B6 is suggested especially when magnesium and/or riboflavin deficiencies are suspected or confirmed. There is some controversy whether it is best to supplement 5-HTP and pyridoxal-5-phosphate together or take them separately, adhering to a two-hour wait period. Our clinical experience indicates that it fine to supplement them together. Many products including a combination of 5-HTP and P-5-P are available.

Some controversy exists regarding the simultaneous use of SSRIs and serotonin nutritional precursors. The pharmaceutical companies seem adamant about avoiding this and often mention the possibility of Serotonin Syndrome, a dangerous condition generally brought about by combining serotonin enhancing medications, especially MAO inhibitors, with medications, herbs, or nutritional precursors that also enhance serotonin activity. Symptoms of serotonin syndrome may include nausea, headache, agitation, diaphoresis, hypertension, tachycardia, and hyperthermia that can go over 104 F. This appears a remote possibility at best when just using 5-HTP or using 5-HTP in combination with one SSRI medication. (20)

SSRIs appear to not only keep serotonin in the neuron synapses longer by inhibiting reuptake, but also by pulling the nutritional precursors for serotonin from the storage vesicles and reuptake ports. In fact, in our clinical experience, many women with PPD do better when taking 5-HTP and P-5-P along with their SSRIs than taking SSRIs alone. Serotonin precursor deficiencies may be the reason that SSRIs don’t work for some, work and then stop working for others, and why it is not unusual for a woman with PPD to have been prescribed two or more different SSRIs over time. The SSRIs do not give a net increase of serotonin so they need enough available serotonin in order to have enough to re-uptake.

Dr. Dean Raffelock- catacholamine chart

The catecholamines are predominantly energizing and mood elevating when produced at appropriate levels. Synthesis of the catecholamines occurs in the CNS, adrenal medulla, and peripheral sympathetic neurons. Norepinephrine and dopamine act primarily as neurotransmitters in the CNS. Epinephrine acts primarily as an adrenal hormone to mobilize energy.

The catecholamines influence most organ systems. When levels are excessive they are catabolic and can lead to the body metabolizing its own nerve, muscle and bone tissue. Low levels can lead to depression, fatigue, and weight gain.

Dopamine: Dopamine is the catecholamine precursor for norepinephrine and is found both in the CNS and adrenal medulla. Its functions include motor function and posture, cognitive function (attention, focus, working memory and problem solving), and pleasure sensations. Dopamine can act either as an inhibitory or excitatory neurotransmitter in response to incoming afferent signals.

Norepinephrine (noradrenaline): CNS norepinephrine mediates mood regulation, drive, ambition, learning and memory, alertness, arousal and focus. Clinically, there is often an inverse relationship between norepinephrine (excitatory) and serotonin (inhibitory). When serotonin is low, norephinephrine may be over-upregulated, resulting in “fight or flight” responses leading to anxiety and/or panic attacks. Over-expression of CNS norepinephrine is clinically associated with anxiety, aggression, irritability, mania or bipolar disease, immune suppression, and hypertension; low norepinephrine is associated with atypical depression, with symptoms of fatigue, hypersomnia, hyperphagia, lethargy and apathy.
(21,22)

Epinephrine (adrenaline): Epinephrine synthesis is dependent upon norepinephrine being converted into epinephrine by methylation.
Hans Selye (1974) described the three phase s of the “General Adaptation Syndrome” to stress (23):

Phase I: Alarm reaction: high epinephrine/high cortisol

Phase II: Resistance: high cortisol/low DHEA, variable epinephrine

Phase III: Exhaustion: depletion of cortisol, epinephrine and DHEA
Adrenal exhaustion is a major factor in depression related to chronic or severe stress.

A woman suffering from PPD should be closely questioned about her symptoms; SSRIs are routinely given to women who have functional hypoadrenia involving the adrenal cortex and/or medulla, or low thyroid function (discussed below). Low glucocorticoid and/or catecholamine levels can cause the symptoms of fatigue, malaise, and depression. (24,25)

Many women with PPD require pharmaceuticals and/or nutriceuticals that address deficiencies in both serotonin and the catecholamines. Nutritional therapies for catecholamine balance include:

§ DL-phenylalanine and L-tyrosine, the amino acid precursors for epinephrine, norepinephrine, and dopamine. DL-phenylalanine also helps to increase endorphins, which are mood-elevating. Many PP women diagnosed with bipolar disorder will respond well to high dose DL-phenylalanine therapy (26), along with serotonin precursors and high-dose (6 grams per day) omega-3 fatty acids in the form of fish oils. (27)

§ L-cysteine, sulfur, iron, and folate, required for conversion of L-tyrosine into L-dopa.

§ Pyridoxal-5-phosphate, required for the conversion of L-dopa into dopamine. Copper and vitamin C are required to convert dopamine into norepinephrine. Pridoxal-5-phosphate, B12, and folic acid are required to convert norepinephrine into epinephrine.

Gamma-Aminobutyric Acid (GABA)

GABA is the most important and widespread inhibitory neurotransmitter in the brain. Low levels of GABA are particularly important to look for when anxiety and insomnia are included in the symptom display of PPD/PPA. GABA is essential for balancing excitatory neurotransmitters and hormones such as cortisol, epinephrine, norepinephrine, and glutamate. Too much excitation without adequate GABA inhibition can lead to: (28)

- Insomnia
- Restlessness
- Irritability
- Anxiety
- Panic Attacks
- Seizures

GABA’s job clinically is to induce relaxation, calmness and aid sleep. Where there are glutamate receptors (powerful excitatory neurons), there will be GABA receptors nearby. GABA allows only the most important excitatory signals to pass by and dampens or quenches extraneous excitatory signals when GABA levels are adequate.

Benzodiazapines (Valium, Klonopin, Zanax, Ativan, etc.) and sleep pharmaceuticals like Ambien and Sonata work on GABA receptors, as does moderate alcohol consumption. L-theanine, lactium (milk peptides), L- glutamine, taurine, and bio-identical progesterone can act as nutraceutical/hormonal GABA agonists. The drug Gabatril is a GABA re-uptake inhibitor as is Valerian extract. A newer nutriceutical product called pharmaGABA seems to yield more effective results than synthetic GABA.

From a Chinese Medicine perspective, serotonin and GABA would be Yin (relaxing, harmonizing, cooling, nurturing, moisturizing, inhibitory) and the catecholamines would be Yang (energizing, mobilizing, warming, excitatory, drying). From both Eastern and Western perspectives, it is important to balance these opposing groups of brain chemicals to obtain balance. A woman with PPD who now has more energy but can’t sleep is just as unhappy as a woman who now can sleep but who is even more lethargic than before treatment.

Balancing neurotransmitters is key. Balancing neurotransmitters and hormones is clinically even more effective.

Hormone-Neurotransmitter Interactions

The relationship between neurotransmitters and hormones in PPD is often overlooked. Neurotransmitters and neuropeptides are required in order to mediate hypothalamic production of releasing hormones, enabling the pituitary gland to properly conduct the hormonal orchestra. The hypothalamus is considered a key part of the mid-brain, the “emotional brain,” so there is little wonder why imbalances in neurotransmitters and hormones can adversely affect emotional states.

Thyroid hormones. The catecholamines and thyroid hormones are closely related in many of their functions. L-tyrosine, along with iodine, is the precursor for thyroglobulin and thyroid hormones T-3 and T-4. A depression with no anxiety, with the predominant symptoms of exhaustion and difficulty stringing multiple positive thoughts together, is most often associated with low adrenal (29) and/or thyroid function (30-32) and generally doesn’t respond well to SSRIs or serotonin nutritional precursor therapy.

It is well known that low thyroid function can cause physiologic depression and fatigue. Giving T3 induces a rise in serotonin, and in animals with hypothyroidism, serotonin synthesis is reduced. (33) T3 appears to desensitize presynaptic Serotonin autoreceptors. (34) Conversely, the diurnal peak of TSH, observed during the physiological circadian rhythm, is serotoninergic dependent. (35)

Thyroid function and serotonin function are interdependent both clinically and bio-chemically. Optimal thyroid function is dependent on optimal serotonin levels. Optimal serotonin balance is dependent on optimal thyroid function. TSH increase is dependent on adequate serotonin stimulation of hypothalamic TRH, allowing TSH to rise. (36) Suppressed TSH currently may more appropriately represent low serotonin states than any real assessment of true thyroid function. The thyroid hormone triiodothyronine (T3) augments and accelerates the effects of antidepressant drugs. Fluoxetine + T3 are better at desensitizing 5-HT hypothalamic autoreceptors than either alone. (37-39)

Estrogen: A growing body of evidence points to estrogen’s importance in serotonergic function. (40) Estrogen inhibits serotonin reuptake. (41,42) Estrogen treatment is shown to selectively enhance serotonin (5-HT1A-mediated) responses in the hippocampus (43,44) Estrogen increased the firing activity of 5-HT (serotonin) neurons in both male and female rats. (45,46) In short, estrogen appears to be nature’s SSRI.

Presently, there is a great deal of controversy regarding estrogen HRT. The HERS study and WHI studies have stirred the controversy without making the important distinction between bio-identical and pharmaceutically altered estrogens; neither is any distinction made between progesterone and progestins. The clinician is encouraged to become very well versed in this area regarding risks versus benefits of HRT. Many women with PPD can benefit from low-dose bio-identical estrogen HRT if indicated and potential benefits outweigh risks.

Progesterone: Bio-identical progesterone has a known anti-depressant/anti-anxiety effect. Throughout pregnancy, the placenta produces copious amounts of progesterone, increasing blood levels to many times pre-pregnancy levels. Post-partum, this supply is suddenly gone, along with its soothing effects on the mother’s nervous system.
Allopregnanolone is synthesized by the reduction of progesterone via the enzymes 5-reductase and 3-hydroxysteroid dehydrogenase (3-HSD). Allopregnanolone is one of the most potent known modulators of GABA receptors. (47,48) Allopregnanolone has behavioral and biochemical characteristics similar to ethanol, barbiturates, and benzodiazepines. (49,50)

Bio-identical progesterone can be very helpful for women with PPD with anxiety and insomnia. Using the  PharmaGABA and bio-identical progesterone simultaneously is often very helpful to relieve anxiety and sleep issues.

DHEA: DHEA increases the firing activity of serotonin neurons. (51) DHEA also increases dopamine and norepinephrine synthesis via mRNA for tyrosine hydroxylase. (52) Because of this, DHEA can be helpful in some forms of PPD. DHEA also inhibits GABA and is therefore a GABA antagonist. (53) Clinically, if the use of DHEA causes insomnia and irritability, most likely the patient is GABA deficient and this should be addressed before continuing to supplement DHEA.

Testosterone: increases serotonergic neuron firing in the raphe area, increasing mood. (54)

Mitochondrial Function

from Metametrix Lab- Ion Panel Booklet

Inefficient mitochondrial function can limit ATP production, lower energy and contribute to or cause physiological depression. More than 90% of all cellular oxygen consumption is used to fuel mitochondrial metabolism. Mitochondria must transfer huge numbers of electrons to produce energy. Mitochondrial dysfunction can affect all organ systems, including neurons and glands.

Dietary fats, carbohydrates , and proteins all need to be converted into acetyl-coenzyme A (acetyl CoA) before entering the Krebs cycle and electron transport chain. The nutritional precursors required for fatty acids, glycerol, and cholesterol to enter the Krebs cycle and generate ATP are riboflavin (B2), L-carnitine, niacin, and biotin. Thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), biotin, and alpha-lipoic acid are required for carbohydrates and proteins to enter the Krebs cycle in the mitochondria.

Within the Krebs cycle, cysteine and iron are needed to convert cis-aconitate to isocitrate. Niacin, magnesium, and manganese are required to convert isocitrate into alpha-ketoglutarate. The amino acids glutamine, histidine, arginine, proline and glycine are needed to form alpha-ketoglutarate. Thiamin, riboflavin, niacin, pantothenic acid, and alpha lipoic acid, are needed to convert alpha-ketoglutarate into succinyl-CoA. The amino acids isoleucine, valine, and methionine are needed to form succinyl-CoA. Magnesium is required to convert succinyl-CoA into succinate. Riboflavin is required to convert succinate into fumarate. The amino acids tyrosine and phenylalanine are needed to form fumarate. Niacin is required to convert malate into oxaloacetate.

All these nutrients are required to produce 36 units of ATP per molecule of acetyl CoA in the Krebs cycle. A significant deficiency of any of these key nutrients can cause mitochondrial dysfunction and contribute to fatigue and depression.

Niacin and coenzyme Q10 are required for oxidative phosphorylation (electron transport chain, or ETC). Normally, the ETC produces another 3 units of ATP in the mitochondria in addition to the Krebs cycle’s 36. A significant deficiency in either of these can also reduce ATP production and contribute to a physiologic depression.

Mitochondrial dysfunction is often overlooked in the treatment of PPD. A study done with postpartum women showed that a comprehensive postnatal nutrient program, including many of the Krebs cycle/oxidative phosphorylation nutrients, relieved many postpartum symptoms including mild to moderate PPD.

Liver Detoxification

NUTRITION: A FUNCTIONAL APPROACH-Jeffrey Bland, Ph.D

For many centuries, Chinese medicine has correlated liver meridian dysfunction with anger, irritability, and depression. From this perspective, suppressed anger often leads to depression. Concepts such as rising liver heat and stagnant liver Qi are used to depict how faulty liver meridian function could dramatically affect emotional states. When the flow of electrons within a meridian is up or down-regulated, the organ dependant upon that meridian will become dis-eased. Many practitioners of Chinese medicine are taught to consider the liver the “seat of the emotional body” because of this strong correlation of liver dysfunction with negative emotions.

In the Orient the term “hot liver” is used to depict someone who has anger issues. The English use the “liverish” to describe one who is irritable. From a Western medicine point of view, most clinicians are aware how an alcoholic’s liver cirrhosis can first cause irritability and eventually depression.

In the past two decades much more information has come to light regarding phase one and phase two liver detoxification pathways. These pathways greatly contribute to the body’s ability to excrete exogenous and endogenous toxic chemicals. Environmental toxin levels (xenobiotics) are ever on the rise and require that the liver play a very important role in their excretion.

Added to this burden of detoxification are the internal production of increased stress hormones and other body chemicals that require excretion. All of these chemicals require that the liver have adequate nutrients to facilitate their excretion.

Phase one liver detoxification consists of oxidation, reduction, or hydrolysis. The cytochrome P450 system mixed function oxidases perform the most important beginning function of detoxifying these exogenous and endogenous toxins. Phase I liver detoxification requires an adequate supply of nutrients, enzymes, and antioxidants. This list includes riboflavin, niacin, pyridoxine, folic acid, cobalamin, glutathione, phospholipids, carotenes, vitamin C, bioflavonoids, flavonoids, vitamin E, selenium, copper, zinc, manganese, CoQ10, and nutrients contained in thiols, pycnogenol, and silymarin.

Phase II liver detoxification consists of conjugation pathways in the hepatocytes. Amino acid conjugation (binding) of toxins requires glycine, taurine, glutamine, ornithine, and arginine. Sulfation requires sulfur-bearing amino acids or elemental sulfur. Sulfation is required to break down and package estrogens, DHEA, thyroxine, cortisol, catecholamines, melatonin, ethyl alcohol, bile acids, tyramine, cholecystekinin, cerebrosides and others. Glucuronidation requires magnesium and B6 to break down estrogens, other steroids, melatonin, and many xenobiotics.

Methylation requires B12, B6, and folic acid to break down and eliminate catecholamines, histamine, and many drugs and xenobiotics. Glutathione conjugation helps to detoxify heavy metals and numerous xenobiotics. Glutathione requires glutamate, glycine, and cysteine or N-acetyl-cysteine plus selenium and vitamin C for its formation. Acetylation, another detoxification pathway, requires B2, B5, molybdenum, and vitamin C in order to do its function.Sulfoxidation transforms toxic sulfite molecules into usable sulfates.

Mothers in the U.S have a high toxic burden that is evidenced by the levels of toxins in mother’s milk. (55) If the liver is too burdened and unable to perform its many tasks of detoxification, this may contribute to PPD.

Omega-3 Fatty Acid Deficiencies and PPD

A deficiency of omega-3 fatty acids has been linked with depression. (56-59) Numerous studies have demonstrated the efficacy of fish oil supplementation in depression. (60,61)

The human brain is 60% fat. The quality of fats that compose neurons significantly influence brain function including moods. A relative deficiency of flexible omega-3 fatty acids compared to the more rigid omega-6, saturated, and cis-trans fatty acids impairs the function of cell membranes and their ability to selectively allow passage of molecules in and out of neurons. The brain is composed of and uses more fatty acids than any other body structure. DHA – referred to by Allport as the “queen of fats” (62) – is responsible for the fastest cellular movements. As the primary structural and cognitive fat of the brain, DHA also affects moods.

A developing fetus’ brain, nerves, eyes, skin, and cellular membranes all require omega-3 oils, especially DHA. The placenta selectively removes omega-3 oils from the mother’s blood stream via the placenta often leaving the mother significantly deficient in these essential oils. (63,64). The recommended dose for omega-3 fish oils when treating PPD is 6-12 grams per day.

Hypericum perforatum (St. John’s Wort):

Over twenty-five double-blind studies have shown the herb St. John’s Wort to produce as good or better results compared to SSRI drugs with significantly fewer side effects. (65-71) In Germany, where hypericum is a prescription drug and covered by insurance, over 20,000,000 take this herb for depression. One of the benefits of taking St. John’s Wort is an increase of serotonin. (72)

SAMe (S-adenosylmethione):

SAMe is a methyl donor in the production of monamines, neurotransmitters, and phospholipids such as phosphatidylserine and phosphatidylcholine. SAMe serves as a precursor for glutathione, coenzyme A, cysteine, taurine, and other essential compounds. SAMe is involved in converting methionine into sulfur and is important in homocysteine metabolism.

When compared with other antidepressants, SAMe tend to work faster and more effectively with virtually no negative side effects. In fact, SAMe has beneficial side effects including improved cognition, slowing of the aging process, improved joint function and less pain, and liver protection. (73)

Normally the brain synthesizes adequate SAMe from the amino acid methionine. Supplementing SAMe in depressed patients increases serotonin and dopamine levels, improves membrane fluidity, and improves the binding of neurotransmitters to receptor sites (74,75). Numerous double-blind studies demonstrate the efficacy of SAMe for depression. (76-78) The suggested dose of SAMe to treat depression ranges from 400-1600 mg a day.

Inositol

Depressed patients have lower brain levels of inositol. (79) Inositol is useful in maintaining healthy serotonin metabolism, and by doing so helps treat many conditions like depression, agoraphobia, panic disorder (80-82), and obsessive compulsive disorder (83).
Research shows that taking 6-12 grams of inositol per day for 4 weeks significantly improves mood and reduces the severity of depression. (84-86) Inositol can be safely used with antidepressant medications. (87)

L-Theanine

L-theanine is known to increase levels of GABA and has an anti-anxiety effect as well as improving cognitive function. (88) L-theanine may also normalize dopamine levels which are often depleted by various stresses. (89) L-theanine significantly reverses glutamate-induced toxicity. (90)

Integrating High Quality, High Potency Prenatal and Postnatal Nutrient Systems into Preventing and Treating Postpartum Depression and Anxiety 

Clinically it is imperative that higher quality, higher potency, more comprehensive prenatal an postnatal nutrient systems be utilized in the treatment and prevention of postpartum depression. It is common knowledge in many 3rd world countries that the postpartum recovery period is 24 months because this is the amount of time women are told to wait between pregnancies to replenish their bodies and avoid many postnatal health problems. These women have more community and extended family support too which significantly reduces the incidence of PPD.

Most prenatal vitamin supplements are inadequate to fully supply developing baby and mother with the potency and quality of nutrients required to fuel pregnancy and the postpartum periods. These are highly nutrient dependent process.
A randomized, double-blind, placebo-controlled clinical trial done on a comprehensive postnatal nutrient program called After Baby Boost showed excellent results, improving 14 common postpartum symptoms including postpartum depression, anxiety, insomnia and mood swings. Parameters measured were breast tenderness, concentration, cramping, depression, dizziness, fatigue, headaches, insomnia, irritability, joint inflammation and pain, mood swings, nervousness, palpitations, sweating, temperature changes (hot or cold), vaginal dryness, and water retention.

After Baby Boost contains high-potency vitamins and minerals including CoQ10, alpha lipoic acid, 2 grams of fish oils with 3 antioxidants to prevent rancidity, and nighttime minerals (calcium and magnesium citrate). The placebo used was a leading prenatal vitamin.

After Baby Boost significantly outperformed the prenatal vitamin in all 14 symptom categories, indicating that most postpartum women require more comprehensive, higher potency nutrient replenishment than prenatal vitamins provide. (91)

Obstetricians rarely stress the importance of a high-quality, nutrient dense diet. Nor do they prescribe high quality prenatal vitamins.  Women are often told, “you are eating for two now, so eat whatever you want.” In actuality, only 300 extra calories are needed per day during pregnancy. It is important that these be nutrient-dense calories. Unrestricted eating of carbohydrates contributes to obesity and can contribute to metabolic diseases including physiologic depression and even, diabetes of pregnancy.

Integrative PPD Treatment

It is hoped that the reader becomes more aware of this simple concept: A baby’s body is entirely composed of the nutrients donated by its mother’s body. Because all physiologic processes and chemicals (neurotransmitters, hormones, metabolic pathways, etc.) are nutrient dependent, nutritional deficiencies can often be the fundamental cause of PPD. While antidepressant drugs are necessary for some, the longer-term solution often requires a well-thought-out integrative approach that includes (1) replenishing nutritional reserves through dietary supplements,(2) psychotherapy and/or  childbirth/PTSD therapies such as EMDR, (3)adequate sleep (often very difficult with a new infant), (4) moderate exercise, (5) deep belly breathing/meditation, (6) community support, (6) a nutrient dense diet, and (7) drug therapy when necessary

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Post Partum takes front stage for January
EDMONTON – Postpartum depression will be front and centre this week at the Willowby Community League Hall on the west end of Edmonton, where a seminar will be held to provide information regarding the disorder.
Read more on Spruce Grove Examiner

Overview: Depression causes feelings of sadness, loss and anger that can interfere with everyday life. It affects up to 16 million Americans. Anxiety disorders are also rather common. In this interview, we learn the latest treatments for depression and anxiety disorders, such as panic attacks, phobias and obsessive-compulsive disorder. Part One: Symptoms of depression Medications such as anti-depressants Role of therapy for depression Relapse risk factors Seasonal Affective Disorder and treatments Part Two: Anxiety Panic Attacks Phobias, including common phobias Phobias with anxiety attacks Treatments for anxiety and phobias Obsessive compulsive disorder Guest: Dr. Hinda Dubin, psychiatrist at the University of Maryland Medical Center and a clinical assistant professor of psychiatry at the University of Maryland School of Medicine. Links: Depression and Anxiety Disorders (Part 1) www.youtube.com Depression and Anxiety Disorders (Part 2) www.youtube.com University of Maryland Department of Psychiatry www.umm.edu Dr. Hinda Dubin www.umm.edu

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Anxiety and depression are the two most common emotions that plague people, causing emotional distress and feelings of inferiority, loneliness, and despair. Help is available for these people in pain—help from God, from His Word, and from the experience of gifted men and women who seek to lead people to wholeness. Readers will readily identify with licensed family counselor Bob Phillips as he provides descriptions of the potentially debilitating effects of these difficult emotions. He reveals the root causes of anxiety and depression, which are fear and anger, and he helps readers acknowledge and deal with these driving forces in an effective, godly way. He includes a gentle and helpful presentation of spiritual issues and the gospel that will benefit believers and nonbelievers alike. This hands–on, user–friendly approach is written with the lay person in mind and includes plenty of practical and effective self–help exercises that readers can use to find freedom. Chri

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Thanks for watching. This video was made to talk about the symptoms I’ve experienced with anxiety and panic disorder. I encourage everyone to make a video talking about your own experiences, and we can share them. I’ve created a new website www.curedbyfaith.com, where I plan to document my path to getting my life back. If you’d like to have your video or story featured there, register on the site. It’s free. Have faith in yourself. We’re gonna get through this. Note to add I’ve gotten better …

Everybody fears something, the only difference is that some people are aware of it and others are not. And while many people share specific fears with majority of the population, there are still a few whose fears are exhibited by marginalized community. This is phobia and while some people regard it as a disorder, some agree that it is nothing but a psychological flaw in every man’s brain.

Not all phobias are the same. Experts categorizes phobia into different groups. But needless to say what a man’s phobia can simply be another’s man favorite thing. The fact that there are people who will freeze to death and there are some who will grow wild in excitement once they are in heights tells us that there is more to phobias than fears, screams and emotional imbalance.

Phobias know no age. You can be a kid and be afraid of spiders and you can be old and be afraid of the same thing. While it is a fact that children exhibit phobias when they are at the ages of 5 to 9, there are phobias which will only manifest late in adulthood.
Experts explain that phobia is an uncontrollable, intense, irrational and constant fear of something that poses little or no danger at all. And since there are literally hundred different kinds of phobias (new are even being discovered as time goes by) this article will only focus on explaining the most common phobia types.

Medically speaking, phobia is an emotional disorder rather than a psychological disorder. The patient needs a very strong interaction between a series of biological and environmental factors for a phobia to appear. These factors include traumatic experiences, disturbances and unpleasant situations that usually become part of a person’s memory. These memories result into fear.

While this disorder cannot be treated with medicine or operations, there are ways for a person to actually overcome his or her phobia. The most commonly used phobia treatment involves a series of cognitive behavior therapies. Generally termed as psychotherapy, it gradually puts the patient affront his or her fears. The progressive exposure of the patient, as assistant by psychiatrist will allow the patient to develop skills that will later allow him or her to adapt to the said fear – ultimately removing discomfort later on defeating the phobia.

The other type of treatment involves medication. Medicines are prescribed by the doctor to aid the phobic patient to control his or her emotions when facing the cause of his or her phobia.

Psychologists categorizes phobia into three classes.

Social phobia is a generic term describing the intense fear of an individual to be humiliated in a social gatherings and public places. To avoid this humiliation, they fear seeing a group of people or general population. They often left with a few friends or none at all.

The next type of phobia is called agoraphobia – or fear of crowded places. People with this kind of fear will find it hard to stay in public places like parks and other areas where there are a considerable number of people such as malls, stadium and church.

The last kind of phobia called specific phobia refers to fear associated with specific people, situations, animals and environments. Common phobias of this type include fear of flying (aerophobia), fear of heights (acrophobia); fear of dead (necrophobia), fear of spiders (arachnophobia) and many others.

Irene Lock is a well known teacher of Kinesiology, for more information click on:-

Understanding the Problems

Finding the Solutions

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