If getting to the cause of depression and treating depression without medication is something you’re interested in, then you’re in the right place.
Like every kind of disease, depression has a cause, and the cause is not a lack of drugs. I have broken down what I have found to be the most common causes of depression into six categories, because if you are depressed you have enough to worry about. You can thank me later! These causes are not listed in any particular order. Unfortunately, all too often a person with depression is suffering from more than one cause. That in itself sounds depressing! But the good news is, all of these can be treated without medication.
1. Out of Balance Neurotransmitters
Out of balance neurotransmitters can cause depression. Neurotransmitters are amazing chemicals your body produces which relay information between nerve cells and other cells in the body. They include two inhibitors, serotonin and GABA, and also four excitors: dopamine, norepinephrine, epinephrine and glutamate. An imbalance of any of these can cause depression. If you want to treat depression without medication you need to know which neurotransmitters are out of balance.
The inhibitory neurotransmitters: serotonin and GABA
Serotonin is a major player in regulation of sleep, appetite and aggression. Imbalance in serotonin is a common contributor to mood problems. When serotonin is out of balance depression, anxiety, worry, obsessive thoughts and behaviors, carbohydrate cravings, PMS, difficulty with pain control, and sleep cycle disturbances can result. One of the most common treatments for depression to prescribe drugs that increase the serotonin by slowing the rate at which serotonin is processed. This of course does nothing to fix the cause of the low serotonin. Furthermore, usually no testing has been done to determine if the depression is due to low serotonin.
GABA is the neurotransmitter that keeps saying, “Just chillax everything is ok.” Low GABA levels contribute to mood disorders and may be associated with anxiety, worry and poor impulse control. High levels of GABA contribute to sluggish energy, feelings of relaxation, and foggy thinking. Without the inhibiting function of GABA, impulsive behaviors are often poorly controlled, contributing to a range of anxious and/or reactive symptoms that extend from poor impulse control to seizure disorders. Alcohol and also benzodiazepine drugs act on GABA receptors and imitate the effects of GABA. Often people with GABA problems will turn to these drugs as a way to self medicate.
The four excitatory neurotransmitters: dopamine, norepinephrine, epinephrine and glutamate
Without enough dopamine you just can’t get no satisfaction! Maybe that’s what was wrong with the Rolling Stones. Dopamine is largely responsible for regulating the pleasure/reward pathway, memory and motor control. Its function is to create both inhibitory and excitatory action depending on the tissue it is working on. Memory issues are common with both elevations and depressions in dopamine levels. Common symptoms associated with low dopamine levels include loss of motor control, cravings, compulsions, loss of satisfaction and addictive behaviors including: drug and alcohol use, smoking cigarettes, gambling, and overeating. These actions often result from an unconscious attempt to self-medicate, looking for the satisfaction that is not occurring naturally in the body. Elevated dopamine levels may contribute to hyperactivity or anxiety and have been observed in patients with schizophrenia. High dopamine may also be related to autism, mood swings, psychosis and attention disorders.
Norepinephrine, also called noradrenaline, is made in the brain and the adrenal gland. Norepinephrine is the go-to neurotransmitter when it’s time for action. Norepinephrine is involved in a wide variety of actions including attention, focus, regulating heart rate, affecting blood flow, and suppressing inflammation. It prepares the body for a fight-or-flight response. Chronic high levels of norepinephrine are often linked to anxiety, stress, elevated blood pressure, and hyperactivity, whereas low levels are associated with lack of energy, focus, and motivation.
Epinephrine, better known as adrenaline, is a lot like norepinephrine. It’s made in the brain and adrenal glands like norepinephrine. Elevated levels of epinephrine are often associated with hyperactivity, ADHD, anxiety, sleep issues, and low adrenal function. Over time, chronic stress and stimulation can deplete epinephrine stores. Low epinephrine can lead to difficulty concentrating, fatigue, depression, insufficient cortisol production, chronic stress, poor recovery from illness, dizziness and more.
Glutamate is the most abundant neurotransmitter in the nervous system. Glutamate is involved in most aspects of normal brain function including cognition, memory and learning. Elevated glutamate levels are commonly associated with panic attacks, anxiety, difficulty concentrating, OCD and depression, whereas low glutamate levels may result in agitation, memory loss, sleeplessness, low energy levels and depression.
A person suffering with depression can have an imbalance of one or more of these neurotransmitters. In order to treat depression without medication, it is important to know which neurotransmitters are out of balance.
Testing is KEY to treating depression without medication successfully.
Above is a sample result of a test which measures the neurotransmitter levels present in the urine. Urine levels correlate well with whole body neurotransmitter levels. One of the strengths of this kind of testing is that it doesn’t just measure neurotransmitter levels in the brain. 90% of the serotonin in the body is made in the intestines. Almost all of the epinephrine, and some of the norepinephrine are made in the adrenal glands. So while I’ve been describing the effects neurotransmitters have on the brain these chemicals also have many critical functions in the rest of the body. For example, outside the brain serotonin is important for the healthy intestine function. This testing makes it possible to correct neurotransmitter imbalances, and as a result help the problems that develop from their imbalances.
Once it’s known what’s going on with these neurotransmitters it’s possible to treat depression without medication. Your body has to make all these brain chemicals. There are specific nutrients that are required for the production of each neurotransmitter. Often a person is low in a particular nutrient and as a result the corresponding neurotransmitter levels are low. For example, Vitamin C, Vitamin D, Iron and Vitamin B3 are all needed for the production of dopamine. If someone tests low for dopamine, the reason may be an insufficient supply of some or all of these nutrients.
2. Stinkin’ Thinkin’
If you want to treat depression without medication, you’ve got to get your thought life right.
The wrong kind of thinking, which I like to call stinkin’ thinkin’, can cause depression. Most of us have control over what we choose to think about, and what kind of thoughts we dwell on. Sometimes we can get into a rut of negative thinking, and then things spiral downward until we are hopeless. If you struggle with stinkin’ thinkin’, I wrote a whole article about it. Here’s the link if you would like to learn more:
3. Intestinal Inflammation
Our intestines and our brains are closely connected
In fact, the intestines are commonly referred to as “the second brain.” The inner lining of the intestines and the brain are made of similar tissue. Both the brain and the intestine produce serotonin. Intestinal inflammation can actually cause depression. When the intestines are inflamed, the brain is inflamed. Chronic inflammation of the brain interferes with the ability of the brain cells to communicate, and can cause depression, brain fog, insomnia, ADD, Alzheimer’s disease, anxiety, autism or fatigue. “What are the signs of an inflamed intestine?” you ask. Great question! Constipation, diarrhea, bloating, acid reflux, and cramps are signs of inflammation, but it’s also possible to have inflamed intestines without any of these symptoms. I explain the details of most common intestinal inflammation conditions in these articles:
If a person is suffering with any kind of brain problem, including depression, the intestines need to be ruled out as a possible source of the problem.
4. Thyroid Dysfunction
It’s estimated that low thyroid hormones are responsible for 10 to 15% of cases of depression. Without a proper thyroid work up, treating depression without medication is not possible. When the thyroid not working right, a person feels like their get-up-and-go got up and left. Many hypothyroid cases are not diagnosed because the doctor only checks the thyroid-stimulating hormone (TSH). In order to correctly assess the thyroid the following tests must be done:
• Thyroid-stimulating hormone (TSH)
• Free serum thyroxine (fT4)
• Free triiodothyronine (fT3)
• Reverse T3 (rT3)
• Anti-thyroglobulin antibodies (anti-TG)
• Anti-thyroid peroxidase antibodies (anti-TPO)
Furthermore, even folks who are taking Synthroid (a T4-only thyroid medication) for a low thyroid can still suffer from depression because the body has to turn the T4 into T3, the active form of thyroid hormone.
If your depression is caused by an underactive thyroid, it can be fixed without medication, but proper testing is critical.
5. Adrenal Problems
There is one adrenal gland located on top of each kidney. These glands make some really important hormones and neurotransmitters. I already explained the connection between adrenaline, and noradrenaline and the adrenal glands. In addition to adrenaline and noradrenaline the adrenal glands make cortisol, DHEA. During times of stress healthy adrenal glands make more cortisol and DHEA along with noradrenaline to prepare us to deal with the crisis. The problem is that often our lives are filled with stress and everyday our adrenal glands are cranking out the hormones in response to the stress. When someone is going through a season of high stress the adrenal response to the stress can become exaggerated and too much cortisol, DHEA, and noradrenaline is produced. This excessive response often leads to anxiety, insomnia, loss of libido and weight gain. If the stress continues the adrenal gland’s response will drop off and there will be insufficient cortisol, DHEA and noradrenaline. This insufficiency leads to depression, fatigue, lethargy, and indifference.
Often fixing depression without medication requires fixing the adrenal glands. You can get more information on fixing adrenal problems in this article:
If you want to fix depression without medication you MUST eat right. Diets high in carbohydrates and low in fats are a recipe for depression! Here’s the deal, I think everyone would agree that eating processed, high in sugar junk food is not good for you and will lead to lots of health problems including depression. I think it would surprise a lot of people to find out that eating a “healthy” low fat high carbohydrate diet the government and medical experts have been promoting create the perfect biochemical foundation for depression. There are several problems with eating this way. The first problem with a diet low in fat and high in carbohydrates is that blood sugar is going to up and down all day. Blood sugar that yo yos all day not only makes a person feel depressed but contributes to weight gain, mental fog and fatigue to name a few problems. A poor diet will lead to nutrient deficiencies. When a body starts to run low on things like magnesium, zinc, vanadium, vitamin D, B12, folate and essential fatty acids it’s just a matter of time until a person will likely become depressed.
Fixing depression without medication will always require eating a nutrient dense diet high in healthy fats. Sometimes testing is needed to determine if there are dire nutrient needs.
It is possible to fix depression without medication!
Depression is not a drug deficiency problem. My hope is that if you’re a person who suffers with depression but isn’t satisfied with the pharmaceutical treatments, this information gives you hope.
I welcome your comments and questions. If you’re ready to figure out what’s behind your depression please contact me and let’s get started getting answers.
1. Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD):modulation by a polyphenolic extract from pine bark (pycnogenol). Dvoráková M, et al. Nutr Neurosci. 2007;10: 151-57.
2. The neurobiology of anxiety disorders: brain imaging, genetics and psychoneuroendocrinology. Martin EI, et al. Psychiatri Clin N Am. 2009; 32: 549-75.
3. The HPA axis in major depression: classical theories and new developments.Pariante CM, Lightman SL. Trends Neurosci. 2008; 31: 464-68.
4. Depression and anxiety symptoms are related to increased 24-hour urinary norepinephrine excretion among healthy middle-aged women. Hughes JW, et al. J Psychosom Res. 2004; 57: 353-58.
5. Desipramine-yohimbine combination treatment of refractory depression. Implications for the beta-adrenergic receptor hypothesis of antidepressant action. Charney DS, et al. Arch Gen Psychiatry. 1986; 43: 1155-61.
6. Monoamine activity reflected in urine of young patients with obsessive compulsive disorder, psychosis with and without reality distortion and healthy subjects: an explorative analysis. Oades RD, et al. J NeuralTransm Gen Sect. 1994; 96: 143-59.
7. Blood serotonin levels in postmenopausal women: effects of age and serum estradiol levels. Gonzales GF, Carillo C. Maturitas. 1993;17:23-9.
8. Biogenic amine turnover and serum cholesterol in suicide attempt. Tripodianakis J, et al. Eur Arch Psychiatry Clin Neurosci. 2002; 252: 38-43.
9. Catecholamines in depression: a cumulative study of urinary norepinephrine and its major metabolites in unipolar and bipolar depressed patients versus healthy volunteers at the NIMH. Grossman F & Potter WZ. Psychiatry Res. 1999; 87: 21-7.
10. Seasonal and biological variation of urinary epinephrine, norepinephrine, and cortisol in healthy women. Hansen AM, et al. Clin Chim Acta. 2001; 309: 25-35.
11. Urinary monoamines and monoamine metabolites in subtypes of unipolar depressive disorder and normal controls. Roy A, et al. Psychol Med. 1986; 16: 541-46.
12. Rack SK, Makela EH. Hypothyroidism and depression: a therapeutic challenge. Ann Pharmacother. 2000 Oct;34(10):1142-5.
13. Cooke RG, Joffe RT, Levitt AJ. T3 augmentation of antidepressant treatment in T4-replaced thyroid patients. J Clin Psychiatry. 1992 FUNCTIONAL MEDICINE Jan;53(1):16-8.
14. Weissel M. Administration of thyroid hormones in therapy of psychiatric illnesses] Acta Med Austriaca. 1999;26(4):129-31.
15. Hickie I, Bennett B, Mitchell P, Wilhelm K, Orlay W. Clinical and subclinical hypothyroidism in patients with chronic and treatment-resistant depression. Aust N Z J Psychiatry. 1996 Apr;30(2):246-52.
16. Haggerty JJ Jr, Prange AJ Jr. Borderline hypothyroidism and depression. Annu Rev Med. 1995;46:37-46.
17. Joffe RT, Levitt AJ. Major depression and subclinical (grade 2) hypothyroidism. Psychoneuroendocrinology. 1992 May-Jul;17(2-3):215-21.
18. Pop VJ, Maartens LH, Leusink G, van Son MJ, Knottnerus AA, Ward AM, Metcalfe R, Weetman AP.Are autoimmune thyroid dysfunction and depression related? J Clin Endocrinol Metab. 1998 Sep;83(9):3194-7.
19. Konig F, von Hippel C, Petersdorff T, Kaschka W. Thyroid autoantibodies in depressive disorders Acta Med Austriaca. 1999;26(4):126-8.
20. von Zerssen D, Doerr P, Emrich HM, Lund R, Pirke KM. Diurnal variation of mood and the cortisol rhythm in depression and normal states of mind. Eur Arch Psychiatry Neurol Sci. 1987;237(1):36-45.
21. Guechot J, Lepine JP, Cohen C, Fiet J, Lemperiere T, Dreux C. Simple laboratory test of neuroendocrine disturbance in depression: 11 p.m. saliva cortisol. Neuropsychobiology. 1987;18(1):1-4.
22. Guechot J, Fiet J, Passa P, Villette JM, Gourmel B, Tabuteau F, Cathelineau G, Dreux C. Physiological and pathological variations in saliva cortisol. Horm Res. 1982;16(6):357-64.
23. Galard R, Gallart JM, Catalan R, Schwartz S, Arguello JM, Castellanos JM. Salivary cortisol levels and their correlation with plasma ACTH levels in depressed patients before and after the DST. Am J Psychiatry. 1991 Apr;148(4):505-8.
24. Goodyer I, Herbert J, Moor S, Altham P. Cortisol hypersecretion in depressed school-aged children and adolescents. Psychiatry Res. 1991 Jun;37(3):237-44. Foreman DM, Goodyer IM.Salivary cortisol hypersecretion in juvenile depression. J Child Psychol Psychiatry. 1988
25. Oldehinkel AJ, van den Berg MD, Flentge F,Bouhuys AL, ter Horst GJ, Ormel J. Urinary
free cortisol excretion in elderly persons with minor and major depression. Psychiatry Res.
2001 Oct 10;104(1):39-47.
26. Young AH, Gallagher P, Porter RJ. Elevation of the cortisol-dehydroepiandrosterone ratio in
drug-free depressed patients. Am J Psychiatry. 2002 Jul;159(7):1237-9.
27. Twardowska K, Rybakowski J. Limbic-hypothalamic-pituitary-adrenal axis in depression:
literature review] Psychiatr Pol. 1996 SepOct;30(5):741-55. 17. Maes M, Vandoolaeghe E, Neels H, Demedts P,Wauters A, Meltzer HY, Altamura C, Desnyder R. Lower serum zinc in major depression is
a sensitive marker of treatment resistance and of the immune/inflammatory response in that illness. Biol Psychiatry. 1997 Sep1;42(5):349-58.
28. Rasmussen HH, Mortensen PB, Jensen IW. Depression and magnesium deficiency. Int J Psychiatry Med. 1989;19(1):57-63.
29. Naylor GJ, Smith AH, Bryce-Smith D, Ward NI. Tissue vanadium levels in manic-depressive
psychosis. Psychol Med. 1984 Nov;14(4):767-72.
30. McLoughlin IJ, Hodge JS. Zinc in depressive disorder. Acta Psychiatr Scand. 1990
31. Pfeiffer CC, Braverman ER. Zinc, the brain and behavior. Biol Psychiatry. 1982 Apr;17(4):513-32.