Mood disorders are prolonged atypical emotional illnesses that cause a problem in one’s life. Included here are unipolar depressive that suffers from depression and bipolar suffers from depression and mania, or state of elevated mood emotions and hyperactivity.
Mood disturbances effect 20 percent of women and 12 percent of men at some point in their lives. Most is the unipolar depressive state. Bipolar is thought to affect between four and five percent of the population. Depression affects women two times more often than men, while bipolar is more equal in the sexes. Men tend to be more manic, while women are more depressive.
Physical, social, or emotional stressors can be triggers to precede depression in manic states. Examples are loss of the spouse or pet, economic swings from riches to rags, or sudden physical impairment. Several factors make women more susceptible to depression than men. Men tend to dominate society, which tends to control women. Loss of control in animal studies has shown to elicit depressive moods. It is thought that women genetically have higher levels of monoamine oxidase, a substance used to degrade neurotransmitters or brain chemicals that affect mood.
Mood Disorder, Depression, or Dysthymia
The definition of depression is mood that is oppressed, irritable and anxious. The patient may have physical signs of frowns and slumped postures. Signs of fatigue: weight loss or weight gain, eye contact may be reduced or absent, the patient is quiet or doesn’t talk much. They have lost interest in work, family, and social activity. Their thoughts may focus on guilt that is inappropriate, despair or helplessness. They tend to have low self-esteem, and they think about it constantly. Mentally, they may have slow thoughts and find it difficult to concentrate. In the elderly, this could be mistaken for Alzheimer’s. They may have difficulty in sleeping and expressing emotions of joy, happiness, and grief. These patients may have thoughts of suicide.
Treatment may consist of attempting pharmaceutically or naturally to alter the brain chemistry or neurotransmitters in support of therapy. Pharmaceutically, antidepressants are classified as selective serotonin receptor inhibitors. They prevent serotonin from being broken down and restored in the brain. This increases the use of serotonin, 5HT, and norepinephrine. Monoamine oxidase inhibitors prevent the breakdown of norepinephrine, dopamine, and 5HT.
Side effects include initial loss of appetite and weight loss, sleepiness in the day, loose stools, headaches, and up to a third of all patients have decreased libido or difficult orgasms. Also possibly hypertension.
Crisis happens if the drugs or the wrong foods are ingested. Cheese high in Thiazine causes this reaction. Some new drugs are coming out to decrease this effect. Erectile dysfunction, insomnia, weight gain, edema are other side effects. Heterocyclic antidepressants increased the availability of 5HT and norepinephrine.
Side effects include blurred vision and tachycardia, or increase in heart rate, xerostomia or dried mouth, and weight gain. These are not used in cardiac patients because of tachycardia and may cause hypotension leading to falls. The patient of depression should always be checked for hypothyroidism. Hypothyroid individuals frequently have depression and are fatigued. This is a fairly common health problem. See the section on Hypothyroidism.
Stress and adrenal functions are other concerns. The adrenal gland controls the hormone cortisol. Cortisol has the effect of conserving blood sugar or glucose levels. It also increases fatty acids in the blood and helps control vascular tension. High cortisol levels have been associated with depression, fatigue, and increase in weight gain. We have known for years that increased stress can lead to depression. High stress stimulates release of cortisol, which can cause clinical problems described above. Ask your physician about checking for both hypothyroid and adrenal problems. Cortisol decreases the amount of tryptophan being delivered to the brain. This is needed for serotonin and melatonin production. Also cortisol decreases the sensitivity of the brain serotonin receptors making the available serotonin less effective. Low levels of serotonin can cause depression. Other factors able to cause depression are heavy metal poisoning, including lead, mercury, and cadmium. Other signs and symptoms of heavy metal toxicity are fatigue, confusion, and neurological signs.
Smoking causes higher levels of cortisol and uses more Vitamin C to detoxify the smoke. Low levels of Vitamin C in the brain have been associated with depression. Alcohol is a brain depressant and should also be avoided. Caffeine in coffee is a stimulant that has been shown to cause anxiety and depression in moderate to high consumption. The combination of caffeine and sugar seems to be worse.
On the positive side, it is conclusive that exercise is effective in the treatment of depression. This is probably due to the ability of exercise to increase endorphins important in mood regulation. Exercise has shown to be as effective as some of the drugs used for depression. Remember, exercise needs to be done about four hours a week and at least at a moderate intensity.
Nutritionally, many different nutrients can lead to depression, fatigue, and mental confusion. A good multi-vitamin/mineral is protective against any deficiency. The most common deficiencies are B6, B12, and folic acid. All can lead to depression, and are some of the more common deficiencies in the United States, especially in the elderly.
Omega 3, fatty acid deficiency, is increasingly being linked to mood regulation, including depression. N3 poly-unsaturated fatty acids make up some of the cell membranes in the brain which regulate the passage of nutrients and waste in and out. Some of these substances are neuro-transmitters, including serotonin and monoamine oxidase.
Food allergies can also cause symptoms of depression, fatigue, confusion, and lethargy. Theoretically, altriptyphan is supposed to increase serotonin and melatonin in the brain. Literature suggests low levels of serotonin in tryptophan. Clinical trials though have not fully supported this theory. Problems are that tryptophan can be converted to other substances. 5HTP or 5Hydroxytryptophan, an amino acid, can enter the brain and is more readily converted to serotonin. One report stated only three percent of tryptophan is converted to serotonin while 70 percent of 5HTP is converted to serotonin. Remember, low levels of serotonin is linked to depression. 5HTP has clinically supported through trials comparing with some of the antidepressant drugs.
SAM, or S-adenosyl-methione is a powerful natural antidepressant. SAM-E has shown benefits against placebo and numerous studies. Also SAM-E in double blind clinical trials has shown to be comparable and sometimes more effective than pharmaceutical antidepressants. SAM-E is produced in the body but found to be decreased in individuals with depression. It should not be used with bipolar disorder.
Phenylalanine and tyrosine also benefit depression. Strong research like with SAM-E 5HTP though has not been done.
St. John’s Wart is very well documented in 25 double-blind studies. St. John’s Wart was found to have comparable results, which some pharmaceuticals but far less side effects and at lower cost.
Kava may be beneficial in treatment of depression with anxiety. Kava should be combined with other natural antidepressants to get this effect.
Finally, Ginkgo Biloba may increase the number of serotonin receptors in the brain. With age, the number of the receptors decrease and this is one reason why the elderly are more susceptible to depression. Ginkgo has a number of studies showing potential anti depressive roles. It may be particularly helpful in the elderly.