Tomorrow is World Mental Health Day and in my opinion, this is a hugely important issue because so many of us struggle with mental health at one time or another. In the UK 1 in 4 people each year are affected by mental health issues, with depression being the most common diagnosis, followed closely by anxiety disorder.
One of the biggest problems with depression and mental health in general, is that it is so invisible. No one else can see just how much you are struggling and suffering. This makes it hard for others to understand what you are going through. It also makes it hard to ask for help, as we can easily feel we are ‘making a fuss’ and feel that we should just ‘be strong and carry on’.
Compare this to say breaking a leg – everyone would understand straight away that you are in pain, that you are crying for good reason and that you need help. No one would question it or think any less of you- they would simply be concerned about helping and supporting you to cope with the problem.
Not so with depression! So not only is it hard to ask for help and support, but it is hard to find the right kind of support. Add to that the trend that so many of us no longer wish to simply ‘swallow a pill’ to deal with our health issues means we need to think more broadly about how we approach depression and mental health in general.
Is depression a prozac deficiency?
So if you are struggling with feeling low, tearful, sad and just can’t feel the joy anymore, AND you have plucked up the courage to go and see your family doctor, the ‘western medical approach’ goes something like this:
Doctor consultation/discussion of symptoms, PHQ9 questionnaire assessment, blood tests to exclude organic causes of depression e.g. underactive thyroid = prescription for antidepressants, talking therapy of some sort.
This model is based on the idea that depression is a ‘lack of serotonin’. It is the biochemical model of depression. And the treatment is an ‘SSRI’ – selective serotonin reuptake inhibitor e.g. fluoxetine (prozac). In other words, the SSRI makes any serotonin that happens to be hanging around in the body last that little bit longer, thereby fooling the body that there is more serotonin floating about than is actually the case. And this will hopefully boost someone’s mood, which is one of the roles serotonin plays in the body.
For some people, SSRI works like magic. About 1 in 8 in fact. The other 7 people don’t get any discernible benefit from this treatment, and not only that, there can be substantial side effects that people on SSRI commonly experience. All of this means it is not for everyone.
Which leaves us with an important question:
Is taking medication the only option?
Or are there other ways to look at this?
To answer this question we need to look at what causes depression in the first place. And this is where it gets interesting, because we quickly learn that this isn’t a simple A→ B situation.
It is more a case of A and B and C and D and E etc etc can all contribute to the clinical picture we like to label up as ‘ Depression’.
The main causes of depression
Here are some causes of depression that I see in my clinical practice on a regular basis.
1) Chronic stress
Whatever kind of stress you are under, whether that is overwhelm, having far too much to do, never taking a break, life is just relentless, or you are in a constant state of fear, worry or anxiety – this stuff builds up over time. No matter how determined you are to stay on top!
Your chronic stress response is designed to help you weather those challenging times, but if the stress continues on and on, this will trigger the ‘chronic stress response’ via your adrenal glands. This directly affects your hormones cortisol and over time. Abnormal levels of cortisol can give rise to depression and anxiety symptoms, as well as interfere with your sleep and a whole host of other stuff.
2) Gut health
90% of your serotonin is made in your gut. So if your gut health is in trouble, then guess what happens to your serotonin levels. I so often see people in my practice with gut conditions eg SIBO and their mood is nearly always affected. Once the SIBO has been treated, the mood improves,
3) Brain health
Inflammation of the brain is a very common cause of depression. So how do we get brain inflammation? We get it from things like:
- Infections (meningitis, encephalitis)
- Trauma: even a relatively minor bump to your head eg hitting your head on a shelf, or falling over on ice can trigger brain inflammation.
- Toxins e.g. alcohol.
4) Nutritional status
Having the building blocks to not only build your neurotransmitters, e.g. serotonin, but also to balance them up properly, takes a whole bunch of nutrients including proteins, minerals and vitamins. If you have a poor diet, or you have gut health that means you don’t break your food down properly and fully absorb the nutrients, your mental health can suffer.
5) Sleep apnoea
How much you sleep and how well you sleep, can all contribute to your mood, simply through how it affects your energy levels. But there is an extra dimension to sleep that I just want to mention.
For those of us who snore, or who have a severe version of that, which is sleep apnea, your brain is being deprived of oxygen during the night. This has a huge impact on brain health, and this in turn can set you up for depression.
So understanding the quality of your sleep, and if necessary having a home sleep assessment carried out, is vital.
Ask a better question
Now that you know there are more causes of depression than a simple ‘ lack of serotonin’, you can ask much more powerful and helpful questions.
❔ How can I support my gut health?
❔ How can I nurture and support my brain health?
❔ Where are my sources of chronic stress and what can I do about these?
❔ How can I improve my nutrition and feed my body with the foods it can truly thrive on?
❔ What is the quality of my sleep?
Building your own depression toolkit.
Here are some of my best go-to strategies and areas to focus on, if you want to support your mental and emotional health in a more empowering and natural way.
You can use these strategies both when you have a diagnosis of anxiety or depression, or you can use them preventatively, if you feel things are starting to slide in the wrong direction.
1) Self-care with excellence
This is all about doing the simple things really well and consistently. That kind of self-care will bring massive benefits. So I’m talking about things like making sure that you drink plenty of clean filtered water, making sure you eat regular meals that are clean nutrient dense foods, and eating regularly. Because when we are struggling with depression, it is just so easy to reach for the sugar, the carbs, the alcohol, but these are the kind of quick fixes that don’t last and in the long run will in fact work against you.
Exercise is a well-known mood booster and it doesn’t have to be complicated. Simply walking will do the job! Getting moving has all sorts of incredible benefits which will support your energy levels, boost your brain endorphins, and give you back some control.
3) Sleep like a baby
Sleep is one of the most powerful healing tools we have. Poor sleep, or the opposite, oversleeping, is a common symptom of depression. So first of all, make sure that you have time to rest, even if you are struggling to sleep. Doing active relaxation practices like breath work, can also help.
And if you are worried about sleep apnea, don’t ignore it, go get it checked out!
4) Do the stuff that truly nurtures you
Whether that is time cuddling your dog, getting out into nature, beautiful music or simply taking the time to really take care of you, knowing what soothes you and how to nurture yourself is incredibly powerful practice.
5) Address your stress
Stress directly impacts your cortisol levels which can, in turn, affect everything from your mood, to your sleep, your energy levels and even your ability to lose belly fat!! Chronic stress is a particularly tricky customer and it causes both anxiety and depression.
So take a good look at where the stress sits in your life, and take active steps to address it.
Depression is very common and if you are struggling with this right now, or you know someone who is, there is plenty you can do to start helping yourself. Or maybe you are simply worried that you are at risk of
becoming depressed and you want to arm yourself up with some great preventative strategies that will really make a big difference.