Whenever I hear that someone is taking an antidepressant drug, I wonder if he/she really needs to be. To me, the number of Americans who take antidepressants (about 10% of adults, or 27 million people) is astounding. While it is true that antidepressants can help some people, they do nothing to address the somewhat surprising underlying causes of depression, such as environmental toxins, hormone imbalances, nutritional deficiencies, spiritual issues and emotional stress. In addition, a review of studies published in Psychotherapy and Psychosomatics found that only 2.7% of 4,000 patients reported benefiting from taking antidepressants for 12 months. Not only are these drugs ineffective, but they can cause side effects ranging from loss of libido to suicidal thoughts.

I treat many patients with depression—without prescribing antidepressants. (I refer patients with unresponsive or suicidal depression to a psychiatrist.) As you’ll see in the stories below, I work with each patient to determine the underlying reasons for the depression and to recommend safe, natural remedies that can help. If any of the descriptions below seem similar to your situation, I urge you to discuss these tests and remedies with a holistic doctor.

WHEN HORMONES WEIGH IN

Joe, a 60-year-old professor, complained of depression and fatigue. He was in good health, and there was no apparent reason for his symptoms. The results of a blood test showed that he had a testosterone deficiency. I prescribed bioidentical testosterone, which resolved his symptoms within six weeks.

Since depression often is caused by low levels of hormones, including thyroid hormone, estrogen, progesterone, testosterone, dehydroepiandrosterone (DHEA), cortisol and/or growth hormone, I usually test hormone levels in men over 55 and women of perimenopausal and menopausal age. Sadly, many conventional physicians and psychiatrists do not make the connection between hormone imbalance and depression. Hormones influence brain neurotransmitter levels. When any of the hormones mentioned above are low, I prescribe a bioidentical hormone, which has the same chemical makeup as the hormone produced in the body. When the hormone levels rise, depression fades.

THE BRAIN NEEDS A BOOST

Sally, a 41-year-old mother, had been feeling depressed for about four months for no apparent reason. She was in good health, and her family was thriving. The results of a urine test showed that her levels of the neurotransmitters dopamine and serotonin were low. I prescribed SAMe (pronounced Sam-ee), a substance that supports the body’s production of serotonin. Within one month, her symptoms were gone.

When depression occurs without any clear cause, I often check patients’ levels of “good mood” neurotransmitters, such as serotonin and dopamine. Antidepressant drugs, such as fluoxetine (Prozac) and sertraline (Zoloft), affect neurotransmitter levels, too, but in different ways. One way that these drugs work is by blocking the reabsorption of serotonin by certain nerve cells and making it more available in the brain. In my view, this artificially elevates brain neurotransmitter levels. Most natural antidepressant supplements, on the other hand, help the body manufacture mood-elevating chemicals on its own, thus addressing the underlying deficiency. Based on the results of a urine test, a patient’s symptoms and prior use and/or success of any of these remedies, I prescribe one of the following…

  • 5-hydroxytryptophan (5-HTP), an amino acid that helps the body manufacture serotonin.
  • S-adenosylmethionine (SAMe), a substance produced naturally by the body that supports the manufacture of serotonin, dopamine and other neurotransmitters.
  • Tyrosine, an amino acid involved in the manufacture of dopamine.
  • L-tryptophan, an amino acid found in poultry and meat that is converted by the body into 5-HTP and regulates mood and sleep.
  • Gamma-aminobutyric acid (GABA), a neurotransmitter that is effective for depression, stress, insomnia and/or anxiety.
  • St. John’s wort, an herbal extract that works like serotonin—boosting antidepressant medications for mild-to-moderate depression but with notably fewer side effects.

I also advise patients to get some of the above amino acids through a diet that includes such foods as eggs, chickpeas and turkey. When patients feel better (and no longer need supplements), I have them continue getting the amino acids through diet.

THE FOODS YOU EAT

Bernard, a 70-year-old retiree, had no idea why he was feeling depressed. After ruling out hormone deficiencies and low neurotransmitter levels, I ran a blood test to check for any nutritional deficiencies. The results showed that he had low levels of vitamin B-12 and omega-3 fatty acids. Supplementing with both of these nutrients improved his symptoms within eight weeks.

Older adults often are deficient in nutrients, causing or worsening depression. What I see most often: Deficiencies of omega-3 fatty acids and B vitamins, which are both essential for healthy mood… and vitamin D, which affects mood because there are vitamin D receptors in the brain. For depression linked to deficiencies, I recommend daily supplementation with a multivitamin containing 20 milligrams (mg) to 50 mg each of vitamins B-1, B-2, B-3 and B-6, and 50 micrograms (mcg) of vitamin B-12… fish oil capsules containing 1,000 mg to 1,500 mg of combined EPA and DHA (increase to 3,000 mg for severe depression)… and 2,000 international units (IU) to 5,000 IU of vitamin D.

THE TOXINS AROUND US

Stuart, a 35-year-old teacher, had fatigue, poor memory and moderate depression. As I always do, I asked very specific questions about his diet. He had been eating lots of sushi—tuna sushi. I suspected high levels of mercury, and a urine test proved me right. Within three weeks of following a protocol to normalize mercury levels, Stuart felt better, and after four months, his symptoms were gone.

Buildup in the body of toxic heavy metals, such as mercury, lead and/or arsenic, can cause a depressed mood. In addition to mercury poisoning from fish, people can be exposed to arsenic, for example, through exposure to pesticides. If testing reveals the presence of any of these metals, I treat patients with chelating agents (substances that bind with the metals and remove them from the bloodstream) such as glutathione, chlorella and specific prescription chelation agents.

WHEN DEPRESSION IS CAUSED BY GRIEF OR STRESS

Sometimes depression is caused by a life situation and has nothing to do, at least initially, with a chemical imbalance in the body. When these life situations occur, such as grieving for a loved one, I don’t believe that antidepressants are the right solution. Instead of suppressing these feelings with medication, people often need to acknowledge and deal with these feelings so that these emotions don’t continue to negatively affect them. I often recommend counseling with a psychotherapist or a religious adviser… and I sometimes suggest using one or several homeopathic remedies, including Natrum muriaticum, which can help patients who suppress their emotions to process them. You can work with someone trained in homeopathy to help you find the remedy for you.