By Ishtiak Ahmed Chowdhury

Tags: Functional medicine for depression, Functional medicine, Depression, Mental health, Major depressive disorder, SSRI, DSM-V, TSH, Gut microbiome

A latest report released by Mental Health America (MHA) in 2021 states that around 10 percent of the youth population in the United States suffer from severe major depression. Additionally, based on a 2016 study, Anxiety and Depression Association of America reported that roughly 7 percent of the adults in America suffer from major depressive disorder. Needless to say, the pandemic and the economic crisis have certainly boosted these numbers.

While depression remains to be a serious concern for many people in the United States and worldwide, the treatment regimens have remained fairly traditional throughout the history of this disorder. Many scientific studies attribute the imbalance in the ratio of glucocorticoid and mineralocorticoid receptors in the brain, as a root cause of serotonin receptor changes that are observed among the patients with major depression.

Despite the various biological factors like genetics, hormonal and receptor imbalances; other factors like socio-economic conditions, trauma, highly stressful childhood events and cultural factors could ultimately lead to depression.

The current treatment for depression generally involves therapy and medication. However, studies indicate that medications like SSRIs (Selective Serotonin Re-uptake Inhibitors) are not nearly as effective as previously thought to be. Several breakthrough studies indicate that despite the traditional approaches, the rates of depression in adults haven’t improved in nearly 20 years even after prolonged administration of SSRIs, SNRIs and TCAs coupled with therapy.

While psychiatrists commonly use the DSM-V manual in the traditional approach and base their diagnoses on clinical symptoms, it never truly shines a light on the root cause. Additionally, medications like SSRIs have severe long term side effects that are detrimental to the well-being of the patients.

This is where functional medicine attempts to induce a paradigm shift in the field of modern clinical psychiatry. According to the Institute of Functional Medicine, it is a focused alternative approach to recognize and address the underlying root cause of a disorder. While current practices in psychiatry utilize a symptom-based approach emanating from generic DSM-V based evaluation, Functional Medicine considers the brain in context of whole body health. For instance, it dives into the root cause via brain mapping to investigate aberrant wave activities and also considers other psycho-social factors attributing to the root cause of depression among patients. In addition, functional medicine also tries to understand the peripheral systems and peripheral hormones that could perhaps be associated with depression. For instance, although the normal range of Thyroid Stimulating Hormone (TSH) is between 0.4 – 4.0; several studies indicate that people whose TSH levels fall in the range of 2.5 to 4.0 tend to suffer from depression. Moreover, different inflammatory disorders (IBD) and gastrointestinal tract imbalances could also attribute to depression. Studies have vividly shown in the past that there is a direct correlation between mental health and the abundance and variation of gut microbiome. For instance, a study published in 2015 revealed that indigenous spore forming bacteria derived from mouse and human microbiome attributes to serotonin production via colonic enterochromaffin (EC) cells, thus modulating peripheral Serotonin levels. In addition, another study published in 2019, successfully analyzed the gut-brain axis in association with tryptophan metabolism: an amino acid, which is very crucial to the production of Serotonin in the human body.

Hence, it can be clearly understood that there are multiple dimensions to treating depression, which indeed is one of the most complex manifestation of clinical disorders to date. However, functional medicine holistically outshines traditional approaches by exploring all those dimensions and offering systematic treatment to major depression patients. This certainly is a silver lining for all the individuals who have been combating depression and seek a remedy.

If you have mental or physical concerns contact specialized therapy at 201-488-6678 and contact The Functional Medicine centers for Personalized Care, LLC www.FxMedCenters.com at 201-880-8247.

 

References

Syme, KL, Hagen, EH. Mental health is biological health: Why tackling “diseases of the mind” is an imperative for biological anthropology in the 21st century. Yearbook Phys Anthropol. 2020; 171: 87– 117. https://doi.org/10.1002/ajpa.23965

Young EA, Lopez JF, Murphy-Weinberg V, Watson SJ, Akil H. Mineralocorticoid receptor function in major depression. Arch Gen Psychiatry. 2003 Jan; 60(1):24-8. doi: 10.1001/archpsyc.60.1.24. PMID: 12511169.

Anacker C, Zunszain PA, Carvalho LA, Pariante CM. The glucocorticoid receptor: pivot of depression and of antidepressant treatment. Psychoneuroendocrinology. 2011;36(3):415-425. doi:10.1016/j.psyneuen.2010.03.007

Kaur Harrisham, Bose Chandrani, Mande Sharmila. Tryptophan Metabolism by Gut Microbiome and Gut-Brain-Axis: An in silico Analysis. Frontiers in Neuroscience. 2019;13:1365. doi:10.3389/fnins.2019.01365

Yano JM, Yu K, Donaldson GP, et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis [published correction appears in Cell. 2015 Sep 24;163:258]. Cell. 2015;161(2):264-276. doi:10.1016/j.cell.2015.02.047

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? [Updated 2020 Jun 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361016/

 

Website: https://adaa.org/understanding-anxiety/facts-statistics

Website: https://www.mhanational.org/research-reports/2021-state-mental-health-america