By Dr. Mercola
Mental health appears to be dwindling across the globe, with depression now being the leading cause of ill health and disability worldwide. Over the past decade alone (2005-2015), rates of depression increased by 18 percent. In the U.S., more than 16 million people struggle with the condition, including 6 million seniors, and 11 percent of Americans over the age of 12 are on antidepressant drugs. Among women in their 40s and 50s, 1 in 4 is on antidepressants.
Clearly, something is very wrong. Part of the problem, I believe, is the fact that the go-to solution simply doesn’t work, and the psychiatric field is slow to branch out into more effective yet less financially rewarding strategies. Antidepressants tend to be the first-line treatment, even though studies have proven they work no better than placebo.
Now, researchers are investigating whether antidepressants might be prophylactically useful. The idea that taking a potent brain-altering drug that has the clinical effectiveness of a placebo to prevent depression is suspect in the extreme. There are many other strategies with far better track records that can both prevent and help treat depression.
Could Antidepressants Be Used Preventively?
“Some studies have estimated that up to half of patients with head and neck cancers may experience depression. A group of researchers … examined what would happen if non-depressed patients were given antidepressants before receiving treatment for head and neck cancer.
Published in 2013, the results of the randomized, placebo-controlled trial were startling: Patients taking an antidepressant were 60 percent less likely to experience depression compared with peers who were given a placebo. In medicine, this approach is often referred to as prophylaxis, or a treatment used to prevent disease.”
Other studies assessing the benefits of prophylactic antidepressants include:
- A 2014 analysis, which concluded antidepressants reduced incidence of major depression among patients treated for hepatitis C by 40 percent
- A 2004 study concluded post-stroke depression, which affects up to 40 percent of stroke victims, could be reduced through prophylactic treatment with the antidepressant mirtazapine. Forty percent of nontreated patients developed depression, compared to less than 6 percent of those receiving the drug
- A 2008 study also found nondepressed stroke patients given escitalopram (brand name Lexapro) were significantly less likely to develop depression compared to the placebo group over 12 months of treatment. However, it was later revealed the lead author had undisclosed financial ties to the manufacturer of the drug, which cast doubt on the results
- Other small studies have also concluded that pretreatment with antidepressants may reduce the likelihood of depression in patients receiving treatment for melanoma
I couldn’t disagree more vigorously with this distorted view of reality. Just because an antidepressant might help prevent drug- or chemo-induced depression does not mean that nondepressed individuals will benefit from taking antidepressants prophylactically. In fact, it may well have the opposite effect. There’s really no telling what kind of devastating societal health effects such a trend might create.
Antidepressants During Pregnancy Increase Child’s Risk of Psychiatric Disorders
Antidepressants are particularly hazardous for children, teens (who are more prone to self-harm on certain antidepressants) and women of childbearing age. Recent research shows use of antidepressants during pregnancy raises the child’s risk of developing a psychiatric disorder. The study evaluated data collected from more than 905,000 Danish children born between 1998 and 2012. The follow-up period lasted for nearly 17 years. The results showed that:
- Among children whose mothers did not use antidepressants during pregnancy, the 15-year risk of psychiatric problems was 8 percent
- Those whose mothers took an antidepressant prior to but not during pregnancy had a risk of 11.5 percent
- Among those whose mothers had started taking an antidepressant prior to pregnancy and continued taking the drug during pregnancy, the risk for psychiatric problems was 13.6 percent
- Children whose mothers started taking an antidepressant during pregnancy had the highest risk of a psychiatric disorder — 14.5 percent
Birth Defects Linked to Antidepressant Use in Pregnancy
Estimates suggest anywhere from 8 to 14 percent of pregnant women take antidepressants, even though studies suggest there are risks involved. A 2015 study — which looked at the effects of selective serotonin reuptake inhibitors (SSRIs) used during the first trimester of pregnancy and in the month before — concluded that:
- Paxil (paroxetine) was associated with an increased risk of five birth defects, including heart defects and anencephaly (abnormal brain and skull formation)
- The use of Prozac (fluoxetine) was associated with heart wall defects and abnormal skull shape (craniosynostosis)
The increase in absolute risk was low; for instance, 10 out of 10,000 women may give birth to a baby with a heart defect but this increased to 24 out of 10,000 among those using Paxil. Still, some birth defects occurred two to three times more often in babies born to women taking the drugs, and when the increased risk is combined with the many other studies showing harm, and few showing benefit, it still poses a serious concern.
SSRIs Increase Risk of Death by One-Third
A recent meta-analysis also shows SSRIs and tricyclic antidepressants dramatically raise your risk of death from any cause — an effect attributed to the disruption of “multiple adaptive processes regulated by evolutionarily ancient biochemicals,” one of which is serotonin. A total of 16 observational studies were included in the analysis, involving some 375,000 participants.
Overall, use of antidepressants was associated with a 14 percent increased risk of a cardiovascular event, such as heart attack or stroke, and a 33 percent increased risk of premature death. Lead author Marta Maslej told Medical News Today:
“We made sure to only include studies that did a good enough job controlling for important variables (like depression and other illnesses), and so we have attempted to statistically rule out other factors that could contribute to mortality. We also ensured that our findings weren’t related to confounding by indication.
This means that people who have more severe depression could be more likely to take antidepressants, and if that’s the case, we could not be sure whether the increase in risk of death is due to using antidepressants or having more severe depression.
To address this issue, we re-ran our analysis on only the studies that assessed depression in participants before they began using antidepressants. When we re-ran this analysis, the risk of mortality remained high which suggests that confounding by indication wasn’t an issue in our study.”
21st Century Reason for Rising Depression Rates
In light of the rapidly rising prevalence of depression, the question “why” is one that really needs to be looked into. I believe a significant yet completely ignored culprit is excessive microwave radiation from cellphones, cellphone towers, cordless phones, Wi-Fi, computers, smart meters, baby monitors and other electronic gadgets.
Last year, Dr. Martin Pall published a review in the Journal of Neuroanatomy showing how microwave radiation from these technologies is clearly associated with many neuropsychiatric disorders, including depression, anxiety, autism and Alzheimer’s.
In a nutshell, microwave radiation activates voltage gated calcium channels (VGCCs) in your cells, and one of the tissues with the highest density of VGCCs is your brain. Once the VGCCs are stimulated, intracellular calcium dramatically increases, as does the release of neurotransmitters, neuroendocrine hormones and highly damaging reactive oxygen species (ROS) — all of which raise your risk for depression and anxiety.
Based on this mechanism, it seems clear that chronic exposure to electromagnetic fields (EMFs) can play a significant role in psychiatric health. As a society, we need to take this seriously. On a personal level, be sure to limit your exposure to EMFs and wireless technology. Simple measures include turning your Wi-Fi off at night, not carrying your cellphone on your body and not keeping portable phones, cellphones and other electric devices in your bedroom.
Turning off all power at the circuit breaker to your bedroom at night is probably the single most important remediation strategy I can think of. The wiring inside your walls generates dangerous levels of magnetic and electrical (not microwave) radiation that impairs your melatonin production, disrupting your sleep.
This, in turn, will also heighten your risk of depression, anxiety, and many other health problems. To learn more about how microwaves and dirty electricity affect your health, please see my interviews with Pall and Dr. Sam Milham.
Anti-Inflammatory Diet Is Essential for Psychiatric Health
Needless to say, your diet also plays a major role when it comes to your psychiatric health. According to Dr. Hyla Cass, a psychiatrist who uses integrative medicine in her practice, one of the first steps in addressing a mental health problem is to clean up your diet and address your gut health. If you don’t, you’ll seriously hamper your chances of getting well.
Food sensitivities can also play a role. For example, gluten can produce symptoms of depression if you’re sensitive to it. In such a case, the key is to remove gluten from your diet entirely. Merely cutting down will not work. Cass has seen many patients recover from severe depression when going gluten-free. It’s also important to avoid sugar and junk food, which raises your risk of depression by promoting inflammation.
In fact, chronic inflammation appears to be a leading cause of depression. One theory as to why certain nutrients work so well for depression is because they are potent anti-inflammatories. Nourishing your gut microbiome is an important component of lowering inflammation, as much of the inflammation starts in your gut. My previous article, “Are Probiotics the New Prozac?” reviews some of the supporting evidence.
Researchers have also found strong connections between the gut microbiome and schizophrenia and bipolar disorder, demonstrating the close relationship between your gut and your brain. To nourish your gut microbiome, increase your consumption of fiber and probiotic foods, such as fermented vegetables, kimchee, natto, kefir, and others. Keep in mind that, in order for it to work, the fiber must be unprocessed. Processed supplement fiber such as inulin powder does not provide gut bacteria with what they need.
Specific Nutrients Associated With Improved Mental Health
Specific nutrient deficiencies can also have a significant impact on your mental health. On CassMD.com you can find a free report called “Reclaim Your Brain,” which details a number of nutritional substances you can use to address conditions like anxiety and depression. Following are three of the most important ones:
•Omega-3s — The animal-based omega-3 fats DHA and EPA are crucial for good brain function and mental health. The 2001 book, “The Omega-3 Connection” by Harvard psychiatrist Dr. Andrew Stoll, was among the first works to bring attention to and support the use of omega-3 fats for depression. Omega-3s have also been shown to improve more serious mental disorders, including schizophrenia, psychosis and bipolar disorder.
While there’s no set recommended dose of omega-3 fats, some health organizations recommend a daily dose of 250 to 500 milligrams (mg) of EPA and DHA for healthy adults. If you suffer from depression, higher doses may be called for.
In one study, an omega-3 supplement with a dose range of 200 to 2,200 mg of EPA per day was effective against primary depression. Good sources include fatty fish that are also low in mercury, such as wild caught Alaskan salmon, sardines and anchovies. If you don’t eat these types of fish on a regular basis, it would be advisable to take a high-quality omega-3 supplement such as krill oil, which has a number of benefits over fish oil, including better absorption.
•Vitamin D — Researchers have suggested vitamin D may play a role in depression by regulating brain chemicals called monoamines, which include serotonin. As a general rule, depressed individuals have lower vitamin D levels than nondepressed people, and having a vitamin D level below 20 ng/mL can raise your risk of depression by 85 percent compared to having a level greater than 30 ng/mL.
Recent research also claims that low vitamin D levels appear to be associated with suicide attempts. Ideally, maintain your vitamin D level between 40 and 60 ng/mL year-round. I also recommend having your vitamin D level checked yearly to assure you’re within this ideal range.
•B vitamins — A number of studies have shown deficiencies of one or more B vitamins (niacin/B3, B6, biotin/B8, folate/B9 and B12) can produce psychiatric effects. For example, vitamin B12 deficiency can trigger confusion, agitation, depression, mania, psychosis and paranoid delusions.
One recent study found vitamins B6, B8, and B12 in combination were very effective for improving schizophrenic symptoms when taken in high doses — more so than standard drug treatments alone. Low doses were ineffective.
The power of niacin (B3) was also demonstrated by Dr. Abram Hoffer, one of Cass’ mentors and a co-founder of orthomolecular medicine, which refers to the concept of nutritional deficiencies being a source of mental illness. Hoffer used high doses of niacin to successfully treat schizophrenics. Amazingly, he was able to get many of these severely ill mental patients well enough to lead normal lives.
It turns out pellagra, a disorder caused by extreme niacin deficiency, produces the same psychiatric symptoms found in schizophrenia. In fact, Hoffer discovered that many schizophrenic patients were niacin dependent, meaning they needed far more niacin on a regular basis than normal in order to remain well.
Other researchers have found niacin may also be successfully used in the treatment of other mental disorders, including obsessive-compulsive disorder, attention deficit disorder, anxiety, and depression.
Holistic Mental Health Suggestions
Regardless of the nature or severity of your mental health problem, to successfully treat it, you need to take a holistic approach. Rarely will medication be the sole answer. And, considering the seriousness of some side effects, which include depression, suicide, cardiovascular events and premature death, taking an antidepressant for preventive purposes is definitely not recommended. Instead, whether you want to prevent depression or treat it, be sure to address your diet and any nutrient deficiencies you may have.
A holistic doctor will be able to help you determine your nutrient status with appropriate tests, and identify any food sensitivities you may have. Most people need higher amounts of vitamin D and omega-3, but to determine your ideal dose, be sure to get a vitamin D and omega-3 index test. Following are some additional guidelines and suggestions — presented in no particular order — to keep in mind:
What to Do if Someone You Know Is Depressed
Perhaps one of the most helpful things you can do if you have a friend or family member who struggles with depression is to help guide them toward healthier eating and lifestyle habits, as making changes can be particularly difficult when you’re feeling blue — or worse, suicidal.
If you are feeling desperate or have any thoughts of suicide, please call the National Suicide Prevention Lifeline, a toll-free number: 800-273-TALK (8255), or call 911, or simply go to your nearest hospital emergency department. You cannot make long-term plans for lifestyle changes when you are in the middle of a crisis.
*Article originally appeared at Mercola.