When Anti-Depressants Don’t Work For You

depressedBefore the year 2000, most medical approaches assumed that the adult brain continuously lost brain cells and was incapable of regeneration. We now know that the brain is incredibly plastic, meaning that it can adapt, grow, and heal. Up until 2 years ago, we believed that the brain was anatomically entirely separate from our immune system. However, the very recent discovery of lymphatic vessels that directly connect the brain to our immune system have incredible implications for our broader understanding of brain health. Add to this a growing body of compelling research linking aberrant immune function to mood disorders, and we finally have some serious tools to investigate alternatives to the traditional serotonin-promoting antidepressant pharmaceuticals that fail for so many people with depression. 

Many of us are familiar with the traditional roster of medications prescribed by our family physicians for symptoms of mild to moderate depression. Their mechanism is generally based on a theory called the “monoamine hypothesis” from the 1960s, in which the cause of depression is theorized to be insufficient levels of various brain chemicals (neurotransmitters), such as serotonin and dopamine. Though these neurotransmitters undoubtedly affect mood, a substantial amount of research suggests that 30% to 80% of people do not respond to these antidepressant medications. And because drug trials most often focus on symptoms, we have very little evidence of whether these drugs actually improve quality of life for people living with depression.  This is where naturopathic medicine and a functional medicine approach, come in.

For the hundreds of patients in my practice with depression or generalized anxiety, moving beyond strategies designed for simple neurotransmitter balance are an absolute must. What’s the underlying cause of the neurotransmitter imbalance? Inflammation is definitely a common contributing factor. A pubmed search of “depression and inflammation” yields over 5000 studies! Included in these is a 2015 study published in JAMA Psychiatry (conducted by the Centre for Addiction and Mental Health’s Campbell Family Mental Health Research Institute in Toronto – way to go!), that concludes that the brains of patients with clinical depression were 30% more inflamed than the brains of patients without depression. It’s not too much of a surprise then when other researchers conclude that a well known anti-inflammatory herb called turmeric, shows great promise for alleviating depression, and with very few side-effects. (Turmeric does interact with some medications, so caution in this regard is advised.)

With mental health concerns, there is certainly no one-size-fits-all solution. However, with all this fantastic research at our fingertips this past decade, I’m amazed that our societal first-line strategy for mental health concerns continues to be drug therapy founded on 1960s theories. As a Naturopathic Doctor, I’m fortunate to be part of a profession that enables me to integrate new research into my diagnosis and treatment plans in a timely manner. It’s time to shift our mental health paradigm to an integrative model that affords so much more freedom and quality of life for people with these destructive symptoms.