This is a very common complaint, although true clinical depression is far less common than is often thought.

Grief, Moodiness, sadness etc., are all normal emotional experiences that we encounter daily. Depression is the ingrained behaviour patterns that disrupt normal everyday living and social relationships. One in four people will express some kind of depressive problem at some time in their lives, with women more at risk than men. Cultural social ; class or race does not seem to have a bearing on the incidence of depression.

Certain criteria are used to establish the presence of clinical depression, with 5 out of the following 7 criteria for at least one month being necessary to constitute clinical depression.

1. Physical inactivity or hyperactivity.
2. Insomnia or hypersomnia
3. Poor appetite with weight loss or increased appetite with weight gain.
4. Loss of energy and experiencing great fatigue.
5. Feelings of worthlessness, self reproach or inappropriate guilt.
6. Diminished ability to think clearly or concentrate.
7. Recurrent thoughts of death or suicide.

Depression is most likely a multi-factorial condition. Essentially it can be psychological and biochemical. Psychological explanations include several models, and these are best referred to a skilled counsellor/psychotherapist who have the tools to explore the subconscious mind. Biochemical explanations are a different story and many nutritional and lifestyle adjustments can make many differences.

Diet.

Food and environmental allergens may cause or set off depressive states. Allergy testing may be used if the person is not too depressed to follow instructions followed by elimination and challenge diets which can be used to determine specific food allergies. See Allergy/Hypersensitivty.

Nutritional deficiency.

Folic acid and Vitamin B12 stimulate the synthesis of tetrahydrobiopterin which is an essential co-enzyme in the formation of several neurotransmitters. Many depressive patients show a deficiency of BH4 which can be corrected by administration of B12 and folate. Many depressive patients are often deficient in Folic acid and supplementation may help many. B12 deficiency should also be corrected and can help.

Niacin deficiency leads to decreased energy metabolism in the brain resulting in apathy, anxiety feelings of loss and sadness, irritability, memory loss and emotional lability. Niacin is made from tryptophan and Niacin deficiency is often a deficiency of tryptophan. Tryptophan deficiency leads to reduced serotonin synthesis, the neurotransmitter that is involved in mood regulation, relaxation and sleep. Low tryptophan will also reduce melatonin synthesis the hormone involved with regulation of reproductive cycles and biological clocks. Depressed patients appear to have low uptake of tryptophan into the brain. This uptake of tryptophan is shared with other neutral amino acids such as isoleucine, leucine, phenylalanine, tyrosine and valine. These are abundant in animal proteins and less abundant in vegetable proteins. Thus a meat and dairy based meal may trigger depression in sensitive people whereas a meal based on unrefined carbohydrate/protein foods (beans and cereals) should not cause a problem.

Phenylalanine is converted in the body into phenylethylamine (PEA) which is an endogenous stimulant and anti-depressive substance. In depressive patients, low levels of PEA are often found, and this may be why these people crave chocolate, which is notably high in phenylalanine.

Methionine deficiency is associated with a deficiency of S-adenosylmethionine which also acts as an endogenous anti-depressant.

Pyridoxine (Vitamin B6) is involved in the synthesis of many monoamine neurotransmitters (serotonin, adrenaline & dopamine) and is frequently deficient in people with depression.

Tyrosine deficiency is seen in some depressive people and may be associated with low thyroid function, reduced monoamine synthesis and reduced tyramine and PEA levels.

Further factors To Consider. Caffeine is known to cause clinical symptoms similar to those of anxiety states when taken in large doses, or even in small doses by sensitive individuals. Never cut caffeine out in one step, reduce the number of cups of coffee or glasses of cola slowly, replacing one or two with something else and do this slowly adding one extra cup or glass every 7-10 days, until you have reduced down to either a small amount or none daily. Symptoms of caffeine intake can be anxiety, irritability, moodiness, palpitations, headache and muscle twitching.

Smoking impairs blood flow to the head because of it's vasoconstrictive action and displaces CO2 in the erythrocytes (red blood cells). It also uses up Vitamin B6 and Vitamin C. Excessive release of adrenalin is also caused by nicotine stimulating the adrenal glands which may also contribute to anxiety states. Thus excessive cortisol will also be produced which inhibits the uptake of tryptophan by the brain.

Endocrine causes of depression may include Hypothyroidism,.hyperparathyroidism, Cushing's Syndrome and Addison's Disease.

Neurological causes of depression may include Multiple Sclerosis, Parkinson's, Cerebral Tumours, Seizures, head trauma and early dementia.

Pharmacological causes of depression may include amphetamine withdrawal,cimetidine, indomethacin, mercury, phenothiazine, reserpine, vincristine and vinblastine.

Infectious cause of depression may include infectious mononucleosis, influenza, tertiary syphilis, Tuberculosis, Viral hepatitis and viral pneumonia.

Collagen diseases can also cause depression and include fibromyalgia, rheumatoid arthritis(RA) and systemic lupus erythomatosous(SLE)

Lack of sunlight can lead to a particular type of depression, known as seasonally affected disorder which is well recognised in Northern countries with long dark winters but is now becoming more recognised by many. It is treated by exposure to full spectrum lighting and there are many 'light boxes' now on the market. Anyone who suffers with this type of depression should be advised to go outside as much as possible.

Holistic Treatment Of Depression.

All the above dietary and psychological factors need to be considered when treating depression. Whatever biochemical alterations you decide on, the depressed patient usually needs some form of counselling and psychotherapeutic approach as well. Relaxation therapy and visualisation is also a good place to start.

Supplements For Depression.

• Vitamin B complex 100mg x 3 times daily.
• Vitamin C 1000 - 2000mg daily (or to bowel tolerance)
• Folic acid 400mcg./day
• Vitamin B12 100mcg./day (Often offered by GP as an injection)
• Magnesium 500mg/day
• Calcium 1 gram a day (Remember if you are taking a calcium supplement you need it to contain magnesium and Vit. D for absorption to be adequate)
• Amino acids - As determined by blood test of serum levels.

Herbal Remedies For Depression.

Relaxants.

• Avena sativa (Oats)
• Chamomile recutita (Chamomile)
• Humulus lupulus (Hops)
• Lactuca virosa (Wild lettuce)
• Lavandula officinalis (Lavender)
• Melissa officinalis (Lemon Balm)
• Passiflora incarnata (Passionflower)
• Scutallaria lateriflora(Skullcap)
• Stachys betonica (Wood betony)
• Tilia europea (Lime Flowers)
• Valeriana officinalis (Valerian)
• Verbena officinalis (Vervain)
• Viburnum opulus (Cramp bark)

Stimulants.

• Cola vera (Kola)
• Ginkgo biloba (Ginkgo)
• Panax ginseng (Korean Ginseng)
• Rosmarinus officinalis (Rosemary)
• Turnera diffusa (Damiana)
• Zingiberis officinalis (Ginger)

Tonics.

• Avena sativa (Oats)
• Equisetum arvense (Horsetail)
• Hypericumperofatum (St. John's Wort)
• Stachys betonica (Wood betony)
• Turnera diffusa (Damiana)

It is often a good idea to prescribe two different medicines for bipolar depression. One to take when feeling ' down' and when to take when feeling 'hyper'.

Please contact me.

Cow's milk, which is a staple food for many people (especially children) can be the cause of many problems, including allergic reactions, digestive disorders and catarrhal congestion. This surprises many people, as we have been brought up to believe that milk is supposed to be the most natural, health-giving food.

Milk however is for calves who:

1. Grow at a much faster rate than babies.
2. Have a build up of the correct fermentative bacteria in their intestines.

The correct bacteria enable them to digest Cow's milk which differs considerably from human milk (which is specifically for babies).

It does not seem surprising that in some people cow's milk creates a lot of fermentation producing gas which causes distension, discomfort and in some cases severe pain. Some people are allergic to the protein in milk, particularly 'atopic' (genetically inherited) children who develop infantile eczema often followed by asthma and hay fever. They may be able to tolerate Goats Milk, which has a slightly different protein, otherwise Soya Milk (made from the Soya bean) is a good substitute. There are many kinds on the market now, most of which have a perfectly acceptable taste. Cow's milk is high in saturated fats and gives many people problems. It is high in cholesterol and increases the risk of heart and circulatory problems. Goats and Soya milk are much more easily digested. Many people, who have suffered all their lives from catarrhal problems including sinusitis, tonsillitis, ear infections including 'glue ear' in children and so on, experience a dramatic improvement if they cut out milk and milk products from their diet. Some, who are actually allergic to milk, must cut it out altogether, others benefit by reducing them to a minimum, and may tolerate skimmed milk, cottage cheese and yoghurt. There are many products on the market made from the Soya bean such as Tofu (fermented Soya curd) and Soya flour, a variety of Soya breads and Soya ice creams etc. can now be easily obtained. The risk of protein deficiency as a result of a milk free diet normally only applies to vegetarians or vegans who do not eat meat, fish, poultry, eggs etc., and rely heavily on cheese as a source of protein. They should be particularly careful to obtain enough protein from nuts, seeds and grains etc.

This is a hypersensitivity reaction to one or possibly more constituents of the environment. An immunological reaction to an external allergenic substance.

There are 4 recorded types.

Type 1 (Anaphylaxis)
This is the most common and occurs within 2 hours of re-exposure to the allergen.

These cause:

1 Vasodilation leading to oedema
2. Redness or rash
3. Muscular spasm especially of the bronchioles
4 Increased mucous production

The symptoms may be systemic and generalized or local. Bronchial constriction (Asthma), arthritis, digestive cramps, eczema, headache, hives, loss of concentration, loss of memory, Nasal congestion and urticaria.
In some people this is an almost immediate response to certain allergens such as bee stings or seafood.
Adrenalin needs to be administered immediately to reduce swelling of the airways and reduce the allergic response.

Type 11 (Cytolytic)
This is the result of immunoglobulins G +M against antigens that are bound to other cells.
The classic example of this type of reaction is that of the incompatible blood transfusion.
75% of all food allergy reactions are to some degree a cytocytic reaction.

Type 111 (Immune complex)
This type forms when an antibody binds with an antigen and cause agglutination and precipitation.
If small it may become trapped in the lining of the blood vessel where it activates complement enzymes and causes an inflammatory response.
This may cause diseases like Glomular Nephritis, Rheumatoid Arthritis and Systemic Lupus Erythematosous.
About 80% of food allergy reactions involve some degree of Type 111 hypersensitivity.

Type 1V (Cell mediated)
This is a delayed reaction mediated by T lymphocytes. Allergens entering the body are engulfed by the macrophages and presented to the T cell in the lymph nodes. T cells are primed for that particular antigen and will proliferate in 36 -72 hours. This type of exposure leads to an inflammatory response.
Transplant rejection, the skin test for TB and contact Dermatitis are examples of Type 1V reactions.

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Plants contain chemical compounds which we are able to identify and therefore understand how and why they work.
Qualified medical herbalists are trained in the same diagnostic skills as conventional Doctors but approach each illness by looking at the patient holistically.

Herbs when supplied by a qualified medical herbalist have a good reputation for both efficacy and safety with few if any side effects.
Due to a herbalists extensive training (4 Years) the herbs that can interact with prescription drugs are fully understood and carefully considered.

Most but not all health food shops will try and give you advice, this in itself can be a dangerous as the majority are untrained.

Seeking professional advice is always the safest course.