Whether you have only recently learned that you have depression or have been living with it for years, you’ll find information on here to keep you updated with developments in the treatment field, including medical research and health news. Our ongoing dialogue with our customers enables us to keep providing you with information and support. Look out for our quarterly newsletter (sign up on the left menu) and articles from leading experts in the field. You can find general health information in our Newsroom, where you’ll find our news releases, articles and media cuttings archive. Recognising the causes of depressionBeating depression naturally

Typical symptoms may include:

• Persistent low mood
• Feelings of despair and hopelessness
• Loss of interest and pleasure in activities
• Lack of energy
• Disrupted sleep patterns
• Difficulty concentrating
• Indecisiveness
• Feelings of worthlessness
• Anxiety, sometimes in the form of panic attacks
• Changes in appetite, leading to weight loss or weight gain
• Impatience, irritability
• Loss of libido
• Persistent, unrelenting negative thoughts
• Suicidal thoughts

No two people suffer the same type of depression, and symptoms vary significantly in severity. The term ‘Depression’ encompasses a wide range of mood disorders and accompanying symptoms, although there are two broad types. ‘Reactive’ depression is the term attributed to an emotional state-of-being seen as a consequence of external factors, such as bereavement. ‘Clinical’ depression, on the other hand, has no known single cause, although the consensus seems to be that it is biological in origin. Anyone can suffer from depressed feelings – indeed most of us will at various times during our lives. These episodes are usually overcome fairly straightforwardly. If an episode becomes long-lasting or periods of depression keep occurring, then it can affect an individual to the point where they become unable to look after themselves on a daily basis, and this is known as clinical depression. According to the World Health Organisation (WHO), depression is the leading cause of disability, with between 5 and 10% of the population suffering from the illness to some extent at any one time. Research from Harvard puts the rate of increase of depression among children at a staggering 23 per cent per annum. [1] The World Health Organisation (WHO) has warned that by 2020 major depression will rank second on the list of illnesses to pose the greatest global health burden, in terms of early death, lost man-hours and use of medical resources. (heart disease is top of the list.) [2] Within an average person’s lifetime they will have a 20% chance of having an episode of depression. The WHO have been quoted as saying that 15% of the population of most developed countries suffer severe depression. [3] Overall, depression affects about 121 million people worldwide and it is thought that about 850,000 lives every year are lost to suicide as a direct result of depression. Whilst depression can be reliably diagnosed and treated in primary care, it is estimated that fewer than 25% of those affected have access to effective treatment. This is often due to lack of resources, lack of trained providers, but also because of the social stigma that is associated with mental disorders, meaning that people may not seek help in the first place. [1] Harvard University study reported in Harvard Mental Health Newsletter, February 2002. [2] World Health Organization (WHO) report on mental illness, 4th October 2001. 3] World Health Organization (WHO) report quoted on BBC Online, 9th January 2001. Available: http://news.bbc.co.uk/1/hi/health/1108793.stm.

Whilst the causes of depression are still poorly understood, it is thought to occur as a result of physical, psychological and environmental factors. The chemical neurotransmitters serotonin, noradrenalin and dopamine are all important in regulating many functions in the brain, including our mood. Depression can occur as a direct result of a chemical imbalance in one or more of these substances in the brain. Stress also plays a part in the onset of depression. The ‘fight or flight’ response is the body’s primitive and automatic response that prepares the body to ‘fight’ or ‘run’ from perceived attack or, in other words, our biological response to acute stress. During a stressful experience, there is a complex set of interactions between the hypothalamus (a part of the brain), the pituitary gland (also part of the brain) and the adrenal glands (at the top of each kidney). Several types of neurotransmitters are involved in this system, collectively known as the HPA-axis. Continued stress, however, can cause overactivity of the HPA-axis and result in an imbalance of neurotransmitters. It is thought that it is this imbalance which plays a pivotal role in the development of depressive symptoms. As with many conditions and diseases, changes in any of the genes involved in a neurotransmitter pathway or those genes that are responsible for controlling neurotransmitter production can also influence the risk of depression. If there is familial history of depressive illness (genetic susceptibility), this increases the chance of an individual experiencing depression themselves.

Long-chain omega-3 fatty acid deficiency is a common feature associated with depression. Over 30 peer-reviewed papers have been published over the last decade, suggesting that increasing omega-3 levels and restoring the body’s natural omega-6 to omega-3 ratio has significant health benefits, and major benefits for depression sufferers. The ratio of EPA to DHA within fish oil is of significance when establishing the efficacy of a supplement in the treatment of depression; the higher the EPA to DHA content, the greater the efficacy; EPA has to be in excess of DHA to show benefits. Therefore oils containing DHA may not be suitable for the treatment of depression and may explain the lack of efficacy with the use of generic fish oils. The ethyl-EPA in E-EPA 90 and Vegepa E-EPA 70 is prescription-strength and especially concentrated, with DHA removed to ensure optimal efficacy. E-EPA has been shown to offer effective support for mood balance, stress relief and the regulation of inflammatory products, balancing the mood-regulating neurotransmitters tryptophan and serotonin. Taken at a dosage of 1 gram daily for three months and as effective as antidepressants in its actions, ethyl-EPA is becoming recognised as a safe, convenient treatment for depression and without the negative side effects associated with conventional medication. References Martins JG, Bentsen H, Puri BK. (2012) Eicosapentaenoic acid appears to be the key omega-3 fatty acid component associated with efficacy in major depressive disorder: a critique of Bloch and Hannestad and updated meta-analysis. Mol Psychiatry. 2012 Apr. Martins JG. (2009) EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr. 28:525-42. Review Sublette ME, Ellis SP, Geant AL, Mann JJ. (2011) Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry. 72:1577-84. Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, Jalali M, Peet M. (2008) Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder. Aust N Z J Psychiatry. 42:192-8. Jazayeri S, Keshavarz SA, Tehrani-Doost M, Djalali M, Hosseini M, Amini H, Chamari M, Djazayery A. (2010) Effects of eicosapentaenoic acid and fluoxetine on plasma cortisol, serum interleukin-1beta and interleukin-6 concentrations in patients with major depressive disorder. Psychiatry Res. 178:112-5.