If you look for information on natural ways to treat low mood or depression, you are likely to find advice on the benefits of nutrition and supplementation with products such as vitamin D, high-EPA fish oils or herbs such as St John’s Wort.  All these products can influence the production of mood chemicals or combat the side effects of stress – itself a key player in the initiation of the complex pathway that can lead to depressive symptoms.  You may also read about the benefits of meditation and exercise, but how exactly can these help and, more importantly, do they help?

The hypothalamic-pituitary-adrenal axis (HPA-axis) is a highly complex system involving the hypothalamus (a part of the brain), the pituitary gland (also part of the brain) and the adrenal or suprarenal glands (at the top of each kidney).  It is this  system that regulates how we deal with stress through the release of the  ‘fight or flight’ hormones cortisol and adrenaline.  When we are chronically exposed to stressors, or fail to recover sufficiently from past stress, our bodies remain, to some extent, engaged in the fight/flight/fright mode of the sympathetic nervous system, which over-stimulates the HPA-axis. This can affect our mood as well as our digestive and immune systems.

Studies show that the HPA-axis is activated in different ways during chronic stress, depending on the type of stressor, the person’s response to the stressor and other factors. Chronic stress can result in impaired HPA-axis function, as implicated in mood disorders including depression.  Meditation and exercise, in contrast, have a placatory effect on HPA-axis activity by increasing melatonin and serotonin production (mood-enhancing products) whilst decreasing cortisol production.

It is well accepted that engaging in regular moderate exercise can have a positive effect on mood and sleep patterns.  Further, it seems that non-depressed individuals who take regular exercise are at a much lower risk of ever developing depression. ¹ To stay healthy or to improve health, adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week, most beneficially spread out at 30 minutes over five days.

1. Harvey SB, Hotopf M et al. Physical activity and common mental disorders. The British Journal of Psychiatry (2010) 197: 357-364

Did you know that Dr Nina Bailey is available to answer any of your health-related questions? Call 0845 1300 424 9-5pm Mon-Fri or send her an email.

It’s a universal rule that when things get a little heavy in conversation, some one will always offer, at some point, to ‘put the kettle on’. In fact a ‘nice cup of tea’ has, for decades, been associated with healing, for making things better or just as an excuse to sit down and talk. In fact, ‘tea and talk’ is the theme for this year’s awareness of World Mental Health Day, an international event, held annually on 10th October. The event aims to bring general awareness to and about mental health issues, and this year’s focus surrounds the association between mental health disorders and chronic illness.

For those individuals suffering from depression, life itself is a daily onslaught of both emotional and physical challenges; ensuring that the right treatment is both sought and offered early is essential to the recovery process. A good GP is therefore central to ensuring that individuals receive the best, and most appropriate, mental health care possible. There is increasing recognition that pharmaceutical intervention is not necessarily the key to all treatments – diet, as well as alternative therapies, can be key players in recovery, and should therefore be openly discussed with patients. With more and more people actively seeking non-pharmaceutical treatments for their depression, it is reasonable to hope that a good, open-minded GP should be knowledgeable about the use of complementary and alternative therapies, not only to give their patients accurate and up-to-date information, but also to take into account the benefits of such treatments on other health areas.

Indeed, with depression comes an increased risk of a myriad of other health issues: metabolic syndrome, diabetes, cardiovascular disease and even early onset dementia, to name but a few. Interestingly, however, there is a common link between all of these illnesses, in the form of omega-3 fatty acids.

Long chain omega-3s, with particular reference to eicosapentaenoic acid (EPA), are integral to normal cell membrane structure and function; low levels of this important fatty acid are linked with many chronic diseases and inflammatory disorders, either through low dietary intake, or through an increase in utilisation, which is not then replaced. The direct intake of EPA, in order to retain a constant supply ready for utilisation within the body, is becoming increasingly recognised as a method of reducing the risk of developing depression, as well as a variety of chronic illnesses that occur with or without the associated depression.

As such, the effectiveness of EPA as an antidepressant, anti-inflammatory and chemo protective agent is rapidly gathering data. Key findings published recently in the Journal of Affective Disorders suggest that individuals who suffer from major depressive disorder are associated with central and peripheral deficits in omega-3 fatty acids, and that these deficits are, in part, due to a reduced capacity to endogenously synthesise these important fats because of genetic differences in the enzymes responsible for their manufacture. The consequences of these genetic differences could also reflect on the susceptibility to develop further health issues, against which long chain omega-3s play a major protective role. The author suggests that intervention with preformed long chain omega-3 offers a therapeutic method that bypasses potentially defective pathways1. Furthermore, these findings offer a possible explanation towards the therapeutic actions that are experienced by individuals who opt to use Vegepa known for its high EPA content, as an alternative to using common anti-depressant drugs.

McNamara RK, Liu Y.Reduced expression of fatty acid biosynthesis genes in the prefrontal cortex of patients with major depressive disorder. J Affect Disord. 2010 Sep 20. [Epub ahead of print]

Omega-3s have dominated the media spotlight for quite some time, notable for their role in the development of the brain, cardiovascular health, immune and eye function, but scientists believe that there is an awful lot more to discover about these important nutrients. Despite the Advertising Standards Agency currently only permitting health claims in relation to heart health and joint health, a good deal of research demonstrates a link between low levels of long-chain fatty acids and mental health problems such as depression, bipolar disorder and schizophrenia.

Experts believe that the average Western diet is a major factor in the development of certain mental health problems, which affect 1 in 4 of us in the UK each year.[1] Most people realise that consuming too many processed foods high in trans fats, saturated fat and sugar isn’t good for our waistlines but what might not occur to people is that this type of eating can also lead to conditions like depression. This type of diet tends to go hand in hand with low consumption of oily fish rich in omega-3 and micronutrient-packed fruit and vegetables. Parents take note because, if this sounds familiar, your children are more likely to develop behavioural problems and learning difficulties, according to Dr Ray Rice of the International Society for the Study of Fatty Acids and Lipids.

When comparing the average Western diet to that which is typical in the Far East, it appears that our diets somewhat fall short. With an incidence of 6%, depression is 60 times more common in New Zealand where fish consumption is very low, when compared with Japan, where it affects just 0.12% of the population.[2] Scientists suggest that one of the reasons for the low rate of depression is the high intake of omega-rich oily fish by our Far Eastern counterparts.

Fish is a vital source of the long-chain omega-3 polyunsaturated fatty acid EPA (eicosapentaenoic acid), which is crucial for moderating the mood-enhancing neurotransmitter serotonin. Fundamentally, the purpose of this fat is to ensure that cell membranes in the body, including those in the brain, are functioning fluidly. Depressive symptoms can occur when low levels of EPA slow down communication between brain cells, creating a chemical imbalance in the brain which affects the production of mood-stabilising neurotransmitters.

The evidence

A number of trials have shown a link between depression and levels of omega-3 fatty acids, particularly EPA. In several studies scientists have demonstrated the efficacy of pure EPA supplementation in depressed patients, ranging from those with mild or moderate depression, to those with severe depression and bipolar disorder. The American Psychiatric Association has since recommended treatment with at least 1g/day of omega-3 for these conditions as an addition to standard treatment.

A large double blind, randomised trial published showed that the omega-3 EPA is as effective as Prozac in the treatment of depression and, when used in combination, is increasingly advantageous.[3] Indeed, leading clinicians and researchers such as Dr Dianne LeFevre, consultant psychiatrist with over 40 years’ clinical experience, and Professor Basant K. Puri, Head of the Lipid Neuroscience Department at Imperial College, London, use our pure EPA supplement Vegepa, for patients with depression, with extremely positive results.

Experts agree that ideally we should get our fatty acids from food – between two and four portions of oily fish a week is the Food Standards Agency recommendation – but on average we in the UK eat only a third of a portion of oily fish a week. For conditions such as depression, which require much higher doses of omega-3, clinicians prefer to use molecularly distilled EPA which has been rigorously purified, to remove unwanted dioxins and PCBs which prevent us from safely consuming high amounts of fish in our diet. Signs of a deficiency, which suggest that supplementation would be advantageous, include dry skin, dandruff, excessive thirst, emotional sensitivity and problems with vision, attention, memory and sleep.

Help us to support the Mental Health Foundation

We are donating a proportion of the proceeds from the sale of Vegepa this month to the Mental Health Foundation, in support of Mental Health Action Week – a campaign to raise awareness of the issues surrounding mental health within the general population. Igennus actively supports charities and research organisations focused on finding effective natural treatments for a range of ailments, with a view to helping to improve the quality of life for those affected by mental and physical illness.

[2] Hibbeln, J.R. (1998) Fish consumption and major depression. Lancet. Apr 18;351(9110):1213.

[3] Jazayeri, S., Tehrani-Doost, M., Keshavarz, S.A., Hosseini, M., Djazayery, A., Amini, H., Jalali, M. and Peet, M. (2008) Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive order, Australian and New Zealand Journal of Psychiatry, 42:3, 192 – 198.