Functional Medicine

Case Study: Janel’s Anti-Depression Plan

Janel came to me to improve her mood and lose weight. On a scale of 1 to 10 she rated her mood as a 1. She was barely making it out of bed and social interaction left her exhausted. She was a non-responder to SSRI’s (ie Prozac and Zoloft) and was concerned about weight gain with a pharmaceutical intervention.

Depression can often result from an unresolved psychological issue, but when depression is not transient, it is frequently due to a neurotransmitter imbalance. This is the precise mechanism that anti-depressants work on.  Janel could not identify a particular event that caused her depression. This lead me to believe that her depression was a biochemical imbalance in the body versus emotional (although often it is both). My aim was to identify which neurotransmitters were low and why, and bring them back into balance to alleviate Janel’s depression.

The Plan

We ran an adrenal stress index and neurotransmitter test on Janel. This is a simple test using saliva and urine. Janel came back with normal levels of serotonin, the “feel good” neurotransmitter, which explained why she did not respond to SSRI’s because she was not deficient in serotonin. However, her dopamine levels were low and this was manifesting in her apathy and desire to retreat from the world.  Janel also had very low cortisol levels, due to years of stress from running her own business. Her adrenals were fatigued and she was failing to produce the right amount of cortisol to take her throughout the day, let alone deal with stressful situations. I needed to reset her cortisol levels, nourish her adrenals and boost her dopamine levels to alleviate her depression.

To regulate her cortisol levels, I used a botanical supplement with adrenal cortex and adrenal supporting herbs. I added a high strength multivitamin, a potent B complex, magnesium, zinc and Vitamin C to provide the co-factors to create both cortisol and dopamine.  I added high dose omega 3’s and Vitamin D to sensitize her body to cortisol and dopamine and I used a dopamine pre-cursor (L-dopa) derived from a nutrient dense bean, Vicia faba, to increase her dopamine levels.

As Janel could barely make it out of bed, I did not over-haul her diet.  Instead, I asked her to add lean protein to every single meal.  Protein provides the amino acids to create neurotransmitters and without sufficient protein, it is impossible to synthesize an optimal level of neurotransmitters. I recommended she consume whey protein in the form of a smoothie and eggs for breakfast as both contain the most bioavailable form of amino acids.  Eggs are also rich choline which sensitizes the body to your neurotransmitters. I added a green powder to her shake to boost her antioxidant and magnesium levels.

I also recommended that Janel swap her cardio workout at the gym for a flow-style yoga. As her adrenals were stressed, her exercise regime was simply another stressor and she needed something more restorative.

The Results

After five days, Janel’s mood had improved from a 1 to a 6. A significant improvement in a very short period of time. Janel felt like she could live her life again. Everyday she felt stronger and she could respond to stressful situations without bursting into tears. While a 6 is a marked improvement from a 1, we wanted her to be a 10. After 2 months of being at a 6, I had to dig deeper.  Something else was contributing to her depression.

Through more functional medicine testing, I identified that Janel had extremely high levels of mercury and was not detoxifying appropriately. She also had very low levels of magnesium and potassium and was very likely to not be producing her body’s key antioxidant, glutathione. I recommended she see an integrative doctor who could we could boost her magnesium levels quickly though IV therapy.  Janel did not want to take this route.

Instead, we increased her magnesium levels by maximizing her dietary intake. Magnesium and potassium are rich in green vegetables so we added green smoothies to her breakfast and used green juices as an afternoon snack.  Lunch consisted of raw salads with protein and dinner cooked vegetables with protein. I upped her supplement dosage and combined several forms of magnesium.I also added ALA, NAC, selenium, sulforaphane, grapeseed extract and suggested she drink coconut water daily to increase her potassium levels.

Nine months on her mood has improved to a 9, she has lost more than 30 pounds, her skin glows and she feels like a 20 year old (she is 55). She is currently undertaking chelation therapy to remove the mercury.

Depression can be complex, but once you find the core root of the depression, you can resolve it.  In Janel’s case, it was toxicity, low nutrient levels and a high stress lifestyle.

Depressed?  Tell me about your successes and challenges.