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If your legs are healthy, no one is surprised that you are a good runner with strength and stamina. And if you are in a car accident with multiple injuries, including a broken leg, no one is surprised that your mobility is impaired and you can no longer run. Your running behavior has been damaged. People bring you flowers and casseroles.
And yet, when our brain is impaired by hormonal imbalances, neurotransmitter deficits, toxic exposure, high levels of inflammation, excessive oxidative stress and decreased brain cell replication, people are surprised that “thinking behavior” is damaged. How many times have we heard (or said!) “Just calm down,” “Stop worrying!” “Cheer up!” and “Look at the bright side!” I do not think that ever works. Brain health is complicated, and it most certainly can wreak havoc on thoughts and mood. Both depression and anxiety disorders color perception negatively. However, we humans keep thinking that our behavior is under our conscious control and somehow, if our will is strong enough, we can power through any adversity of the mind.
Unfortunately, this belief leads to a great deal of judgement and stigma for people with mental illness, interferes with seeking help, can lead to social isolation, and is life threatening. I personally love all the memes about Winnie the Pooh and Eeyore (the ever-depressed donkey) in which Pooh doesn’t try to cheer him up. Eeyore is still invited to parties, still included in all his friend’s shenanigans, and no one asks him to change. He is loved as he is. Would that we could all be a little more like Winnie the Pooh.
There are some sobering statistics about mental health issues, especially depression. In a recent examination of Danish adults, depression was associated with a reduced life expectancy of 14 years in men and 10 years in women (Laursen et al., 2016).
Even type 2 diabetes doesn’t cause that level of mortality impact, and look at the resources we spend on diabetes every single year for treatment, prevention and research. How do you suppose that compares to expenditures for mental health issues?
This article is not about therapy, but I have to mention that there are therapy interventions that can make a huge difference. There is a great deal of research on cognitive behavioral therapy (CBT) showing that it is highly effective in a wide range of mental health issues. This is not the kind of therapy that focuses on repeated discussions of the past, but rather on identifying and changing patterns for the future.
There are also prescription drugs for both depression and anxiety. Some have better results than others. All have significant side effects. Taking a prescription drug may be useful for some, but I urge people to discuss the pros and cons of different interventions with their health care practitioner/mental health professional to decide if it is the best course of action. Drugs can alleviate symptoms, and that can be a godsend, but they do not address the underlying physical issues affecting brain function.
Also, there are two glandular disorders that can manifest as depression and/or anxiety. Low thyroid function mimics depression almost perfectly. It is estimated that up to a third of people with depression have an underlying hypoactive thyroid disorder. Thyroid activity that is too high—hyperthyroidism—almost perfectly mimics anxiety disorders. Adrenal function can also dramatically impact mood, with manifestations that look like depression or anxiety. Therefore, one of the most important things to do when dealing with depression and/or anxiety is to have a complete physical exam, including in depth thyroid and adrenal testing to address these underlying issues if present.
And while you know that there are excellent natural medicines to address adrenal and thyroid issues (which you can find by searching through other entries in this blog online), today we are focusing on doing a deep dive on just three dietary supplements with published human clinical trials that can make a difference in both symptom relief and brain repair.
Echinacea Phytocannabinoids for Anxiety
Echinacea may be a surprising choice because it is best known for boosting immune system function. However, the Hungarian Academy of Science found that there a group of alkamides that act as phytocannabinoids that are found plentifully in the root of one species (Echinacea angustifolia) grown under specific conditions. When extracted and concentrated, these compounds (not found in hemp or marijuana) have the ability to partially bind to cannabinoid receptors in the brain. This binding causes a sensation of calm and relaxation without drowsiness, addiction, appetite changes or interference with thinking and judgement.
This botanical had the best alkamide profile, and laboratory examinations found it to be the most effective—even matching chlordiazepoxide (Librium) for results, but without any of the side effects.
A study published in Phytotherapy Research included women and men with generalized anxiety disorder (GAD) that were assessed using the State-Trait Anxiety Inventory (STAI). Participants were scheduled to use this specialized echinacea extract for one week. Researchers then evaluated their anxiety before, during and after using the product. While the anxiety decreased on day one, in three days, anxiety levels were significantly lower in both state and trait categories. Additionally, the effects remained stable for the duration of the clinical trial—without side effects.
Another placebo-controlled clinical study found that this specialized echinacea extract from Europe has excellent potential for individuals with more severe anxiety. The differences between the groups were impressive. In seven days of use, anxiety scores decreased by almost threefold in the echinacea group when compared to placebo.
Curcumin and Saffron for Depression
Inflammation is a significant factor in most chronic diseases, so it should not surprise us that it plays a major role in depressive disorders. Inflammation changes the nature of how cells interact with each other. The strongest natural anti-inflammatory agent is enhanced absorption curcumin. There have been many depression studies on one form, a curcumin with turmeric essential oils for boosted absorbability called BCM-95 curcumin.
Research at Cork University Hospital and College in Ireland found that chemical stress responses from the hypothalamic-pituitary-adrenal (HPA) axis increase the release of inflammatory cytokines. This has a detrimental effect on the brain and behavior. This is a much more complex set of factors than the previous brain chemistry only model.
Since stressors of various kinds elevate inflammatory markers, an effective treatment plan needs to focus on reduction of inflammation. In a randomized, placebo-controlled clinical study of curcumin and individuals with major depressive disorder (MDD) compared the efficacy and safety of high absorption curcumin blended with turmeric essential oils vs. the prescription anti-depressive fluoxetine (alone or in combination).
The purpose of the study was to determine whether the curcumin could be a useful therapeutic treatment for people with MDD. To qualify for inclusion in the trial, participants were required to be 18 years or older, diagnosed with MDD, and score more than seven on Hamilton Depression Rating Scale (HAMD-17), a standard diagnostic tool used for interviewing and screening patients with possible depression.
The highest proportion of response, measured by the HAMD-17, was in the group using the combination of fluoxetine and BCM-95 curcumin at 77.8 percent. Interestingly, the single-therapy groups scored almost exactly the same, with fluoxetine at 64.7 percent and the curcumin/turmeric essential oil combination at 62.5 percent—numbers so close that the data is not statistically significant from one another.
Therefore, in this study, the specialized curcumin worked as well as the prescription drug fluoxetine in terms of the measurable changes in the HAMD-17 score from baseline to six weeks of treatment. This study provides the first human clinical indication that specialized curcumin may be used as an effective and safe treatment for individuals with MDD without causing significant adverse effects.
Two other ways that curcumin combats depression are by decreasing oxidative stress and increasing neurogenesis, the creation of new brain cells. Both these processes are intimately and powerfully linked to mood.
In addition to curcumin, another yellow orange spice has been proven to help people with depression: saffron.
Saffron fights depression in a number of ways. For many years, researchers believed that depression was primarily a condition of neurochemical imbalance. Today, there is a much more nuanced picture of depression, and most scientists and therapists would agree that brain chemistry, inflammation and the intersection of childhood events and hypothalamic-pituitary-adrenal (HPA) axis stress hormone responses, can all contribute to various types of depressive disorders.
For cases of milder depression—possibly for people dealing with dysthymia (also known as persistent depressive disorder), saffron can offer relief. A double-blind placebo-controlled clinical trial reported in the journal Phytotherapy Research, found that saffron reduced symptoms in just six weeks.
In more serious and harder-to-treat forms of depression, especially when they overlap with anxiety, saffron also works to alleviate symptoms. As for helping balance the mind and body’s healthy chemistry, saffron is uniquely qualified. Saffron has been shown to boost serotonin production, lowers cortisol and helps preserve levels of gamma-aminobutyric acid (GABA). Proper balance of these neurotransmitters is necessary for healthy mood.
The results of a double-blind, placebo-controlled clinical trial published in the journal Phytomedicine show that saffron relieved symptoms of mild to moderate post-partum depression in 96 percent of breastfeeding mothers compared to 43 percent in the placebo group after eight weeks. The complete response rate was 66 percent of the saffron group versus 6 percent for the placebo group. There were no significant adverse effects for the mothers or their infants.
Curcumin works along many pathways, but these differ somewhat from saffron. That means that the combination of curcumin and saffron can offer a wider spectrum on benefits. In fact, a clinical study found that this combination yields impressive results.
In this study, curcumin at a low dosage level, a high dosage level, and a low dosage level combined with saffron were compared to a placebo for their ability to relieve the symptoms of MDD.
One interesting result of this study was that even at lower doses, people responded very well to curcumin or the combination of saffron and curcumin. The botanical dosages effectively helped relieve symptoms of depression and accompanying anxiety for individuals in the test groups. The researchers noted that results may be even stronger for people who can start using saffron and curcumin at an earlier onset of symptoms.
One thing to note here is that it didn’t take a lot of saffron to be an effective dose—only 15 mg twice daily combined with 250 mg twice daily of curcumin was sufficient to make a very positive change. Therefore, though either curcumin or saffron alone can be highly effective, their combination has a natural synergy that boosts benefits significantly.
Conclusion
There are so many other supplements that can offer profound benefits to people struggling with depression and/or anxiety. Some of the best are omega-3 fatty acid extract of salmon, St. John’s wort, vitamin D, standardized ashwagandha, theanine, phosphatidylserine, GABA and more. Reviewing studies to evaluate what is best for you and working with a professional that can offer guidance can have tremendous benefits.VR
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Generalized Symptom Profiles for Depression and Anxiety
According to the National Institute of Mental Health (NIMH), depression is characterized by:
• Persistent sad, anxious or “empty” mood
• Feelings of hopelessness or pessimism
• Feelings of irritability, frustration or restlessness
• Feelings of guilt, worthlessness or helplessness
• Loss of interest or pleasure in hobbies or activities
• Decreased energy, fatigue or being “slowed down”
• Difficulty concentrating, remembering or making decisions
• Difficulty sleeping, early morning awakening or oversleeping
• Changes in appetite or unplanned weight changes
• Aches or pains, headaches, cramps or digestive problems without a clear physical cause and that do not ease even with treatment
• Suicide attempts or thoughts of death or suicide
And generalized anxiety disorder by:
• Feeling restless, wound-up or on-edge
• Being easily fatigued
• Having difficulty concentrating
• Being irritable
• Having headaches, muscle aches, stomachaches or unexplained pains
• Difficulty controlling feelings of worry
• Having sleep problems, such as difficulty falling or staying asleep.
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Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.
