Serotonin Deficient Depression SDD
© www.PeterSmithUK.comThe Nature of Serotonin
Serotonin influences your mood, with adequate levels of serotonin one feels balanced and calm. Serotonin also plays an important role in good quality sleep and our sleep/wake cycle.Deficiency of serotonin can cause depression characterises by very painful thoughts and feelings, anguish, pessimistic thoughts and feelings, low mood, feelings of worthlessness, suicidal thoughts and insomnia.
Imbalances in serotonin may also be involved in:-
aggressive behaviour,
learning disabilities,
obsessive-compulsive disorders,
eating disorders (dopamine may also be involved in this),
irritable bowel syndrome and
increased sensitivity to pain.
With regards to depression you can think of serotonin as the mind's natural painkiller that anaesthetizes painful thoughts, feelings and memories. Without adequate serotonin activity in the brain one can feel the full brunt of one’s painful memories, the pain and suffering in the world and simply mental pain for no reason. Restoring healthy serotonin levels can release you from the grip of this painful psychological condition, however it may not make you feel happy. The state of happiness much more that the absence of painful depression, it's a mistake to think that as soon as you stop being ill with depression you will automatically feel happy and get a free pass on stress. I regret to say that I’ve met several psychotherapists that made this fundamental mistake. It could happen if you were blessed with a naturally happy disposition but then it’s unlikely you would suffer from depression in the first place especially one due to a chemical imbalance in the brain.
I’ve known people be surprised to find that once they have overcome their depression using therapy and remedies their life became just OK. Ordinarily healthy people do not feel totally happy all the time, the normal state of the human condition is to have ups and downs, trials and tribulations and experience a full range of appropriate emotions in response to life experiences. When serotonin levels are low ones emotional range can be confined to only low, painful and unhappy feelings; I've heard many people with endogenous depression describe their condition feel like a kind of internal mental prison.
The purpose of this book is to show you effective nondrug techniques to free yourself from the limitations imposed on your mind by the chemical imbalance in your brain. Once you’ve broken free from the chemical limitations you will at least have the possibility to live a healthy life and achieve happiness, fulfilment and success in whatever way you measure them. You will still need to do other things beyond just balancing your brain chemistry, such engage in rewarding work, develop relationships and interests, use personal growth and psychotherapy techniques to free yourself from painful memories and unhealthy psychological programming (do a psychological jailbreak if you want), meditate, keep fit etc. etc.
An analogy can be made with physical health, curing oneself of an illness makes you free from illness not necessarily super fit; to become super fit you have to work at it.
As an inhibitory neurotransmitter serotonin not only calms and quells painful unhappy thoughts and feelings but it also contributes to controlling anxious and worrying thoughts and feelings. It may not be as directly involved in anxiety as GABA, but a deficiency of serotonin can cause a state of anxiety. When both serotonin and GABA levels are low it can create a state of anxious depression. I had this condition for almost a year in my early 20s and can personally testify that it is a particularly hideous combination.
The nature of serotonin deficient depression (SDD) is notably different to dopamine deficient depression (DDD). To visualise SDD, picture a tortured Russian poet, nervy, at least slightly anxious, painfully pessimistic, intensely unhappy. Without the possibility of the peaceful, happy and optimistic thoughts that serotonin enables us to create, the mind can be take-over by negativity and pessimism. It is often said that a person with depression appears numb and unresponsive, however on the inside a person with SDD feels anything but numb. With SDD ones inner world is very intense, there can be an overwhelming amount of stuff going on, and all of it painful. The intensity of the inner pain and unhappiness can be so all-consuming it takes up their entire focus, this may make them become unresponsive to the outside world, but it is most decidedly not a numb or un-feeling state. Quite the opposite in fact without adequate serotonin to inhibit unhappy thoughts there is an overabundance of painful feelings. In DDD on the other hand one lacks intensity. The loss of all enthusiasm, motivation and capacity for joy is more a state of apathy, creating a pointless insipid existence devoid of interest and engagement in life.
learning disabilities,
obsessive-compulsive disorders,
eating disorders (dopamine may also be involved in this),
irritable bowel syndrome and
increased sensitivity to pain.
With regards to depression you can think of serotonin as the mind's natural painkiller that anaesthetizes painful thoughts, feelings and memories. Without adequate serotonin activity in the brain one can feel the full brunt of one’s painful memories, the pain and suffering in the world and simply mental pain for no reason. Restoring healthy serotonin levels can release you from the grip of this painful psychological condition, however it may not make you feel happy. The state of happiness much more that the absence of painful depression, it's a mistake to think that as soon as you stop being ill with depression you will automatically feel happy and get a free pass on stress. I regret to say that I’ve met several psychotherapists that made this fundamental mistake. It could happen if you were blessed with a naturally happy disposition but then it’s unlikely you would suffer from depression in the first place especially one due to a chemical imbalance in the brain.
I’ve known people be surprised to find that once they have overcome their depression using therapy and remedies their life became just OK. Ordinarily healthy people do not feel totally happy all the time, the normal state of the human condition is to have ups and downs, trials and tribulations and experience a full range of appropriate emotions in response to life experiences. When serotonin levels are low ones emotional range can be confined to only low, painful and unhappy feelings; I've heard many people with endogenous depression describe their condition feel like a kind of internal mental prison.
The purpose of this book is to show you effective nondrug techniques to free yourself from the limitations imposed on your mind by the chemical imbalance in your brain. Once you’ve broken free from the chemical limitations you will at least have the possibility to live a healthy life and achieve happiness, fulfilment and success in whatever way you measure them. You will still need to do other things beyond just balancing your brain chemistry, such engage in rewarding work, develop relationships and interests, use personal growth and psychotherapy techniques to free yourself from painful memories and unhealthy psychological programming (do a psychological jailbreak if you want), meditate, keep fit etc. etc.
An analogy can be made with physical health, curing oneself of an illness makes you free from illness not necessarily super fit; to become super fit you have to work at it.
As an inhibitory neurotransmitter serotonin not only calms and quells painful unhappy thoughts and feelings but it also contributes to controlling anxious and worrying thoughts and feelings. It may not be as directly involved in anxiety as GABA, but a deficiency of serotonin can cause a state of anxiety. When both serotonin and GABA levels are low it can create a state of anxious depression. I had this condition for almost a year in my early 20s and can personally testify that it is a particularly hideous combination.
The nature of serotonin deficient depression (SDD) is notably different to dopamine deficient depression (DDD). To visualise SDD, picture a tortured Russian poet, nervy, at least slightly anxious, painfully pessimistic, intensely unhappy. Without the possibility of the peaceful, happy and optimistic thoughts that serotonin enables us to create, the mind can be take-over by negativity and pessimism. It is often said that a person with depression appears numb and unresponsive, however on the inside a person with SDD feels anything but numb. With SDD ones inner world is very intense, there can be an overwhelming amount of stuff going on, and all of it painful. The intensity of the inner pain and unhappiness can be so all-consuming it takes up their entire focus, this may make them become unresponsive to the outside world, but it is most decidedly not a numb or un-feeling state. Quite the opposite in fact without adequate serotonin to inhibit unhappy thoughts there is an overabundance of painful feelings. In DDD on the other hand one lacks intensity. The loss of all enthusiasm, motivation and capacity for joy is more a state of apathy, creating a pointless insipid existence devoid of interest and engagement in life.
- With DDD one can get virtual total loss of interest in life so that life becomes a tortuous drudgery.
- With SDD one is tortured by feeling the pain and suffering of all things or just being alive in general.
- A person with lack of serotonin may think about suicide as a desperate option to end the excruciating pain they feel.
- The person with lack of dopamine may think about suicide because they feel there’s nothing much left to live for, what is the point so speak.
Having said all this please note that the above descriptions can only ever serve as a general guide, my descriptions of the nature of neurotransmitters and the differences between them are just useful rules of thumb based on my own experiences and over two decades of study and clinical observation.
When you supplement the amino acid tryptophan it can only boost the levels of serotonin, it cannot make more dopamine; and vice versa: when you supplement tyrosine it produces dopamine, it does not make more serotonin. This fact is very helpful to know because it enables you to supplement just the one specific neurotransmitter at a time and get a clear feeling of its distinctive antidepressant effects. It also enables you to test which neurotransmitter you’re deficient of.
Unfortunately it's possible to have a deficiency in both serotonin and dopamine at the same time, I lack the literary skills to adequately describe this complex state. The loss of feeling and connection to the world due to lack of dopamine may actually dumb down the feelings of suffering the low serotonin creates. This may sound like a benefit, but it can create a complex condition with a background feeling that the world is still a painful place (SDD), but there is no point to anything anyway (DDD); not a happy place! Also to make things worse the neurotransmitter levels may not be constant, causing waves of pain then apathy. Treating such a mixed condition may be challenging in the beginning stages.
Tell a person with SDD to look on the bright side because there are other people much worse off in the world will only focus their mind and feelings on this additional pain and suffering, making them feel worse, don’t do it! If you can cheer someone up with such comments they were just “normally” unhappy/stressed and not mentally ill with depression.
Serotonin is also found in the walls of the intestine (the enteric nervous system) andmay be significantly involved in irritable bowel syndrome.
When you supplement the amino acid tryptophan it can only boost the levels of serotonin, it cannot make more dopamine; and vice versa: when you supplement tyrosine it produces dopamine, it does not make more serotonin. This fact is very helpful to know because it enables you to supplement just the one specific neurotransmitter at a time and get a clear feeling of its distinctive antidepressant effects. It also enables you to test which neurotransmitter you’re deficient of.
Unfortunately it's possible to have a deficiency in both serotonin and dopamine at the same time, I lack the literary skills to adequately describe this complex state. The loss of feeling and connection to the world due to lack of dopamine may actually dumb down the feelings of suffering the low serotonin creates. This may sound like a benefit, but it can create a complex condition with a background feeling that the world is still a painful place (SDD), but there is no point to anything anyway (DDD); not a happy place! Also to make things worse the neurotransmitter levels may not be constant, causing waves of pain then apathy. Treating such a mixed condition may be challenging in the beginning stages.
Tell a person with SDD to look on the bright side because there are other people much worse off in the world will only focus their mind and feelings on this additional pain and suffering, making them feel worse, don’t do it! If you can cheer someone up with such comments they were just “normally” unhappy/stressed and not mentally ill with depression.
Serotonin is also found in the walls of the intestine (the enteric nervous system) andmay be significantly involved in irritable bowel syndrome.
Serotonin Deficiency Questionnaire
You can use this questionnaire and the description above as guides, but questionnaires are fundamentally poor ways to determine medical conditions and nothing beats real world experimentation, if you suspect you have SDD try the remedies in this chapter and you will know for real if boosting serotonin is helpful for you.
If you score more than 15 points it would be worth trying increasing your serotonin levels with the remedies discussed in this chapter.
Regularly eating carbs on their own to try and boost serotonin could lead to a condition called hypoglycaemia where your blood sugar initially rises then crash down to low, the exact opposite of what you want when you have mental health problems, not to mention the other harmful effects of surges of insulin including the risk of developing insulin resistance diabetes and heart disease.
The healthy way to eat carbohydrates is choose low glycaemic index carbs and always eat them with plenty protein and healthy oils. The presence of the oil and protein slows down the release of sugars in the carb and prevents surges of insulin, this stabilises your blood sugar which helps stabilise you mood and improves you energy (especially your stamina). Surges in insulin also accelerate degenerative ageing processes within the body. See the chapter on mastering blood sugar for more information.
Paradoxically tryptophan and serotonin levels temporarily fall after eating a protein meal, despite this the best overall diet to build serotonin levels is actually a high protein diet especially from oily fish and the foods mentioned above.
Personally I take 1000 mg of tryptophan three days a week to maintain healthy levels of serotonin activity in my brain, without this simple and safe support my serotonin levels start to fall and within a week or two I start to go through life accompanied by a melancholic black dog.
Many practitioners have prescribed doses of 6000 mg and I’ve taken experimental doses of 6000mg, the next day this very high dose would make me feel happy but very mellow and tranquil to the extent of being drowsy and sedated. 6000 mg is double the 3000 mg dose I normally prescribe for acute severe depression and six times the maintenance dose I typically prescribe. I have found a dose of 3000 mg more than capable of quickly diminishing severe depression into a minor background feeling.
Any dose over 2000 mg is liable to cause a lingering sedated feeling the next day which you would probably not want to live with all the time, however during periods of painful, antsy, potentially suicidal depression, bipolar rapid-cycling or mixed-states it is highly desirable to not only treat to depression but also sedate the whole psyche to reduce risk of suicide.
The correct maintenance dose of tryptophan induces a good night’s sleep after which you should feel refreshed and more energetic, if you feel drowsy the day after taking tryptophan try adjusting down the dosage.
Tryptophan is also converted into vitamin B3 (niacin, niacinamide), this process takes priority over serotonin production. So if your body is not topped up with sufficient B3 less of the tryptophan you take will be converted into the antidepressant serotonin we are after. You can prevent this simply by taking a B complex containing B3, or a separate niacinamide supplement at the same time as your tryptophan. Some manufacturers (Dr's Best) conveniently include vitamin B3 in a tryptophan formula to maximise serotonin production.
Some research suggests that raising serotonin levels in the systemic blood may actually be potentially harmful to the heart if it is done excessively and over a long period of time. This violates the first rule of natural medicine i.e. first do no harm. 5 HTP is more readily available in the UK than tryptophan however and in an emergency if you desperately need an antidepressant the short term (several weeks) use of 5 HTP is perfectly OK. Alternatively considerSAM-e and or Rhodiola, both of which are quick acting antidepressants.
Besides the potential harmful effects of 5 HTP I've observed that tryptophan produces superior antidepressant effect anyway.
St John’s wort does have some side effects such as an increased risk of sunburn and it such an effective detoxifying agent that when combined with pharmaceuticals it may flush them out to the liver to quickly, see cautions below.
All the above remedies directly increase serotonin levels and they may be taken individually or combined together, see below for a comparison of their different qualities.
A simple minimal prescription for long-term low serotonin levels (serotonin deficiency syndrome, dysthymic depression or bipolar syndrome) is:-
To work out exactly how a remedy is going to affect you, you have to try it for yourself, but to help get you started the notes below are based upon my clinical and personal observations.
There was a time when I had the combination of serotonin and dopamine deficiency myself. No amount of boosting serotonin alone improved the depression and boosting dopamine with tyrosine alone would flip me into borderline hyper-mania only to rapidly cycle back into a depression, I was thoroughly trapped in this predicament for five years only barely functioning in a diminished capacity. It turned out that Rhodiola just happened to produce the perfect balance I needed at that time. It played a central role (together with tryptophan, tyrosine Lithinase B complex and B6) in my recovery from several years of serious illness. It dependably balanced my brain chemistry throughout the recovery period, whenever I omitted to take it the condition would begin to return within days. After two years I was able to wean myself off a daily dose and at the time of writing I still use it for or five days per week.
St John's wort does have some other potentially undesirable side-effects:
Firstly it increases the skin's sensitivity to sunburn and therefore you need to take extra precautions (sun avoidance/blocking etc.). Please take this seriously particularly if you are fair skinned as sun-burning is highly cancer-causing.
Secondly St John's wort effectively increases the liver's ability to detoxify and flush drugs out of the body. This property of St John's wort can be a benefit or a problem. If you take St John's wort at the same time as you are taking an essential medication such as an anti-epileptic drug or the contraceptive pill it's possible that your liver will flush these drug out of your system to quickly and leave you unprotected. On the other hand if you want to detoxify and flush drug residues out of your body and liver then St John's wort can help you do this in addition to being an effective antidepressant.
Thirdly it may be hazardous to take St John's wort together with pharmaceutical antidepressants; this is because on the one hand the St John's wort may flush the antidepressant drugs out of your body so quickly that you have a rapid withdrawal and experience a sudden withdrawal depression. This effect should be fairly short-term however because the St John's wort will itself quickly take over as an effective antidepressant. Another possibility, with potentially serious physical consequences, is that if you continue to take antidepressants at the same time as the St John's wort together they may cause what is called serotonin syndrome. See caution one below. The bottom line is be safe, and unless you're medically qualified and absolutely know what you doing don't mix alternative antidepressant remedies with pharmaceutical antidepressants at the same time.
It is suggested within the medical literature that it is possible that tryptophan may raise blood pressure. I have not observed this phenomenon in myself or my patients with the size of dosages I use. As an experiment I once took triple my maximum dose and monitored my blood pressure every 15 minutes for several hours afterwards, and did not observe any increase in my blood pressure. It's also possible to lower elevated blood pressure by many points with a combination of the right dietary changes, magnesium supplementation and training your nervous system the relaxation response. However if hypertension is a concern for you simply monitor your blood pressure when you introduce tryptophan and periodically thereafter.
Antidepressants reduce your ability to remove serotonin from the nerve junctions (synapses) therefore prolonging serotonin's life and increasing its levels, taking tryptophan or other serotonin boosters increases your production of serotonin. This combination of making more serotonin and simultaneously prolonging its’ life may “flood” the synapses with excessive levels of serotonin causing a dangerous condition known as serotonin syndrome. BE SAFE, DON’T DO IT.
See the “wash out times” for individual antidepressant drugs in the appendix. This is the time the drug lingers in your system once you’ve stopped taking it and which you need to wait before taking alternative antidepressant remedies. Serotonin syndrome can also be induced my mixing different antidepressants like SSRIs and MAOIs together at the same time. The drugs ecstasy and LSD have also been linked to serotonin syndrome.
Symptoms of serotonin syndrome include rapid heart beat, increased body temperature, sweating, loss of co-ordination nausea and a rapid, dangerous rise in blood pressure; it’s not common but it can be serious. If you have concerns over this start on low doses and monitor your blood pressure and pulse for several hours after taking your prescription.
Under proper use none of the remedies recommend in this book will cause serotonin syndrome.
Meditation is a skill that takes time and commitment to learn, don’t expect to be able to hold the mind still for long in the beginning. One of the most important things is to find a meditation technique that suits you, so be prepared to shop around and try different techniques. Once you've found the right technique you may be pleasantly surprised how easy it is to make a continuous progress.
I am available for private or group meditation classes.
Recommended chanting meditation from kundalini yoga with surprising antidepressant effects is:
The Golden Meditation
During the meditation all you have to do is keep checking you are doing everything correctly: is my back straight, are my hands flat and polishing screen, am I making a little grin on the end of each word and use my focus held on the mid brow point. Checking these things occupy and hold the mental focus on the meditation. Just do the exercises and eventually you will reach feelings of joy. You do not have to do attempt to make up this feeling, just do the exercises correctly and see what happens.
Done daily for minimum of 11 minutes for minimum of 40 consecutive days this meditation is said to treats depression and gives one a happier mental outlook. The time can be increased if desired to either 22 or 31 minutes.
During the night when light stops entering our eyes the pineal gland manufactures melatonin our natural sleep hormone. Melatonin is made from serotonin, and serotonin levels plummet in the brain once melatonin starts to be produced and the serotonin is rapidly used up to make melatonin. In the morning when light begins to enter our eyes again melatonin production is switched off and serotonin levels rise. It is not completely proven but almost certainly the case that the antidepressant effects of bright light therapy are produced by bright light therapy raising serotonin levels.
See the chapter on bright light therapy for more information.
You will be able to purchase all of the above remedies at either
www.Nutricentre.com or
www.iherb.com (you can get a 5% discount off your first order at iherb by using my discount code HUK817.
Is there a history of depression in your family? | 2 |
Do you have a history of sleep problems, either waking up early and not being able to get back to sleep, being a light sleeper or having difficulty falling asleep? | 3 |
Have you had IBS or do you often experience bloating, loose bowels, constipation, or other gastrointestinal distress? | 3 |
Do you have a history of anxious depression, i.e. feeling anxious or nervous at the same time as feeling down and depressed? | 4 |
Have you had depression that started because of a bad experience but seemed to last much longer than was appropriate? | 4 |
Have you had painful depression that came on with no apparent reason? | 7 |
Have you ever taken and gotten relief from your symptoms with prescription antidepressants such as Prozac? | 10 |
Have you ever taken and gotten relief from your symptoms by taking 5-HTP or tryptophan? | 10 |
Is alcohol your drug of choice, do you use alcohol to manage your mood? | 3 |
If you use marijuana does it have a relaxing effect? | 2 |
Do you have a regular pattern of unexplained, inappropriate rages or explosive, angry outbursts? Especially around the times you may have had depression. | 3 |
Have you had suicidal thoughts during your life? | 5 |
Have you have thoughts or behaviours of self-destruction? | 4 |
Total of points you circled |
If you score more than 15 points it would be worth trying increasing your serotonin levels with the remedies discussed in this chapter.
Treating Serotonin Dependant Depression (SSD) with Diet, Supplements and Exercises
Serotonin Boosting Diet
Good food sources of tryptophan that serotonin is made from include: wild game, cottage cheese, duck, egg, avocado, turkey, nutmeg, turmeric, liquorice (anice), brown rice, peanuts and sesame seeds. Eating these foods will not have anything like the strong effect supplementing tryptophan will have, but will ensure adequate background tryptophan levels.Serotonin and Carbohydrates
There is some misleading information online and in print that you can get a serotonin boost by consuming carbohydrates. Some of the original research on this was done with rats and it turns out that rodent brains respond differently to carbohydrates than our brains. Subsequent studies in primates (our close relatives) showed that to get any serotonin boost from carbohydrates you have to eat absolutely pure carbohydrate on its own which is not a very healthy way to eat carbohydrate. It was found that if a carbohydrates meal contains as little as 4% protein then the serotonin boosting effect does not occur and it’s very easy to exceed this 4% level. Other research showed however that consuming a little plain carbohydrate such as rice or potato at the same time as supplementing tryptophan does increase the entry of the tryptophan into the brain. This effect was demonstrated in primates (monkeys) and will almost definitely occur in us humans. My personal experience is that if I take my tryptophan supplement with a small potato, spoon of rice or handful of raisins I can achieve the same antidepressant effect with half my usual dose. This may sound like a good idea but I don't recommend because what you are doing is inducing a surge of insulin that helps the tryptophan enter the brain. You may only get a small surge of insulin from a small portion of carbs but on a healthy diet you want to completely stabilise your blood sugar and prevent ALL surges of insulin. It would be healthier not to eat the simple carbohydrate snack and take a full standard dose of tryptophan on its own.Regularly eating carbs on their own to try and boost serotonin could lead to a condition called hypoglycaemia where your blood sugar initially rises then crash down to low, the exact opposite of what you want when you have mental health problems, not to mention the other harmful effects of surges of insulin including the risk of developing insulin resistance diabetes and heart disease.
The healthy way to eat carbohydrates is choose low glycaemic index carbs and always eat them with plenty protein and healthy oils. The presence of the oil and protein slows down the release of sugars in the carb and prevents surges of insulin, this stabilises your blood sugar which helps stabilise you mood and improves you energy (especially your stamina). Surges in insulin also accelerate degenerative ageing processes within the body. See the chapter on mastering blood sugar for more information.
Paradoxically tryptophan and serotonin levels temporarily fall after eating a protein meal, despite this the best overall diet to build serotonin levels is actually a high protein diet especially from oily fish and the foods mentioned above.
Supplements to boost Serotonin (daily amounts):
The amino acid tryptophan is converted into 5-Hydroxytryptophan (5-HTP) and then into serotonin, supplementing tryptophan is one of the most direct and effective ways of increasing serotonin levels in the brain.Tryptophan à 5-HTP (5-hydroxytryptophan) à Serotonin
- Tryptophan 1000-1500 mg before bed. You can half this dose if you eat a potato, some bread, rice or oats at the same time as a carbohydrate snack helps the tryptophan enter the brain from the blood. At this dosage tryptophan could be continued almost indefinitely however to prevent any possibility of the brain habituating to (getting used to and overcoming) the antidepressant effect I always recommend emitting one day a week. This six days on one day off protocol effectively keeps remedies working at full strength even with long term for conditions like endogenous depression, dysthymia and bipolar syndrome.
Personally I take 1000 mg of tryptophan three days a week to maintain healthy levels of serotonin activity in my brain, without this simple and safe support my serotonin levels start to fall and within a week or two I start to go through life accompanied by a melancholic black dog.
Many practitioners have prescribed doses of 6000 mg and I’ve taken experimental doses of 6000mg, the next day this very high dose would make me feel happy but very mellow and tranquil to the extent of being drowsy and sedated. 6000 mg is double the 3000 mg dose I normally prescribe for acute severe depression and six times the maintenance dose I typically prescribe. I have found a dose of 3000 mg more than capable of quickly diminishing severe depression into a minor background feeling.
Any dose over 2000 mg is liable to cause a lingering sedated feeling the next day which you would probably not want to live with all the time, however during periods of painful, antsy, potentially suicidal depression, bipolar rapid-cycling or mixed-states it is highly desirable to not only treat to depression but also sedate the whole psyche to reduce risk of suicide.
The correct maintenance dose of tryptophan induces a good night’s sleep after which you should feel refreshed and more energetic, if you feel drowsy the day after taking tryptophan try adjusting down the dosage.
Tryptophan is also converted into vitamin B3 (niacin, niacinamide), this process takes priority over serotonin production. So if your body is not topped up with sufficient B3 less of the tryptophan you take will be converted into the antidepressant serotonin we are after. You can prevent this simply by taking a B complex containing B3, or a separate niacinamide supplement at the same time as your tryptophan. Some manufacturers (Dr's Best) conveniently include vitamin B3 in a tryptophan formula to maximise serotonin production.
Important Cofactors to Supplement Along with Tryptophan
To ensure tryptophan is converted into serotonin which we want more of and not into quinolinic acid an inflammatory chemical which we want to reduce its essential that you are not deficient of vitamin B6, magnesium and zinc. I would even recommend not taking tryptophan until you have supplemented these other nutrients for 5 days or so:-- High B complex (B 50 mg up to 8 per day). If you are currently depressed start on the high dose and work down from there.
- Magnesium 400-600 mg.
- Zinc 25-50 mg or a multi-mineral containing zinc. Minerals like zinc are not easily absorbed in the intestines so always chose a quality chelated product, or better still the Food State/True Food format from Natures Own, Cytoplan or Higher Nature.
N.B. tryptophan should be taken on and empty stomach or at least away from protein otherwise its effectiveness is diminished. Take them 30 minutes before or 2 ½ hours after a meal containing protein.
Tryptophan verses 5 HTP
You can buy 5 HTP as a supplement and some people mistakenly believe that it would be superior to tryptophan because it is metabolically closer to serotonin. In fact the reverse is true, because 5 HTP is only one step away from serotonin it can be converted into serotonin too quickly before it has had time to enter the brain. For this reason more 5 HTP ends up being converted into serotonin outside the brain in the systemic blood.Some research suggests that raising serotonin levels in the systemic blood may actually be potentially harmful to the heart if it is done excessively and over a long period of time. This violates the first rule of natural medicine i.e. first do no harm. 5 HTP is more readily available in the UK than tryptophan however and in an emergency if you desperately need an antidepressant the short term (several weeks) use of 5 HTP is perfectly OK. Alternatively considerSAM-e and or Rhodiola, both of which are quick acting antidepressants.
Besides the potential harmful effects of 5 HTP I've observed that tryptophan produces superior antidepressant effect anyway.
- St Johns Wort 300 mg (standardised) twice per day, taken with meals.
St John’s wort does have some side effects such as an increased risk of sunburn and it such an effective detoxifying agent that when combined with pharmaceuticals it may flush them out to the liver to quickly, see cautions below.
- Rhodiola (standardised) (I use NOW from www.iherb.com) 500-1000 mg per day. Divide the dough is between two meals.
All the above remedies directly increase serotonin levels and they may be taken individually or combined together, see below for a comparison of their different qualities.
Experimentation
Alternatively if you want to experiment and develop a very tailor-made prescription you could try taking just 1-2 B complex 50 mg and the following individual B vitamins (B9, B12 and B6) on at a time for a couple of weeks to see if one of these B vitamins alleviates your depression more effectively in your individual case. This type of experimentation may be too complex and advanced if you are a beginner to self-medicating. However if you have long term depressive illness and all bipolar syndrome such experimentation may enhance your ability to balance your brain chemistry and keep the condition in remission.- Folic acid (B9) 400-800 mcg.
- B12, sublingual lozengeres 2000-4000 mcg methylcobalamin.
- B6 50-150 mg (plus 100 mg from the B complex is the still below toxic levels)
A Minimal Serotonin Prescription:
A simple minimal prescription for long-term low serotonin levels (serotonin deficiency syndrome, dysthymic depression or bipolar syndrome) is:-
- Tryptophan 1000 to 1500 mg last thing at night daily or perhaps just several days per week, or every second day.
- B complex 50-100 mg twice pre day taken with meals.
Comparison of the Remedies
To work out exactly how a remedy is going to affect you, you have to try it for yourself, but to help get you started the notes below are based upon my clinical and personal observations.Rhodiola verses St Johns Wort
St Johns Wort primarily increasing serotonin only, it may be as close to a substitute for Prozac as you can get, albeit somewhat milder in action yet without the side-effects. Rhodiola on the other hand produces quite a different effect, it produces a noticeable serotonin and dopamine effect. Rhodiolas’ dual effect of boosting serotonin and dopamine may make it the ideal remedy for depression when both serotonin and dopamine are deficient. It may also be the remedy of choice for boosting dopamine levels with bipolar syndrome. Boosting dopamine on its own with the amino acid tyrosine can occasionally produce a overstimulating effect on the bipolar brain potentially triggering a manic episode. Remember serotonin is an inhibitory neurotransmitter (sedating painful thoughts) and dopamine is an excitatory neurotransmitter (stimulating excitement and pleasure to be alive). By simultaneously increasing calming serotonin production Rhodiola may help you to boost dopamine levels in a safer and more controlled way. Despite this in people with a very high risk of hyper mania any medicine that increases dopamine levels even Rhodiola need to be taken with care at least in the initial stages and only after one has learned how to manage and switch off hypomanic episodes.There was a time when I had the combination of serotonin and dopamine deficiency myself. No amount of boosting serotonin alone improved the depression and boosting dopamine with tyrosine alone would flip me into borderline hyper-mania only to rapidly cycle back into a depression, I was thoroughly trapped in this predicament for five years only barely functioning in a diminished capacity. It turned out that Rhodiola just happened to produce the perfect balance I needed at that time. It played a central role (together with tryptophan, tyrosine Lithinase B complex and B6) in my recovery from several years of serious illness. It dependably balanced my brain chemistry throughout the recovery period, whenever I omitted to take it the condition would begin to return within days. After two years I was able to wean myself off a daily dose and at the time of writing I still use it for or five days per week.
Caution Rhodiola
All antidepressants may temporarily increase interest in suicide the first couple of weeks you take them. Hypothetically because Rhodiola produces more of a dopaminergic effect (increases energy, motivation) compared to St Johns wort it may increase your motivation faster than it relieves your depression and therefore in theory it could carry a greater risk of temporarily increasing the risk of suicide compared to St johns wort. If this is a concern have a therapist assist you, and or build up your serotonin levels first for a couple of weeks before starting Rhodiola. Also be conscious and remember that if you experience these feeling it is temporary and means the remedy is working so give it time to help you, the increased sauce and interest in suicide will pass.Caution St Johns Wort
St John's wort is no exception and carries the same potential for increasing interest in and risk of suicide, remember this is a temporary state and an indication that your brain chemistry is being revived.St John's wort does have some other potentially undesirable side-effects:
Firstly it increases the skin's sensitivity to sunburn and therefore you need to take extra precautions (sun avoidance/blocking etc.). Please take this seriously particularly if you are fair skinned as sun-burning is highly cancer-causing.
Secondly St John's wort effectively increases the liver's ability to detoxify and flush drugs out of the body. This property of St John's wort can be a benefit or a problem. If you take St John's wort at the same time as you are taking an essential medication such as an anti-epileptic drug or the contraceptive pill it's possible that your liver will flush these drug out of your system to quickly and leave you unprotected. On the other hand if you want to detoxify and flush drug residues out of your body and liver then St John's wort can help you do this in addition to being an effective antidepressant.
Thirdly it may be hazardous to take St John's wort together with pharmaceutical antidepressants; this is because on the one hand the St John's wort may flush the antidepressant drugs out of your body so quickly that you have a rapid withdrawal and experience a sudden withdrawal depression. This effect should be fairly short-term however because the St John's wort will itself quickly take over as an effective antidepressant. Another possibility, with potentially serious physical consequences, is that if you continue to take antidepressants at the same time as the St John's wort together they may cause what is called serotonin syndrome. See caution one below. The bottom line is be safe, and unless you're medically qualified and absolutely know what you doing don't mix alternative antidepressant remedies with pharmaceutical antidepressants at the same time.
Isn’t Tryptophan Dangerous?
In 1989’s there was a serious medical event involving tryptophan when a large amount of improperly manufactured tryptophan was released onto the market from a single manufacturing plant. It caused a condition called Eosinophilia-Myalgia Syndrome that killed and injured many people. All cases of this condition were tracked back to the faulty product produced by Showa Denko Inc, a Japanese biotech company. One of the problems I regularly see on the web is that information is published without a date on it or any reference to its origin. If you search for tryptophan on-line you may find warnings that it can cause the debilitating and potentially fatal syndrome Eosinophilia-Myalgia. It should be understood that this was due to a one off toxic event in the late 1980’s. See www.nemsn.org for accurate information. I personally take tryptophan three days a week every week and I wouldn't do that if I had any doubts whatsoever regarding its safety. Tryptophan is inherently safe.It is suggested within the medical literature that it is possible that tryptophan may raise blood pressure. I have not observed this phenomenon in myself or my patients with the size of dosages I use. As an experiment I once took triple my maximum dose and monitored my blood pressure every 15 minutes for several hours afterwards, and did not observe any increase in my blood pressure. It's also possible to lower elevated blood pressure by many points with a combination of the right dietary changes, magnesium supplementation and training your nervous system the relaxation response. However if hypertension is a concern for you simply monitor your blood pressure when you introduce tryptophan and periodically thereafter.
SAM-e
SAM-e was mentioned on the front cover of Newsweek (July 1999). SAM-e can be a powerful and very quick acting antidepressant. It needs to be taken on empty stomach like amino acids, and needs to be well manufactured from a professional supplier so that it is protected from stomach acid (enteric-coated). SAM-e is a pricey remedy. It can occasionally cause stomach pains but usually only with larger doses so don't let this put you off trying it. Like all effective antidepressants SAM-e is noted for its ability to push a person with bipolar syndrome into a hypo/hyper manic state, indeed this ability is a testament to its potent antidepressant effects. People with bipolar syndrome can use SAM-e as an antidepressant as long as they are aware of this phenomenon and have already established good control over the hypo/hyper manic aspect of their condition. To do this you can use the following natural therapies: omega-3 fish oils, Lithinase, total darkness therapy and the amino acids glycine or taurine, see bipolar section for more information.- SAM-e 400-1600 mg. This can also be a very quick acting antidepressant (always take some B6, B12, folic acid or simply a B complex with SAM-e that stop it makinghomocysteine, a heart disease risk factor).
Cautions 1 Mixing remedies and serotonin syndrome:
Do not take tryptophan or any other serotonin boosting remedies: SAM-e. Rhodiola or St. Johns Wort if you are also taking antidepressant drugs.Antidepressants reduce your ability to remove serotonin from the nerve junctions (synapses) therefore prolonging serotonin's life and increasing its levels, taking tryptophan or other serotonin boosters increases your production of serotonin. This combination of making more serotonin and simultaneously prolonging its’ life may “flood” the synapses with excessive levels of serotonin causing a dangerous condition known as serotonin syndrome. BE SAFE, DON’T DO IT.
See the “wash out times” for individual antidepressant drugs in the appendix. This is the time the drug lingers in your system once you’ve stopped taking it and which you need to wait before taking alternative antidepressant remedies. Serotonin syndrome can also be induced my mixing different antidepressants like SSRIs and MAOIs together at the same time. The drugs ecstasy and LSD have also been linked to serotonin syndrome.
Symptoms of serotonin syndrome include rapid heart beat, increased body temperature, sweating, loss of co-ordination nausea and a rapid, dangerous rise in blood pressure; it’s not common but it can be serious. If you have concerns over this start on low doses and monitor your blood pressure and pulse for several hours after taking your prescription.
Under proper use none of the remedies recommend in this book will cause serotonin syndrome.
Speed of Action of the Antidepressants
Tryptophan andSAM-e can be very quick acting producing signs of improvement within 24 hours or less. Rhodiola may take several days before significant effects are observable and St John's wort can be the slowest acting sometimes taking 5 to 10 days before its effects are noticeable. If you do not feel significant improvements in your depression within a month of taking any of these remedies serotonin deficiency is probably not involved in causing your depression and I would try boosting your dopamine and or PEA using the prescriptions in this book; if this still does not help rule out heavy metal toxins, metabolic problems like hypothyroidism, increase your consumption of fish oils and start a course of psychotherapy.Serotonin Life Style, Meditation and Exercises
Meditations
For serotonin balance you want to do meditations that empty the mind and take a break from depressive thinking. Slow focused breathing can empty the mind and give you a break from your negative thinking. Some people are unable to hold the mind on slow breathing or it can make them feel uncomfortable, even panicky, an excellent alternative is melodic chanting meditations. The act of chanting can fill the mind and block out other thoughts while you are doing it, it can also be used as a means to create a still and empty state of consciousness, so do leave time after the chanting stops to just sit still and hold the peaceful mind as long as you can. In this way the meditationbegins when the chanting stops, once you lose the peaceful mental state you can do another round of chanting until you still the mind again and then stop chanting and try and hold that state again. For example you may need to chant for say 30-40 minutes or more to achieve a state of stillness in the beginning and you may only be able to hold this state for a minute or two in the beginning, before needing to chant again. It may only take 5-10 minutes chanting the next time to empty the mind, after which you may be able to hold the mind still for twice as long.Meditation is a skill that takes time and commitment to learn, don’t expect to be able to hold the mind still for long in the beginning. One of the most important things is to find a meditation technique that suits you, so be prepared to shop around and try different techniques. Once you've found the right technique you may be pleasantly surprised how easy it is to make a continuous progress.
I am available for private or group meditation classes.
Recommended chanting meditation from kundalini yoga with surprising antidepressant effects is:
The Golden Meditation
- Sit comfortably in an easy pose, either cross-legged if you can do that and keep your back straight or on the edge of a chair.
- Make the spine straight, and sit for a few moments focusing on the spine being straight, take a few deep long slow breaths focusing your mind inward on your breathing.
- Hold your hands out in-front of the shoulders palms facing forward with the elbows relaxed and bent, the hands will naturally sit slightly to the outside of the shoulders.
- The hands are flat with the fingers gently pulled straight, as if the hands were resting on a glass screen.
- Close and relax your eyes, and hold your focus on the mid brow point just above the bridge of the nose ( the anja chakra).
- The hands move around in comfortable circles (upward through the center) as if they are polishing a flat glass screen. Do not let the body rock backwards and forwards as the hands move, the only movement is in the hands and arms. Keep the shoulders relaxed.
- Inhale fully and chant the mantra until you run out of breath (say 4-5 repetitions), then inhale fully again and repeat, continue for at least 11 minutes, or ideally 20-30 mins.
- When you chant the mantra the corners of the mouth are slightly pulled up into a smile/grin at the end of the words gobinday and hari pronounced hareee.
- The mantra is:
GOBINDAY GOBINDAY (SUSTAINER)
HAREEE HAREEE (CREATION/ THE INFINITE)
During the meditation all you have to do is keep checking you are doing everything correctly: is my back straight, are my hands flat and polishing screen, am I making a little grin on the end of each word and use my focus held on the mid brow point. Checking these things occupy and hold the mental focus on the meditation. Just do the exercises and eventually you will reach feelings of joy. You do not have to do attempt to make up this feeling, just do the exercises correctly and see what happens.
Done daily for minimum of 11 minutes for minimum of 40 consecutive days this meditation is said to treats depression and gives one a happier mental outlook. The time can be increased if desired to either 22 or 31 minutes.
Exercise
Exercise has proven antidepressant effects. Some research suggests that exercise increases the turnover of tryptophan in the brain, however it has not been thoroughly established that exercise boosts serotonin levels specifically. The observed antidepressant effects of exercise may be more appropriate for PEA deficient depression than for serotonin deficient depression. Having said you should always try exercise whatever type of depression you think you have.Bright Light Therapy
There is reliable scientific evidence that exposing the eyes to bright light has significant antidepressant effects, perhaps equivalent to mild pharmaceutical antidepressants (but without any side effects).During the night when light stops entering our eyes the pineal gland manufactures melatonin our natural sleep hormone. Melatonin is made from serotonin, and serotonin levels plummet in the brain once melatonin starts to be produced and the serotonin is rapidly used up to make melatonin. In the morning when light begins to enter our eyes again melatonin production is switched off and serotonin levels rise. It is not completely proven but almost certainly the case that the antidepressant effects of bright light therapy are produced by bright light therapy raising serotonin levels.
See the chapter on bright light therapy for more information.
Recommended Brands and Suppliers
[ UNDER CONSTRUCTION]You will be able to purchase all of the above remedies at either
www.Nutricentre.com or
www.iherb.com (you can get a 5% discount off your first order at iherb by using my discount code HUK817.
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