The past few decades have seen the development of many new drugs to treat depression, anxiety and related conditions. These medications can be lifesaving, but can also cause unpleasant side effects or personality changes. Some people may prefer to address the causes of their depression through natural solutions rather than taking drugs. The research of Carl Pfeiffer, PhD, MD - a pioneer in the nutritional treatment of psychological disorders – led him to write: “for every drug that yields a beneficial result, there is a nutrient that can produce the same effect.”

Depression is a signal from the brain that neurotransmitter levels are too low. This signal is not unlike muscle cramps telling us that we need more potassium or dry skin suggesting a need for fatty acids.

Neurotransmitters enable brain cells to communicate with one another, carrying impulses that are critical for a balanced emotional state and that also control major functions in the body. There are a vast number of neurotransmitters, some of which may not have been discovered yet, but the ones that are known to control emotions the most are serotonin, dopamine and norepinephrine.

These neurotransmitters are synthesized in the brain, using amino acids as raw materials, through a series of chemical reactions that require the presence of certain vitamins and minerals -especially vitamin B6 and folic acid. Without enough amino acids, vitamins and minerals, neurotransmitters become depleted and the stage is set for developing unbalanced emotional states, including depression.

There is no great mystery regarding how amino acids reach the brain: they come from the digestion and assimilation of protein and are carried to the brain through the blood. It should logically follow that eating more protein would result in higher neurotransmitter levels. In fact, this may happen only in a minority of cases, and a better approach to rapidly stimulate neurotransmitter synthesis is to take specific amino acids and associated nutrients in supplement form.

The primary amino acids involved are tryptophan (or 5HTP) and tyrosine. Tryptophan is necessary to make serotonin, and tyrosine is converted to dopamine and norepinephrine. Taking only one of these amino acids to the exclusion of the other is rarely effective, and this may explain why studies that only looked at one of these amino acids yielded disappointing results. In addition, the effective daily intake of each amino acid and associated nutrients may vary more than tenfold from person to person, based on a variety of individual factors, including the degree of depletion at the onset of treatment.

We now have laboratory tests that can accurately measure neurotransmitter levels and greatly simplify the task of developing a proper supplement plan, eliminating much of the guesswork and trial and error. These tests have been substantially refined over the past years; they are very reliable and truly reflective of actual brain levels of neurotransmitters. They are also affordable and non-invasive in that they use a simple urine sample. A baseline test is usually critical to understanding a person’s unique patterns and designing the most appropriate supplement program. Repeat testing may be necessary for fine-tuning when results are not completely satisfactory.

This approach to dealing with depression is a natural one in that it strives to replace depleted nutrients rather than relying on a drug-like effect on the brain. However, it does not deal with the reasons why neurotransmitters are depleted. Without a more comprehensive or holistic approach, there is a risk that any positive results will be sustainable only as long as the supplements are taken.

To address the underlying causes of neurotransmitter depletion we need to look primarily at three areas: diet, exposure to environmental toxins and the biochemical individuality that determines specific long-term nutritional needs.

1. Diet

   Many people today live with the misconception that protein is bad and should be avoided at all costs. I often recommend a book entitled The Schwarzbein Principle by Diana Schwarzbein, MD, to help dispel this myth. There are many sources of quality protein, not only red meat, to suit different tastes and preferences. Without enough protein, the brain becomes depleted of the essential raw material it needs to make neurotransmitters.

   Fat also plays a critical role in neurotransmitter function. Having enough “good” fats in the diet is also an important step in preventing depression. Replacing depleted fatty acids with natural supplements like fish oil has been shown, in many studies, to help mitigate depression and many related disorders.

   In addition to inappropriate diet, food allergies can also cause a wide range of psychological disorders, including depression. It might sound like a stretch that an allergy can be the cause of depression, especially if you are used to thinking of allergies in terms of sneezing or nasal congestion, but we are dealing here with a different kind of allergy. Food allergies can be much more subtle and are often associated with poor digestion and, therefore, with the assimilation of partly undigested proteins that can directly disrupt neurotransmitter function. The excellent and appropriately titled book Brain Allergies by William Philpott, MD provides an extensive and easy-to-understand discussion of this topic.

2. Environmental toxins

   It should come as no surprise to read that we live in a toxic world where heavy metals like mercury and lead – as well as thousands of chemicals – are found in our food, water and air. Many of these substances are known, or suspected, to cause damage to the brain or to interfere with neurotransmitter synthesis even in minuscule concentrations. Some individuals may have genetic traits making them especially vulnerable to toxins. Deficiencies of certain vitamins or minerals can also reduce the body’s ability to excrete toxic elements, thus amplifying their deleterious effects on the brain.

   This toxic onslaught may well explain the present astounding epidemic of conditions ranging from depression and anxiety to ADD and even autism. Assessing the damage caused by toxic exposure is often an indirect process but, fortunately, we have various strategies that can help lessen the toxic burden on the brain through very specific dietary and supplement protocols.

3. Biochemical individuality

   In the course of a lifetime of remarkable achievements, Dr. Pfeiffer noted that people with depression and other psychological disorders often presented with certain clusters of symptoms that fell in clearly identifiable categories. For example, some people tend to be mostly sad, others more anxious and others highly irritable.

   Dr. Pfeiffer later discovered that people with certain symptom patterns also tended to express one of several biochemical markers in blood or urine. This implied that their symptoms had a chemical basis, but it took him years of extensive research and trial and error to define what this meant in terms of practical application. He later found that each of these markers indicated a need for certain vitamins or other nutrients, suggesting either a simple deficiency or an increased need triggered by genetic or other factors.

   The first marker Dr. Pfeiffer identified related to a disturbance in blood of a protein called histamine. Although we often hear of histamine in relation to allergies, most allergic people actually have normal levels of histamine in blood.

   In certain people, however, histamine builds up to abnormally high levels because a process called methylation is impaired. This process is needed not only to break down histamine, but also to synthesize neurotransmitters and to clear environmental toxins from the body. As a result, people with high histamine cannot synthesize enough neurotransmitters and are also more vulnerable to the deleterious effects of environmental chemicals.

   Certain nutrients, primarily calcium and the amino acid methionine, or SAMe, are used to activate methylation, and people with this trait can expect to see major improvements in how they feel within two months of starting these supplements.

   At the opposite end of the spectrum, there are people who break down histamine too quickly. Dr. Pfeiffer found that these individuals are primarily deficient in folic acid. Since folic acid is also needed to make neurotransmitters, they frequently become depressed as well and, in fact, they may be the most severe cases, with a tendency towards despair. They also improve quickly when taking folic acid with associated nutrients and avoiding the supplements recommended for the previous group.

   The third marker identified by Dr. Pfeiffer is called pyrrole, a chemical that builds up in the urine of certain people. High pyrrole results from a greater-than-normal need for vitamin B6 and zinc, probably because of a genetic trait. People with this trait may suffer from anxiety, mood swings, irritability, and explosive behavior, but often improve within days of supplementing with adequate doses of the needed nutrients.
   

Finally, Dr. Pfeiffer identified people with high levels of copper and low levels of zinc in blood. These individuals tend towards hyperactivity in childhood and adolescence and need nutrients that include cysteine, zinc and manganese to help balance blood levels of these minerals.

Dr. Pfeiffer reported astounding results using these nutritional protocols. Although he was a board-certified psychiatrist he refused to use medications, believing that drugs work by controlling symptoms rather than by establishing a healthy balance in the brain. Since Dr. Pfeiffer never produced double-blind studies, his work was quickly dismissed by mainstream psychiatry. Today, some enlightened practitioners continue to use his tests and protocols, and scientists like Bill Walsh, PhD, of the Pfeiffer Treatment Center in Chicago continue to build on his research with impressive results.

Dr. Pfeiffer reported on his findings in a book entitled Mental and Elemental Nutrients that is, unfortunately, out of print. Another book that discusses Dr. Pfeiffer’s discoveries, Depression Free, Naturally, authored by Joan Larson, PhD, is currently available and very readable.