How To Treat Depression & Anxiety Holistically - Part Two
In Part One of this series, I delved into the fact that depression and anxiety are not problems of JUST the brain or JUST the body. There is a definite mind-body connection, and the best treatments (and prevention) for depression and anxiety treat both. I also started going into the root causes – everything from childhood trauma to candida – and the solutions that might be able to help you. If you haven't read Part One yet, click here to go back and check it out!
Lots of people think “holistic” = “natural” or “alternative.”
But that’s not actually what holistic means!
A “holistic” approach looks at a person as a whole. Rather than seeing each part of the person - say their digestive system, or hormones, or mental health - as separate entities, holistic medicine views them all as interconnected.
(Sometimes, that does mean we use natural and alternative approaches to healing.)
But it always means that we’re looking at YOU as a whole person and not just a set of symptoms or a diagnosis.
I think that’s so important to make clear as I dive into the 2nd part of my series on treating depression and anxiety holistically.
Today, I’m going to explore how environmental exposure to toxins and hormone imbalances can play a role in depression and anxiety. It might seem crazy to think your detox pathways or PCOS could be related to depression or anxiety - but they can! Today I’ll explain exactly how and what you can do about it.
If you haven’t read Part 1 of my series, go HERE and read it first! Then come back and dig into Part 2!
What Toxins Are (And Aren’t)
Toxins is one of those words that gets thrown around a lot. But what does it really mean?
A toxin is any chemical or compound that has noxious or harmful effects on living organisms.
Toxins can come from outside us (our environment) but they can also be generated internally. For example, our hormones can become toxins if they stick around too long. They must all be “detoxified” - broken down and cleared from the body in order to make room for new fresh hormones to be produced. We also produce toxins in the gut.
But, the major source of toxins is the outside environment.
We have THOUSANDS of toxin exposures every single day. Here are just some of the most common ones:
- Smog in the air we breathe
- Touching receipts coated with chemicals
- Pesticide residue on food
- Prescription medicine contamination in drinking water
- Hair & beauty products made with dangerous chemicals
The EPA estimates that in 2014, 4 billion pounds of toxic chemical waste was released into the air, water or placed in some type of land disposal in the U.S.
(And they consider this an IMPROVEMENT over the 4.7 billion pounds released in 2002!)
It’s likely that at least 25% of the United States population is dealing with heavy metal poisoning, too.
And while our body is equipped to deal with toxins (that’s what our liver is for!) the amount of toxic exposure humans have today is overwhelming. That’s why so many people's detox systems are overburdened. We can’t detox at a rate fast enough to keep up with all the toxins coming in!
This leads to fatigue, allergies, skin reactions, accelerated aging, autoimmunity, brain fog, yeast and bacterial overgrowths, and… increased depression and anxiety.
How Toxins Mess With Our Brains
The brain is a powerful and vulnerable organ.
The brain is made of nearly 60% fat. And that’s a problem - because many chemicals and toxins are fat soluble (including the nefarious heavy metals!).
The brain is so susceptible to toxin damage that there’s a specific name for toxins that negatively impact the brain neurons’ function: neurotoxins.
Neurotoxin exposure is a direct cause of depression and anxiety because they cause neurotransmitter dysfunction and inflame the brain.
This creates problems with brain signaling.
Neurons work by secreting specific brain chemicals (primarily serotonin and dopamine) out of the end of one neuron (called vesicle) into the space between the neurons (called the synapse).
Ideally, these chemicals are taken up by the receptor sites on the next neuron meant to receive the message. When that happens, a response signal is stimulated, and it continues on down the line to next neuron. If too much of any one brain chemical is released, it should be reabsorbed into the storage vesicles. This is called reuptake.
It’s sort of like your neurons are all playing a game of telephone.
But when toxins get in the way, the game gets messed up. The next neuron can’t hear the message clearly and passes it on wrong - or maybe not at all.
The toxins (and the inflammation caused by them) block the receptor sites on the neurons from taking up the chemicals - aka “hearing the message.” Your neurons don’t get the signal.
And that means you don’t feel the effects of serotonin or dopamine, because they aren’t able to do their job.
Then, the serotonin and dopamine that should have been taken up start building up in the synapse.
Your body goes into action: it knows it can’t let too much of these chemicals accumulate. It starts creating enzymes to break down the serotonin and dopamine that are stuck in synapse.
The end result? Your reserves of serotonin and dopamine are lowered.
Depression and anxiety are both a result of the receptor sites in your brain being “shut down” and the lowered serotonin and dopamine this ultimately causes.
Signs Your Detox System is Overburdened and Needs Help
If you’re dealing with symptoms of depression or anxiety, it’s a sign your detox systems could be overburdened - along with these other signs:
- Memory, concentration, and focus problems
- ADD or ADHD
- Skin problems (acne, eczema, psoriasis, hives, rashes)
- Fatigue
- Overeating & food cravings
- Autoimmune conditions
- Feeling chronically flu-like
- Yeast overgrowth (Candida)
- Bacterial overgrowth (SIBO)
- Food intolerances
But - all of these symptoms can be related to OTHER problems as well - which is why it’s so important to get accurate lab testing, and not just guess at a diagnosis based on symptoms.
Here’s what I commonly see with my patients:
A patient with depression or anxiety will also have digestive tract infections or dysbiosis, yeast overgrowth, or food intolerances.
These promote inflammation in the gut, and the inflammatory cytokines circulate in the blood and travel into the brain across the blood brain barrier, impacting brain function.
(What do I do to help? Glad you asked! After testing, I use specific amino acids like 5-HTP, tyrosine, and GABA, plus nutrient cofactors to deal with shut-down receptor sites and neurotransmitter deficiency. At the same time, I’m addressing underlying root causes of the gut infections.)
How To Address Depression & Anxiety Related To Toxin Exposure
The solution to depression and anxiety caused by toxin exposure is to address the cause of the inflammation: those toxins!
That means limiting exposure as much as you can: get a water filter, air purifier, buy organic, switch to natural beauty products, etc.
From there, I start by enhancing detoxification pathways with nutrient protocols, hydration, herbs, saunas, skin brushing, and lymphatic system support so the toxins can be broken down and excreted from the body.
Next, I use lab testing to identify where in the detox pathway things are getting gummed up. Is your Phase 1 or Phase 2 liver detox malfunctioning? Proper testing can tell us!
I also use Organic Acids Testing and Heavy Metals testing to see exactly what toxins you’re dealing with.
I have to give a warning here: you MUST be careful when doing detox work. It can be dangerous to stimulate detox and have the body suddenly dump toxins from storage into circulation.
It’s never good to detox someone who still has a leaky gut or gut issues - and it can make your gut issues get worse.
You shouldn’t feel sick when detoxing - this usually indicates pulling toxins out of storage faster than your body can clear them.
An experienced practitioner can help you detox safely.
Depression, Anxiety & Hormones
I’ve saved the best (worst?) for last: hormones!
On some level, almost all depression & anxiety is related to hormone imbalances.
Neuroscientists at the National Institute of Mental Health have even stated that most depression in the United States is caused or contributed to by HPA-axis dysregulation (also called adrenal fatigue) and hormone imbalances.
The most important players for depression and anxiety are cortisol, DHEA, testosterone, estrogen, and progesterone. Together they can trigger a biochemically-induced depression.
Cortisol Dysfunction
Cortisol is a stress hormone that’s has to be just right. Too high or too low, and you can have lots of problems. But it’s tricky because your cortisol levels shouldn’t be steady throughout the day: they should follow a predictable arc of rising quickly in the morning when you’re exposed to light and slowly lowering throughout the day.
(That’s why cortisol problems can be easily overlooked! You can’t just look at one reading - you need to look at both levels throughout the day, and the rate at which they rise and fall to get the complete picture of cortisol health.)
Low cortisol levels are related to depression - and in particular, are linked to postpartum depression. Low CAR response (the rise of cortisol first thing in the morning) can also be related to depression.
But - high cortisol (especially high at nighttime) is also related to depression - both high and low levels can cause similar symptoms. Again - that’s why you must have accurate testing!
What messes up cortisol levels?
The big triggers for cortisol imbalances are are sustained and chronic stress! It can be mental OR physical stress - anything from a stressful job, being a super-busy new mom, or over-exercising can wreak havoc on cortisol levels.
Sex Hormones Imbalances
Progesterone, estrogen, and testosterone are the primary sex hormones - but they can also have a huge impact on mental health and depression and anxiety in particular.
Here are just a few of the many ways sex hormones can directly impact mental health:
Progesterone helps balance blood sugar levels. Remember - the brain is dependent on adequate glucose to function. Low progesterone levels can lower the supply of glucose available to the brain. This decrease in "brain fuel" contributes to the most common psychological and emotional symptoms of PMS like:
- Irritability
- Rage
- Depression
- Tension
- Anxiety
- Confusion
- Fatigue
- Memory lapses and loss
- Inability to concentrate
- Decreased stress tolerance
Estrogen and progesterone also have a strong effect on the neurotransmitters involved in mood regulation:
- Progesterone binds GABA receptors (which decreases anxiety and depression)
- Progesterone raises serotonin hormone levels in brain
- Estrogen increases dopamine activity in the brain
That means, any change in hormone levels (even subtle ones!) can contribute to psychological symptoms.
Unfortunately, the treatment given to many women who do experience mood symptoms with their monthly cycle is the hormonal birth control pill.
This drives me crazy as it only compounds the problem!
Birth control pills deplete the body of essential vitamins and minerals like folate, b vitamins, and magnesium - all of which are involved in the synthesis of chemicals for brain health (among other things!).
This can result in intensified depression, anxiety and PMS! A number of studies have linked depression with the use of oral contraception.
Studies have also indicated that using the Pill for extended periods of time can alter the gut microbiome, especially predisposing users to candida overgrowth and other bacterial and fungal issues.
The nutrient deficiencies that are induced by the Pill are largely due to the influence on the gut microbes, where many of these nutrients are synthesized. (So again, many of these issues point back to the gut - make sure you read Part 1 of this series!)
But that’s not all…
Thyroid Problems
Every cell in your body has receptors for thyroid hormone - including the brain!
(That should give you a clue to how essential a healthy thyroid is for overall well-being!)
Thyroid hormone makes progesterone receptors more sensitive. This means that low thyroid hormone can mimic the symptoms of low progesterone. (Remember the fun PMS stuff we talked about in the previous section??)
Low thyroid hormone can also directly impact neurotransmitter levels. It can cause low dopamine levels - which translates to lack of motivation, drive, and willpower.
Taking Control Of Anxiety & Depression
No matter what root cause (or causes) of depression and anxiety you’re dealing with, there are certain steps you take with your diet and lifestyle to help alleviate symptoms.
For some of my clients, just making lifestyle and diet changes is enough to completely alleviate symptoms of depression and anxiety! Here are some things to try in all the major categories:
Eat:
- Eat plenty of healthy fats (like avocado, coconut, and olive oil)
- Avoid processed foods and excessive sugar
- Some people can benefit from removing dairy & gluten
- Choose organic foods (especially the Dirty Dozen)
- Aim for 10 servings of fruits & veggies per day
- Focus on eating for balanced blood sugar (avoiding processed carbs!)
Move:
- Exercise has been shown to be as effective in most cases as antidepressant drugs for alleviating depression
- Find what works for you and what you ENJOY doing
- If you haven’t been exercising regularly, just start with 20-30 minute walks daily
Sleep:
- Turn off screens 1 hour before bedtime
- Schedule enough time for enough hours (8 hours or more)
- Sleep in a dark room, with the temperature slightly cooler
Stress:
- Active stress management is something I recommend for ALL my clients (no matter what health concern they have)
- Meditation, yoga, tai chi or qi gong, making art, dance, journaling are some of my favorite options for managing stress
- Making a conscious decision to “switch” from fight-or-flight mode to rest-and-digest mode
- Consider working with a counselor or therapist - especially if unresolved emotional issues are a factor for you
Next Steps For Treating Anxiety & Depression
After reading Part 1 and Part 2 of this series, you might be feeling a little overwhelmed.
It seems like you could have hormone issues, toxin exposure, gut issues, and maybe yeast overgrowth, too! (Plus there’s definitely some past trauma lurking that needs to be dealt with….)
As one of my mentors in Chinese medical school used to say: “You are entitled to more than one problem at the same time!”
The truth is that while some people have one primary cause, the majority of depression or anxiety cases is due to a “perfect storm” of factors.
Everything we’ve discussed in this series can be interrelated:
- Having dysregulated cortisol levels can not only contribute to changes in the brain and brain chemistry, but can alter the way the immune system operates, leaving us more prone to inflammation and more vulnerable to infections in the gut
- Having a leaky gut from food intolerances or infections will affect the brain directly, but will also be a major contributor to detox system overwhelm
- Having low thyroid function can cause symptoms of low progesterone
The complex way all these systems interacts means one thing: you don’t want to go this alone!
I really believe everyone should have a trusted practitioner by their side, guiding them through the process of healing.
The right practitioner (trained in a holistic approach like Functional Medicine) can untangle the strings of depression and anxiety and get back to feeling like yourself!
If this resonates with you, I’d be honored to have you book a 20-minute consult with my team. These consults are totally free and a chance for us to share how we are trained to help you!
→ Learn more and book a free consult with my team here.
How To Treat Depression & Anxiety Holistically - Part One
Butterflies in your stomach before a first date. Sweaty palms before asking your boss for a raise. Grief when your dog dies. Crying over a breakup.
These are all normal and healthy moments of nervousness and sadness.
But then there’s a shift….
Laying awake at night with a pit in your stomach… when tomorrow’s just another Tuesday. Overwhelming sadness when everything is going OK. A feeling of despair you can’t shake…
These are signs of a more serious issue: anxiety and depression.
If you’ve ever experienced anxiety or depression, you’re currently dealing with them, or are supporting someone you love with one of these conditions all you care about is getting rid of them.
But it’s not always simple. Anxiety and depression are multifaceted issues. And that’s where the problem starts.
Doctors and practitioners want to put you onto one 2 paths:
- Treat the brain. This is everything from antidepressants and anti-anxiety meds to talk therapy with a psychologist. On this path, anxiety and depression are seen purely as a mental health issue - so treatment focuses on your brain.
- Treat the body. On this path, anxiety and depression are seen as symptom of a problem somewhere else in the body. Treatment often focuses on changing your diet (especially avoiding certain foods) and adding in exercise.
This gets me so frustrated!
Like nearly EVERY health condition, depression and anxiety are not problems of JUST the brain or JUST the body. There is a definite mind-body connection, and the best treatments (and prevention) for depression and anxiety treat both.
In this series, I want to do some real talk about anxiety and depression. We’re going to dig into the root causes - everything from childhood trauma to candida - and the solutions that might be able to help you.
Nothing is off limits and I’m not going to vilify any one kind of treatment.
I hope this can be an open and honest discussion about anxiety and depression like you’ve never experienced before.
Trauma, Circumstance, and Perception in Anxiety and Depression
Before I dive into some of coexisting conditions I see around anxiety and depression (and the steps you can take to help treat it), I want to make a very important distinction. While I believe (and the research shows) things like compromised gut health and hormone imbalance can cause anxiety and depression, it’s not the case for everyone.
Trauma, circumstance and perception can all be root causes of anxiety and depression.
And even if eating a blood-sugar balancing diet DOES help you manage anxiety and depression, it doesn’t mean that your anxiety was just caused by eating too much junk food. The trauma was real. This is a very sensitive issue, so I want to make sure this is clear.
Here’s what I see a lot in my practice: when a woman has co-existing conditions like leaky gut or a hormonal imbalance, when trauma happens (and it happens to almost all of us to varying degrees), it’s more likely that the temporary stress of the trauma develops into the long-term problems of anxiety and depression.
How you perceive trauma is important too. What qualifies as a trauma to one person wouldn’t be for another person - and neither one is right or wrong. Your perception is YOUR perception. But, you can learn tools that can help change the way you perceive things.
(It’s the difference between seeing your mother-in-law’s comments as a personal attack against you or just a manifestation of her own insecurities that you can brush off.)
If you’re equipped with self-care practices and coping mechanisms before the trauma happens, you’re much more likely to avoid depression and anxiety.
This is where “treating the brain” is so important.
For those of you who are dealing with past trauma or very difficult circumstances, I’d suggest looking into EMDR and Brainspotting in addition to everything else I lay out in this post.
- EMDR is shorthand for Eye Movement Desensitization and Reprocessing. It’s a kind of psychotherapy that combines aspects of traditional talk therapy with eye stimulus. Research has shown it helps you process through trauma much faster than talk therapy alone (think the work of 8 years of talk therapy in just a few EMDR sessions). It’s a recognized treatment by the World health Organization, the Department of Defense, and the American psychiatric Association. Learn more about it and find a clinician here.
- Brainspotting is a therapeutic tool that can be used in conjunction with other forms of therapy. It works by accessing the autonomic and limbics within the central nervous system to help work through traumas - especially those that are not in the conscious mind (and therefore hard to talk about and treat). Learn more about Brainspotting and find a clinician here.
And I encourage everyone - whether or not they’re dealing with anxiety and depression - to get started on the inner-work that makes you more resilient to trauma. It can be as simple as beginning a meditation practice or finding a counselor.
A note on antidepressants and anti-anxiety medications: I believe antidepressants and antianxiety medications can be life saving for some people. They also have serious side effects and address the symptoms over the root cause. No one other than you and your doctor can decide if medication is the right step for you. But, whether or not you use medication as part of your treatment, I encourage you to explore treating the coexisting conditions and root causes I share about in this post.
Gut Health and Depression
When I hear about depression and anxiety, I immediately think about gut health. I rarely (I mean rarely!) see a patient with symptoms of depression and anxiety who doesn’t have some sort of gut health problems.
And intuitively, it makes sense. We feel our emotions in our guts just as much as we feel them in our mind - the “stomach in your throat” feeling, butterflies in the stomach, a “gut punch” when you get bad news, needing to go to the bathroom when you’re anxious or nervous.
We also know that 90% of the body’s serotonin is actually produced in the gut - not the brain - and that other important mood chemicals are made in the gut, too.
Irritable Bowel Syndrome (IBS) is also closely associated with depression and anxiety.
In my practice, I see 2 kinds of gut health problems contributing to anxiety and depression over and over again: leaky gut and candida overgrowth.
How Leaky Gut Leads To Depression & Anxiety
One of the most famous studies on gut health and depression was conducted in 2008: “The gut-brain barrier in major depression.”
This study is famous (and still cited all the time) because the researchers made some amazing discoveries.
First, they concluded that “There is evidence that depression is accompanied by an activation of the inflammatory response system and that proinflammatory cytokines and lipopolysaccharide (LPS) may induce depressive symptoms.”
In layman’s terms, that means:
- Inflammation is one cause of depression
- There is evidence that leaky gut may cause symptoms of depression
The study measured antibodies produced by the body’s immune system against lipopolysaccharides (LPS) in depressed patients and in controls (without symptoms of depression). LPS are large molecules of dead cell wall of the gram-negative enterobacteria - also called endotoxins. LPS should NOT be in the bloodstream. If LPS are present in the bloodstream, it means the tight junction of the gut have become loose (aka leaky gut).
The researchers found that the immune markers against the LPS bacteria in the gut were much higher in depressed patients than in the control group.
This means that the depressed group had more leaky gut and gut microbiome dysbiosis than the control group.
In fact, researchers concluded that patients with major depression should be tested for leaky gut. (And I’d argue, anyone with any symptoms of depression or anxiety - not just major depression!)
What causes leaky gut?
LPS are dead bacterial cell walls - and generally having high levels of them in the bloodstream indicates dysbiotic flora in the gut in addition to leaky gut. This can too much of the wrong bacteria, too little of the right bacteria, or too much or too little bacteria in the wrong place.
Leaky gut can also be caused by parasites, SIBO (Small Intestine Bacterial Overgrowth), yeast overgrowth (more on that to come), and untreated food sensitivities and intolerances.
Food sensitivity symptoms are usually an immune system response to foods we eat. The reaction creates inflammatory compounds that get into the bloodstream, circulate, and can create anxiety, brain fog, depresion, and fatigue.
Low nutrient status can also contribute to depression. When food isn’t properly absorbed in the gut (due to dysbiosis or leaky gut) the body doesn’t have the “nutritional building blocks” like amino acids, folate, vitamin B6 and more it needs to create the chemicals to control mood. This can cause depression and anxiety.
Yeast Overgrowth, Depression
Other than leaky gut, the most common gut health problem I see in relation to anxiety and depression is candida overgrowth. Candida is a kind of yeast that almost all people have present in their body. Candida is responsible for thrush in babies and yeast infections in women. In normal amounts it is healthy - but it’s when it overgrows that it causes problems. And the way candida impacts depression is especially interesting!
Candida is a yeast - which means it produces alcohol (ethanol) and acetaldehyde (the chemical responsible for the main symptoms of hangovers!) Both these chemicals are toxins to the body.
In a normal healthy person, (who hasn’t been drinking!), there should be little to no alcohol in the bloodstream. But if that person has an overgrowth of Candida, the alcohol produced by the yeast is entering the bloodstream - we call this “auto brewery syndrome” and it literally makes you drunk.
In a study conducted by doctors at Biolab in London, UK, a number of chronically unwell patients were tested for blood ethanol levels an hour after ingesting a sugar solution. The study found the patients consistently had high blood levels of ethanol which the researchers concluded came from small intestinal yeast overgrowth.
And - even worse - when candida is well established, it transform into the fungal form its branching (hyphae) “feet” can penetrate the intestinal wall.This creates literal holes in the gut, enhancing leaky gut syndrome and allowing more alcohol and acetaldehyde into the bloodstream.
What does that do to you?
Ethanol metabolism…
- Interferes with energy metabolism; this results in fatigue & muscle aches
- Causes hypoglycemia or "low blood sugar"
- Creates nutritional deficiencies
Then the ethanol is converted into acetaldehyde which…
- Is responsible for most of the symptoms of a hangover
- Causes dilation of blood vessels in the brain which result in the characteristic severe headaches
- Is toxic and inflammatory to the brain’s neurons
- Binds glutathione - the body's main antioxidant - thus increasing oxidative stress and allowing free radicals to damage cells throughout the body. Without enough glutathione, the liver can’t detox properly
- Increases the release of adrenaline, causing heart palpitations, anxiety etc. Panic attacks become more common.
What causes candida to overgrow?
All of these factors make your body more hospitable to the overgrowth of candida:
- Antibiotics
- Oral contraceptive pills
- High sugar/starch alcohol diets
- Stress
- Having other GI infections, or
- Having immunosuppression related to adrenal fatigue
Candida overgrowth can be treated - but the root cause that began the overgrowth must also be addressed!
Action Steps For Healing Gut Issues
The first step to healing gut issues is to find out exactly what is going on.
I don’t like to “guess and check.” For patients in my clinic, I always start with specific stool tests for parasites, dysbiosis, and yeast overgrowth. For SIBO, I test using a lactulose breath test.
Once we identify exactly what issues are occuring, we tackle them - treating parasites and pathogens, and then using diet and supplements to heal leaky gut. Gut mucosa heal rapidly when the aggravating factors are resolved! On average, my patients see big changes in as little as 3 weeks.
Coming Up: Hormones & Toxins
I hope reading Part 1 of this post has left you feeling empowered - and maybe even hopeful. If gut issues are contributing to your anxiety and depression, treating them can help you take a big step forward.
In Part 2 of this post, I’m going to address two other major factors in anxiety and depression: exposure to toxins and hormone imbalances. There’s still a lot left to cover!
I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with anxiety or depression, I’d love for you to book a free 20-minute root cause symptom analysis consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.