In Episode 19 of The Holistic Nutritionists Podcast, Natalie Douglas and Kate Callaghan discuss holistic treatment for depression and alternative therapies for depression.

• When low serotonin isn’t the cause
• Inflammation and its link with depression
• Hormonal imbalances and how they contribute to depression
• Tips on reducing inflammation through diet
• Supplement strategies in the management of depression
• Lifestyle recommendations for treating depression
• The importance of asking for help

• Amy Crawford and CTC therapy 
• Amino Acid Therapy/The Mood Cure

Natalie K. Douglas 0:01
Hello and welcome to The Holistic Nutritionists Podcast. My name is Natalie Bourke, Holistic Dietitian, and Nutritionist from HealthByWholeFoods.com.au. And with me as always, I have the Holistic Dietitian, Kate Callaghan. Oh, the Holistic Dietitian, where that come from? The Holistic Nutritionist who is also a dietitian, FYI, Kate Callaghan. How are you going Kate, after that terrible introduction?

Kate Callaghan 0:24
I’m good. The DAA might contact you and get angry with you for referring to me as a dietitian.

Natalie K. Douglas
That’s right. Too late. Too late, doesn’t matter.

Kate Callaghan
Even though I am a qualified dietitian, that’s not what I call myself anymore.

Natalie K. Douglas
No, can’t, it’s against the law Kate.

Kate Callaghan
Against the law. Yeah.

Natalie K. Douglas
You can’t prescribe people to eat butter and low-carb diets ever, or you’re basically not a dietitian.

Kate Callaghan 0:53
Too funny.

Natalie K. Douglas 0:54
Anyway, how’s your morning been?

Kate Callaghan 0:57
My morning is good. It’s actually afternoon now. It’s been a busy morning, actually. I’ve had a client. I’ve, what else have I done? I’ve done some work with doTERRA. I’ve done a little bit of catching up on emails.

Natalie K. Douglas
Yes.

Kate Callaghan
I have a webinar that I want to watch, it’s on the breast microbiome.

Natalie K. Douglas 1:14
Oh, heard really interesting stuff about that, like the translocation of probiotics to the breast and other areas but that’s interesting. You have to report back.

Kate Callaghan 1:25
Me at my weekend watching. That’s how exciting my weekends are, I get to watch webinars on the breast microbiome.

Natalie K. Douglas 1:31
You are one crazy cat, someone needs to tie you down.

Kate Callaghan
Living on the edge.

Natalie K. Douglas
That’s right. Well, today, we’re actually talking about depression. So we want to jump right in so that we can actually have enough time to give all of the information. But before we do get started, I feel like this would be a really appropriate time to read the disclaimer since I often forget. So the advice given in this podcast is not intended to provide medical advice or to take the place of medical advice or treatment from your primary health care physician. The facts and information offered are based on a combination of scientific evidence, clinical practice experience, and personal experience. So with that said, we want to basically go through today a bit of information about depression, and what what, what’s what the research says. And it might be a bit different to what you may expect or what you have heard before. And we also obviously want to give you guys a lot of practical tips and ideas of how you can address it if you are going through depression, or you know someone who is, or even if you’re experiencing a period of really low moods that maybe isn’t, as far as, you know, being classified as depression, but still low mood nonetheless, it can definitely help in that regard. So I’m going to get out and get started. And first just go through a bit of what the research is saying, which I found really interesting because I feel like it’s something that people aren’t aware of and aren’t questioning. So I was doing a bit of looking around. And I found that there are actually several research papers that have been done on depression and only about 25% of depressed patients have low levels of serotonin and norepinephrine, which are two neurotransmitters associated with the lifted mood. So I found that really interesting because that’s definitely something that we’re all taught that the only kind of reason for depression is an imbalance in neurotransmitters or particularly low serotonin. So I found that interesting. But there’s also been research that shows in some depressed patients, they actually have really extremely high levels of serotonin. And it’s as if that’s not all confusing enough. There is research that shows low levels of serotonin in non-depressed people. So all of that kind of begs the question as to whether depression is truly an illness of a chemical imbalance exclusively, or if there’s possible, if there’s you know, another possibility in something else driving it. Now, it may not be that there like that low serotonin isn’t a factor at all for some people. But it’s just really quite interesting that hey, it’s not actually, it’s not actually showing to be true in a lot of depressed people. So off particular interest to me is actually the link between depression and inflammation. So there’s now an established link, and it has been for some time between these two things, which I want to briefly discuss before we go into the more practical aspects of treatment. So a few bits of evidence to support these links so far include that, when people are going through an acute illness where inflammation is present, patients often present with depression symptoms. Also, when markers of inflammation are bought back down or imbalanced, depressive symptoms seem to subside. And when patients were given a particular medication known to significantly increase inflammation 25% of them developed major depressive disorder. And finally, other studies have shown that higher amounts of inflammation increase the risk of getting depression. So how does, how exactly does that play out in the body? Well, basically, when the body is inflamed, whether that be acutely or a low level of chronic inflammation, which we’ll discuss shortly, certain inflammatory molecules are produced. So they say molecules have been shown to be elevated in depressed people. So just to recap, as I said, before, that SSRI, which is Serotonin Reuptake Inhibitors don’t actually work for some people, as in correcting that, quote-unquote, correcting that serotonin imbalance. It doesn’t actually work for some people but it does work for others. So there are people that, as I said, they they do work for, but that is like that one potential reason. And we need to make sure that we’re looking at the other one. So it actually turns out, which I also found really interesting is that SSRIs can decrease some of these inflammatory markers. So that’s one potential cause of depression in terms of inflammation, but I don’t believe it’s the only one. And Kate, what really interests me and what I’m sure interests you is the connection between female hormonal imbalances and depression. So we did a great podcast on the dangers of the oral contraceptive pill, which people can look up, and I’ll link to in the show notes. And one of the things we discussed was the increased risk of depression while on the pill. So, Kate, I know, like, personally, I have experienced depression and the cause of my depression was actually somewhat hormonally related. I had hypothalamic amenorrhea and had zero kind of progesterone and estrogen. And that was the root at the root cause, or at least was one of the things that was at the root cause of my depression. But what are your thoughts on that side of things? Do you see any link between hormonal imbalances and depression?

Kate Callaghan 7:08
Oh, absolutely. And do you know, I just had this bit of aha moment. So the first time I was actually diagnosed with mild depression myself and put on medication, I was 17. And I’m well aware of the established link between depression and the oral contraceptive pill. And it just clicked in my brain now, just maybe two decades later.

Natalie K. Douglas
Better late than never.

Kate Callaghan
That so I started taking the pill at 16. So I wonder if that actually threw my hormones off balance enough to contribute to that depression when I was 17. I mean, I had a pretty shitty time at school anyway. There were some girls who would hope the nicest of girls to me. And I had a whole lot of whole lot of things going on in my family and suffered from depression as well. So there’s that genetic link there. But absolutely, so there’s synthetic hormones that we know to find in the oral contraceptive pill can contribute to depression. And this has been turned in the research. Whereas our natural sex hormones, our natural production of our sex hormones, the estrogen and progesterone, that work together they actually have a complementary effect in terms of being antidepressants. Progesterone as well is more anti-anxiolytic, so it decreases anxiety. So definitely, I see this in women with hypothalamic amenorrhea, because that’s typically you’ll see, really, really low levels of estrogen. Because it is not producing the sex hormones and as well as low levels of progesterone, because if you’re not ovulating, then you’re not going to be producing much progesterone at all. I also see it in women with menopause, obviously because when you go through menopause, your ovarian production of estrogen decreases and eventually stops in the switch to relying on adrenal production of estrogen. So that’s one of the reasons why depression is more common in menopause as well. So yeah, absolutely, you need to nourish your sex hormones and get those back on track to help stabilize those moods for sure.

Natalie K. Douglas 9:11
Yeah, interesting. So I think that that’s really relevant to a lot of people that will be listening to our podcast, which is why I wanted to touch on it. And definitely, if anyone’s looking for information on how do you rebalance your hormones, we have done multiple podcasts on different topics around imbalanced hormones. So definitely have a listen to that, as well as looking at both of our blogs, or booking a consult, and we can help you further. But let’s move on a little bit further into treatment. So if we’re looking at inflammation being a major cause of depression, then it’s actually really important that we know how to address that. So there are a few ways that are all kind of equally important, or a lot of factors that are equally important to address. So let’s start with diet. So, if you’ve been following either of us for any amount of time, you’ll be aware that we both promote and prescribe an anti-inflammatory diet. So, in its simplest terms, it means focusing on eliminating inflammatory and highly processed foods such as sugar, industrial seed oils, conventional soy, low fat or highly processed dairy, and gluten in most cases. And then replacing those inflammatory foods with anti-inflammatory nutrient-dense sources of protein, fat, and carbohydrates. So, things like vegetables, fruits, healthy fats, like avocado, coconut oil, olive oil, ghee, grass-fed butter, grass-fed meat, free-range chicken, eggs, pork, wild-caught seafood, and you know, properly prepared ancient grains and legumes in accordance to your specific individual tolerance. So that’s largely going to bring down inflammation from a dietary perspective. Then, from a supplemental point of view, I’d be looking into things like a high-quality fish oil, or cod liver oil, magnesium. And magnesium is actually being given in quite high doses in depression. So, I would definitely work with a practitioner and don’t be afraid to go on the higher end if that’s what they’re recommending, because there is research around that. Activated B vitamins, curcumin, and probiotics. There’s also a lot of evidence around SAMe, but this isn’t necessarily the answer for everyone and should be prescribed by a practitioner and same deal with a whole bunch of herbs. It can be beneficial like St. John’s Wort, or there’s some anxiety. If there’s some anxiety happening as well then things like Kava, holy basil, lemon balm, motherwort, rehmannia, rhodiola, and withania it can all be beneficial. However, like we aren’t herbalist and we’re not your practitioner, so just make sure that you do actually work with a practitioner to prescribe those appropriately. And then of course, looking into things like lifestyle management. So you know, making sure you’re addressing sleep, stress management, play and pleasure, connection, physical activity, and daily movement. They can all be really important as well. And the final point I would make would be make sure that you look after your gut health because if there is parasites, SIBO, any kind of gut dysbiosis, then you’re really going to have trouble. You put a bit of a limit on how far you can get with healing depression when you’ve still got a leaky gut or any kind of compromised gut situation. So using probiotics has actually been done a lot in the research of depression. So acidophilus. lactobacillus casei, and bifidobacterium combination has been shown to decrease symptoms of depression, and increase plasma glutathione levels. Lactobacillus helveticus, I can, I’m sorry, I’m really bad at pronouncing them but I am doing my best. And also bifidobacterium longum has also shown to decrease stress and anxiety. And same deal with rhamnosus and plantarum. So there’s a lot of bacteria that have been researched in depression and I would, in terms of turning that into a practical recommendation, look for a broad-spectrum probiotic, eat fermented foods. So, Kate, that’s kind of treating it from an inflammatory perspective. And what I was kind of focusing on when I was doing a bit of research and reading, but I know that you’ve had a lot of success with 5-HTP. Did you want to touch on that a bit?

Kate Callaghan 13:50
Yeah, sure. Nat, did you mentioned omega-3 fatty acids?

Natalie K. Douglas
I do, yes.

Kate Callaghan
Okay. Sorry.

Natalie K. Douglas
Good that we mentioned it again.

Kate Callaghan
And I would second you know, getting those organ meats in so, especially as vitamin B’s that are really high, and things like liver are really essential for reducing depression.

Natalie K. Douglas
Yeah.

Kate Callaghan
And don’t skimp on fats. Don’t skimp on cholesterol, your brain needs it. Saturated fat, cholesterol, essential fatty acids, all the fats, all the fats.

Natalie K. Douglas
All of them.

Kate Callaghan
All of the fats.

Natalie K. Douglas
Just become fat, like a fat molecule. Never mind. That didn’t work out.

Kate Callaghan
That didn’t work out as you planned to get it. No. Wait, wait. No. So yeah, so 5-HTP. So it’s 5-Hydroxytryptophan. And basically, it’s an amino acid, which is a precursor to our neurotransmitter, serotonin, which is our happy hormone. So I have been playing around with this a bit. So if some of you have followed me, you might have noticed that I have mentioned a little bit of a dip in moods lately. And so this has helped to stabilize my mood. So many having a really low dose, around 50 milligrams in the afternoon, and, you know, speak with your health practitioner about it, you can have a higher dose, but I’m pregnant. So I’m just going on the lower side at the moment and amino acid supplementation, it’s really really cool. There’s a lot that they can do in terms of helping to balance our brain chemistry, but it’s not necessarily a long term thing. So it’s kind of you take them short term to balance your brain chemistry, and then you’re weighing yourself off them. Because as Nat said, at the start. That you can actually have too much serotonin. And, I think it’s called serotonin syndrome.

Natalie K. Douglas
Yeah.

Kate Callaghan
And that can actually cause depression or contribute to depression as well and show those depressive-like symptoms. So you do need to be mindful of this, that it’s not just a matter of going out and getting a supplement and just taking it willy-nilly. You need to be mindful of how your body reacts to it and then knowing when to stop taking it as well. And knowing that it’s not in a forever thing. That’s the same with most supplementation.

Natalie K. Douglas
Yeah.

Kate Callaghan
Actually, it’s not something that you need to take all of the time. I mean, magnesium might be an exception to that, I think, in terms of general health, but for most supplements, it’s a short term thing to fix deficiencies. So that’s just a little bit on 5-HTP. If anyone does want to read more on amino acid therapy, and how it can boost your mood and the research around it. There’s a lot of research around 5-HTP in comparison to traditional antidepressants, in comparison to placebos. And it’s actually shown to be just as effective if not more so in many scientific studies, without the side effects. The same goes with St. John’s Wort, lots of lots of research around that. Check out The Mood Cure by Julia Ross.

Natalie K. Douglas 17:01
The Mood Cure. Okay, we’ll make sure we link to that in the show notes.

Kate Callaghan 17:03
The Mood Cure, lots and lots of information. And there’s little questionnaires in there as well. So you can see, see where you’re at in terms of your mood, and what can work specifically for you. I would also say, always consult with a health care practitioner, always consult with your doctor. If you’re taking medication and you’re listening to this podcasting, or well, I’m just going to try the natural route and get off my medication, please do not do that straight away. Go and talk to a doctor and say, I’m going to introduce these lifestyle strategies, I want to get off my medication, that’s completely fine that you want to, but you need to work in conjunction with your doctor in getting off those medications. And you need to do so slowly,

Natalie K. Douglas 17:42
Yeah.

Kate Callaghan 17:44
And mindfully and under supervision. So you can always start to introduce these lifestyle strategies, while you’re still on the medication and that’s going to help rebalance everything. But but please, please, please do not do it alone, ever, ever, ever, ever.

Natalie K. Douglas
Yeah.

Kate Callaghan
Now, same goes with bringing in 5-HTP and St. John’s Wort. Check with your doctor because a lot of the time you won’t want to take antidepressants together with these because then that can lead to that excess serotonin, or serotonin syndrome, which can make matters worse.

Natalie K. Douglas 18:14
Yeah. Kate, I’ll jump in there for a second and just mentioned that my. So my partner actually was on antidepressants for a good kind of more, I’d say about five years or so. And quite high doses of them. And he was looking to come off them. And what we did was, you know, I went to the appointment with him to his doctor, we discussed what we wanted to do, and the doctor was on board. And before we even started to pull him off them, we implemented diet and lifestyle changes. And then gradually under her supervision, and under my supervision, we started to incorporate a lot of the supplements that we’re talking about. So in a kind of tapering the supplements out, tapering the medication down method, but it was still a very rocky ride. And anyone who’s come off antidepressants will know how extremely difficult it is, especially if you’ve been on them for quite a long time and especially if you’ve been on quite a high dose. So despite all of our you know, pre-work, and doing things slowly, it’s still really difficult. So you do make need to make sure that you have support around you and that people are aware of what you’re doing because it it’s not an easy transition. But I will say that it’s all ended well, he hasn’t been on them for a good like two years or more now, after being on them for, you know, a good chunk of his kind of 20s and whatnot. So and now, we still use a lot of supplementation in in the way of like magnesium, B vitamins, fish oil, just for general kind of mood and energy health because, as Kate mentioned in her family, there’s quite a lot of depression type. I guess, people in there or a pattern. And it’s the same deal with my partner’s family. So we’re aware of that and do use supplements when we need to. But as Kate said, make sure that you are doing it with a doctor, with a practitioner, and also with support around you from family and friends because that can be really, really helpful.

Kate Callaghan 20:32
Yeah, and if you go to your doctor, and you tell them of your intentions, and they’re not supportive, don’t just go. Oh, well, I’ll do it myself. Find another doctor.

Natalie K. Douglas 20:41
Yep. Amen to that.

Kate Callaghan 20:44
And yeah, absolutely with you on the support thing. That’s, that’s first and foremost that before you get into these lifestyle strategies of food and supplementation, get support from your friends, from your family, and the professional support as well. Like, I cannot highly rate enough going and seeing a counselor and speaking. There is no shame in going and speaking to someone. And it could potentially be life saving, you really need to, and if you if you have any suicidal thoughts, you need to get to the doctor right now. And don’t be ashamed of that or feel that you can’t speak up about it, you need to put yourself first and please, please, please go to the doctor ASAP. And if you know, if temporarily you need to go on medication. That’s also okay.

Natalie K. Douglas 21:29
Yeah, definitely. And I think sometimes, you know, it’s, it’s easier or often it’s easier in some situations to talk to a stranger about how you’re feeling because a lot of us are quite aware of how our feelings and our thoughts affect the people closest to us. And sometimes when you’re in that depressed, depressive state, it can be really hard to feel like you’re putting that burden on someone else that’s close to you. And sometimes you hold back in your thoughts and your feelings. Whereas when you’re speaking to someone that isn’t attached emotionally to the situation, it can be a lot easier to work through those kind of issues. So I’m with Kate, I don’t think there’s any shame in going to speak to someone no matter who you are, if you’re a health professional listening, you know, like a nutritionist or a naturopath or anything like that, and you’re listening to the podcast and you think oh, no, I should, I should know better I know about the body. That’s like, it doesn’t matter. Like we all need to be taken care of when we all need someone. And we all need help at different stages in our life. It doesn’t matter how much we know, sometimes life just gets on top of us. And it can be really helpful just to step back and let someone you know, take control or at least be a sounding board for those thoughts and help you work through them.

Kate Callaghan 22:50
Definitely, personally in the last two years. I saw our counselor after I had Olivia. He came in once a week for six weeks, I think. At the start of the year, I paid $500 to get a CTC a Combined Therapy Cocktail session with Amy Crawford at The Holistic Ingredient. And I’m, I haven’t been paid to say this, I paid $500 for this session, and it was truly transformational. Pretty much just two hours of me crying.

Natalie K. Douglas
I love it.

Kate Callaghan
But it was, it was amazing. And you know, to start with, I was thinking, wow, $500 is a lot. But I was in a real funk. And I was finding that I was not experiencing any joy. I was low more often than not, and you know, 500 bucks to actually feel better in yourself and happier. That’s actually really cheap.

Natalie K. Douglas 23:44
Yeah, I agree. And I’ve seen multiple, like growing up I saw quite like, in my teenage years and early, like or late teenage years I saw, you know, psychologist and you know, many times, even in the last two or three years. For me, I’ve seen different practitioners at different stages, because it can be really overwhelming to just try and deal with it yourself. And it’s such a big relief when you let go of that ego, kind of pride-driven decisions that stop you from going and just go and show up. And it helps you be so much more effective to everyone around you when you actually do make time to take care of yourself and acknowledge that. You know, we’re all a bit imperfect, and that’s okay. So I think that, you know, it’s so it’s really easy for us to feel like we can’t ask for help. I know particularly, I felt that pressure in the past, especially being in the kind of health and nutrition, holistic world feeling the pressure of, you know, having it all together and having it all figured out. But I can’t tell you how freeing it is to let go of that expectation. Because really, you’re the only one projecting that thought on to everyone else. No one, everyone else you asked to ask is always like, oh, no, everyone needs a practitioner, everyone needs someone. So I just think that’s the biggest freeing thing you can do for yourself.

Kate Callaghan 25:15
Absolutely. I’m, I’m really not ashamed of admitting that I do not have my shit together.

Natalie K. Douglas
No.

Kate Callaghan
And there’s a there’s a quote that I’ve shared before and it goes, there’s no need to be perfect to inspire others. Let people get inspired by how you deal with your imperfections.

Natalie K. Douglas
Oh, I love that.

Kate Callaghan
Oh, yeah.

Natalie K. Douglas
I haven’t heard of that one before. I really like it. I like that one.

Kate Callaghan
Yeah. So we don’t need, need to be perfect. And even if we’re health professionals, it’s okay to admit that you don’t have it together because then people can relate to you. And you can sort it out, and you can have their support, and support them while you’re sorting it out. And it’s all a journey. We’re in this together, you don’t, it’s not about being this sage on the stage.

Natalie K. Douglas 26:01
No. That’s it. I love it. Well, I actually think that’s a really nice note to to start wrapping it up on. So just to recap, I think practically, like what you should get out of this episode is don’t be afraid to ask for help. Follow an anti-inflammatory diet and one that’s full of nutrient-dense foods. Make sure that you’re addressing any gut issues, any hormonal imbalances, and making sure that you’re surrounding yourself with supportive people, and don’t ignore the power of sleep, of stress management, of play and pleasure, and of daily movements. So you don’t need to kill yourself in the gym every day but you do need to get out and move every day. That can be really helpful as well. So we will link to everything that we discussed in the podcast. So that if anyone wants to check out the research on the amino acid therapy, or wants to check out Amy Crawford, or any of that stuff, we will link to that and make sure that you get in contact with you know, a trusted practitioner if you are looking to come off antidepressants with natural medicine as well. So, Kate, was there anything you wanted to add to that?

Kate Callaghan 27:15
Oh, no, I would I would second the whole. Moving your body every day as well. Getting some exercising that has been shown by the research to be just as effective if not more so than antidepressants. So yeah, move your body.

Natalie K. Douglas 27:26
Move your body. Sorry, I don’t even know what song that was. I was listening to RNB Friday’s in the car before. So maybe it was something from there.

Kate Callaghan
I know, I know what you’re talking about. I’ve been listening to unwind 90’s.

Natalie K. Douglas 27:41
Yeah. Oh, my God. Is that on Pandora?

Kate Callaghan 27:43
Yeah, yeah, and then I got friggin Spice Girls stuck in my head last night.

Natalie K. Douglas
Oh, I do love a good Spice Girl song.

Kate Callaghan
Oh, but it was one of those really slow ones and then I couldn’t get to sleep. It was really annoying.

Natalie K. Douglas 27:52
Oh, no, I don’t like those songs. Now, now you’re probably gonna get in your head again. You better.

Kate Callaghan
No, but now I’ve got that, now tell me what you want, what you really really want.

Natalie K. Douglas
That’s always.

Kate Callaghan 28:00
We’re recording aren’t we? Let’s stop recording.

Natalie K. Douglas 28:03
Yeah. Yeah. We should probably stop. Alright guys, well thank you for tuning in. And as always, if you have any questions, any comments, suggestions, please contact us. If you enjoy the podcast, please leave us a review or rate us on iTunes, that helps us reach more people. We will see you in a fortnight’s time. And Kate, I hope you have a lovely afternoon.

Kate Callaghan 28:23
You too. Thanks, Nat.

Natalie K. Douglas 28:25
Bye.

Kate Callaghan
Bye.