While uncovering the root cause of depression can often be complicated, there are times when one supplement just saves the day.
That’s what happened when Annie came to see me:
Annie was only 24 years old and already a veteran of the mental health system.
She had been hospitalized four times during her adolescence and young adult years with depression, anxiety and an eating disorder.
When we had our first appointment, she was struggling to eat enough calories (usually only one meal a day, and mostly just carbs, “because it’s all I can eat without puking,”) her mood was low and negative and she often obsessed about cutting herself. Also, she had panic attacks every few days and couldn’t get to sleep without a few shots of bourbon (because “I can’t get my mind to calm down”).
She was increasingly hopeless and was pretty sure that things would never get better.
Part of her lack of optimism was because she felt like her psychiatrist had given up on her. He had prescribed her most of the antidepressants available over the years, and nothing seemed to help much.
After our first phone call, I felt pretty confident I knew ONE thing that would help her.
It’s Easy to Find What You’re Looking For If you Know Where to Look
The first step in the mental health nutrition work I do with people is to assess their neurotransmitter (NT) deficiencies using a tool designed by nutritional mental health pioneer Julia Ross MA, called the Amino Acid Therapy Chart.
It gives you a quick and accurate window into their NT deficiency symptoms and then provides guidance into what amino acids will likely be helpful.
Amino acids are what’s left after protein is broken down in the body by digestion. For many decades, nutritionally minded mental health practitioners have been using these natural substances as targeted interventions to address symptoms including depression, anxiety, ADHD, OCD and others.
I use amino acids every day in my practice and can’t say enough about how quickly and powerfully they can work to address mental health symptoms when NT deficiencies are the issue.
So then what are neurotransmitters?
Neurotransmitters are communication chemicals that serve as the main mood regulators in the brain. Low (or sometimes high) levels of the chemicals are responsible for most mood and behavioral issues.
There are four main neurotransmitters involved with mood and behavior: Serotonin, Catecholamines (Dopamine/Norepinephrine), GABA and Endorphins. Low levels of each of these, lead to a very specific pattern of mental health symptoms. Take a look to get a sense of the common symptoms related to each deficiency.
While all four neurotransmitters are important for understanding a person’s mental health in general, only two play a significant role in depression: Serotonin and the Catecholamines (affectionately referred to at the “CATS.”)
It’s interesting that while low levels of Serotonin and CATS both lead to depression, the kind of depression that result from deficiencies of each are quite different.
Here’s the basic rule:
Low Serotonin = anxious depression
Low Catecholamine = low energy/ low motivation depression.
I usually refer to depression resulting from low level of the CATS to be an “Eeyore depression” (that’s right, from ‘Winnie the Pooh.’) Think of Eeyore dragging and moping and you get a good picture of what a low CATS depression is like.
So back to Annie.
As I listened to her case, ONE neurotransmitter deficiency just jumped right out at me, and I bet by now you can guess which one!
Here were my thoughts after our first appointment:
- She was extremely low in serotonin, as a result of being malnourished (remember she had barely been eating for years because of her eating disorder).
- NONE of the antidepressants she had been taking over the years worked because she didn’t have enough serotonin in her brain (because of low levels of amino acids, there were no building blocks to make serotonin.) A little know fact is that antidepressants don’t make new serotonin, they just make better use of the serotonin available in the brain. So if there isn’t enough serotonin in the brain to begin with, antidepressants won’t work well. Click here to learn more about antidepressants.
Just so we are on the same page about low serotonin symptoms, here’s a list:
- Worry, Anxiety
- Low self esteem
- Obsessive thoughts or behaviors
- Panic attacks; phobias
- Suicidal thoughts
- Insomnia, disturbed sleep
Does it surprise you that low serotonin was the first thing that jumped out at me when thinking about Annie?
The Two Fastest Steps to Address Serotonin Deficiency
If you identify with three or more of the Serotonin symptoms listed above you might want to consider these steps.
1) Make sure you are getting enough protein.
When protein is digested, it’s broken down into 20 different amino acids to be used in the body. Nine of these amino acids are called “essential” because they are needed, but can’t be made by the body.
One of the these is L-Tryptophan (you have probably heard that it’s in “turkey,”) but it’s also in many other foods with protein.)
L-Tryptophan and its derivative, 5HTP (5-Hydroxytryptophan), are the only two things on the planet that Serotonin can be made from!
Since L-Tryptophan is only available from food with protein it’s essential to be eating enough protein if you are depressed.
I suggest that people with mental health issues shoot to get between 70-75 gram a day. To keep track use a protein counter like this one.
Also, it can be helpful to focus on foods high in Tryptophan, because not all foods containing protein have the same amino acid compositions. Here’s a list of foods to focus on.
2) Supplement with L-Tryptophan or 5HTP
The easiest and fastest way of building up levels of these Serotonin precursors is to take them as nutritional supplements. These are very common supplements that can be purchased at Whole Foods or any health food store.
In my practice I have found them to be the MOST POWERFUL treatment for depression by far.
When they are the right supplement, at the right dose, they are like magic!
Which do you start with?
I usually have people start with 5HTP because it’s easier for the body to convert it into Serotonin (only one step away.). If for some reason someone doesn’t respond as well as hoped for, I have them switch to L-Tryptophan.
In my experience, about as many people respond to 5HTP as L-Tryptophan, but it’s not uncommon for someone to have a powerful response to one but not the other. So if you how low serotonin symptoms, start with one and if don’t get benefit, try the other.
How do you know how much to take?
I find that dosing is the most confusing and frustrating thing about taking amino acid. I can’t tell you how many people come to me saying they have tried amino acids and they “didn’t work.”
The most common reason for amino acids not working besides the person not needing them, is that they took them at the wrong time of day or took too low of a dose to be effective.
Click here for a detailed explanation of how to find the right dose of L-Tryptophan and 5HTP.
If you decide to work with either of these, please follow the dosing recommendations carefully. It may make the difference between a robust response or a disappointing experience.
IMPORTANT NOTE: If you are on an ANTIDEPRESSANT medication, don’t take either of these supplements without consulting with a trained professional skilled in Amino Acid Therapy. Speak to a medical professional before starting any nutritional supplements.
Annie’s L-Tryptophan Experience
Once I was pretty clear that her issue was low serotonin, I suggested that she try L-Tryptophan with some zinc and vitamin b6 (these are both cofactors that are essential for converting tryptophan into serotonin. Because of her panic and anxiety, I decided to try Tryptophan first because 5htp can raise cortisol in some anxious people.
She followed the dosing recommendations that I provided above. Over the first few days she didn’t feel much and become disillusioned.
With some encouragement she continued increasing her dose. When she got to 1500 mg of L-Tryptophan twice a day, something amazing happened.
Her depression which has been at a constant 8 for many years (on a 1-10 scale, with 10 being suicidal) went down to 4. Her anxiety which had been at a 7 went down to a 3 and her panic attacks went from 3 or 4 times a week to once a month.
This was the first shift in her symptoms that she had experienced in many years and gave her the encouragement and optimism to really start working in her therapy (which she has been in for years, but found it to be very unproductive).
After a few months she was able eat more normally again.
Annie check in with me two years after discovering tryptophan. She had been in the first romantic relationship she had ever been in and was moving to a city with her new boyfriend, hours from her parents (a development she never imagined possible.)
Though life was not perfect, she was happy much of the time, and felt like she was heading in the right direction.
Now What About You?
I know that some of you are thinking that this kind of response is too good to be true. I promise these kinds of reaction DO happen but clearly not every time.
If the symptoms of low serotonin listed above “feel” like you, I would urge you to give 5HTP or L-Tryptophan a try.
If you don’t notice any positive response to one, move on to the other. I can’t tell you have many times I have seen one not work, and then the other be just the right thing. You just never know which is going to be better.
If you decide to experiment with their 5HTP or L-Tryptophan share your experience either in the comments section below or on my Facebook page.
What do you have to lose?
If it doesn’t help, you’re only out the cost of the supplements, which would be less than a $20 experiment. If it does, you may feel like you won the lottery!
This article was originally published on Dr. Friedman’s website.
Very interesting article. We have a few family members with mental health issues and we will have a look if adjusting their nutrition could maybe have an impact. Thank you for all you do! 🙏
“Eeyore depression” Great way to describe it!
This is very interesting!
wow super interesting! just another example of how DIET IS EVERYTHING!
This is fascinating!
Great de-mystification of Amino Acid Therapy!