Depression? - There is Reason to be Hopeful

Depression?  There is Reason to be Hopeful

Arkansas Nutrition and Natural Healing

Dr. Roger Trubey, Dr.PH, MPH, and Doctor of Integrative Medicine 362 Unger Trail, Mountain Home, Arkansas 72653

Call 501-538-4944

Anyone who has suffered with chronic depression knows all too well how terribly painful an experience it is.  A few find answers, most don’t.  Those who don’t, understand the maxim, “the death of hope leads to the hope for death.”

But is there any reason to be very hopeful?  

For more than 3 ½ decades, with the approval of Prozac, chronic depression has unquestionably been linked to inadequate levels of neurotransmitters (serotonin, dopamine etc.), due to damaged neuron bundles in the brain that regulate and prevent depression.  But unfortunately, there are over 1100 known neurotoxins, whose damage to these neurons is cumulative over a lifetime.  

Perhaps this is why standard drug therapy for depression, including reuptake inhibitors like Prozac™, Zoloft™, etc. is not found in seniors to be any more effective than a placebo.  But hardly any more impressive is that several studies of adults have revealed a startling fact.  Reuptake inhibitors as a class of drugs provided relief of depression not much better than a placebo.  The Journal of the American Medical Association concluded that the benefit of antidepressant medication compared to a placebo, in mild to moderate depression, may be on average, minimal to nonexistent.  Newsweek magazine concluded that scientists are beginning to see these drugs as expensive Tic Tacs.

Here is the painful truth:

Doctors write more than 250 million prescriptions for SSRIs like Prozac, Zoloft, and Paxil every year.
When researchers looked at 38 clinical trials covering 3,000 depressed patients on these drugs, they found that 75% of mood improvement came from the drugs’ placebo effect. ( Kirsch I. “Antidepressants and the placebo effect.” Z Psychol. 2014; 222(3): 128–134.)

In a systematic review published in Molecular Psychiatry July 20, 2022:4

“The serotonin hypothesis of depression is still influential. We aimed to synthesize and evaluate evidence on whether depression is associated with lowered serotonin concentration or activity in a systematic umbrella review of the principal relevant areas of research …

17 studies were included: 12 systematic reviews and meta-analyses, 1 collaborative meta-analysis, 1 meta-analysis of large cohort studies, 1 systematic review and narrative synthesis, 1 genetic association study and 1 umbrella review …

Two meta-analyses of overlapping studies examining the serotonin metabolite, 5-HIAA, showed no association with depression … One meta-analysis of cohort studies of plasma serotonin showed no relationship with depression Dr. Joanna Moncrieff, professor of Critical and Social Psychiatry at University College London

 Dr. Moncrieff is the lead author of the serotonin paper. ‘This idea that they work by targeting the underlying biological mechanisms that produce the symptoms of mental disorders is actually not supported by evidence for any type of mental disorder, whether that’s depression or schizophrenia or whatever,’ she told Newsweek.

Instead, she argues, the drugs change ‘normal brain states’ and ‘normal mental states and processes’ in ways not that much different than recreational drugs like alcohol.”  The paper’s co-authors … call for a fundamental reassessment of how mental illness is treated. ‘We have a mistaken view of what psychiatric drugs are doing,’

Dr. Moncrieff concludes, “I think we can safely say that after a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin” 

So, if we are to be hopeful at all, it will not come from drugs which never increase the number of neurotransmitters, but from a more comprehensive understanding of what is actually taking place in the brain of those having to suffer the effects of this illness.

It is now well known that for nearly all doctors practicing functional medicine the underlying cause of depression is inflammation.  And this is also true for anxiety, brain fog, and all the more serious cognitive disorders, including dementia, Parkinson’s disease, Alzheimer’s disease among the more common disorders.

The brain is having to cope with a variety of very pro-inflammatory compounds – IL6, TH17, IL1, and individuals with depression are loaded with these and other pro-inflammatory cytokines, including TNF-α, IL-1β, IL-8, IL-18 and CRP.  When these are running wild in the brain, damaging brain cells, it is not possible to be cognitively well.  


When these damaging cytokines interfere with neurotransmitter synthesis and metabolism and interrupt neuroendocrine function, the problem is not the neurotransmitters but the inflammation that disrupts their proper function, which is likely why the standard antidepressant drugs have such little benefit.


So, the hope in depression is to discover the source of the inflammation.  There are a number of culprits that would be considered underlying factors leading to depression.  Here are a number of them, but not necessarily all of them that should be considered.

  • Hypothyroid disease
  • Oral contraceptives and hormone dysfunction 
  • Blood sugar dysregulation and obesity
  • DNA/Genetic mutations
  • Chronic infections
  • A damaged and leaky gut
  • Emotional trauma
  • Autoimmune disease
  • Sleep deprivation and sedentary lifestyle 
  • Environmental factors, including – indoor mold exposure, toxic chemicals, EMF sensitivity, toxic metals
  • Multiple nutrient deficiencies from the Standard American Diet (SAD diet)

On that last bullet point Functional Psychiatrist, Dr. Jame Greenblatt has this to say:

Over the last decade, scientific research has clearly established a relationship between malnutrition and brain function across every major psychiatric illness, from depression, ADHD, and schizophrenia, to eating disorders, anxiety, and dementia. Evidence confirms clear associations between nutritional imbalances in the body, and the prevalence and severity of mental illness and symptoms. Traditional psychiatry treatment for mental illness, however, fails to recognize and address nutritional imbalances as factors in mental illness.


Of course, there is likely a number of others that could be added to the list above, but the important need is to discover the primary factors and then to correct them. In working with patients, I go into the above in more detail as we unravel the ones most likely affecting the patient I am seeing. 

And there are usually one or more assessments that I find helpful to give me a much clearer indication of the factors that are provoking inflammation in those who are dealing with this very troubling illness. These objective measurements provide valid, scientific reasons for inflammation and cognitive dysfunction that have been woefully neglected in past approaches. By recognizing and treating each person’s unique internal imbalances and biochemistry, outcomes can be dramatically improved.

 If you would like to discover the specific areas of concern that are the root drivers of your inflammation, give me a call and make an appointment so we, together, can find the path of healing that you seek so that you can really enjoy life again.

There is hope for depression; it does not have to be a lifetime of agony. 


“For I know the plans I have for you, declares the LORD, plans to prosper you and not to harm you, plans to give you hope and a future.” -Jer. 29:11