Depression is often framed purely as a disease driven by neurotransmitter imbalance, yet growing evidence suggests this view is incomplete. Neurochemical changes may be downstream effects—signals or adaptive responses to deeper biological, psychological, and environmental stressors rather than the sole root cause.
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The paradigm of depression being a disease/disorder has evolved around the concept that neurotransmitters are primarily the root cause.
Yet, dysregulation in this field could very well be a symptom, coping mechanism and signal from a multitude of different issues ranging from inside, as well as outside of the body (as explained in my previous post).
The association of depression solely being linked to low levels of norepinephrine and serotonin is flawed throughout studies. There are many other variables that can result in this outcome.
Several studies indicate that as few as 25% of depressed patients have low levels of neurotransmitters, while paradoxically, some patients have abnormally high levels of neurotransmitters with no history of them ever being low.
Does the placement of depression into the category of disease/disorder attach a greater overwhelming thought process to the word than if we were to label it as a symptom?
One could argue that generally speaking, symptoms are alleviated with greater ease when compared with the disease.
It is easy to allow our identity to be taken hostage by adopting the ownership of depression and succumb to its depths.
Yet when we shift our thinking to understand that depression does not embody us as individuals, nor does it yield an element involved in modeling our identity, we shift our thoughts to a greater sense of self-empowerment.
We can overcome the ‘depression vs self’ mentality by accepting that depression is an adaptive and protective mechanism from the human body, accompanied with respect for the opportunity it brings forth to gain further insight into what needs nurturing.
I understand this is a challenging and delicate shift to take, yet the perception of the experience is paramount to one’s thoughts.
Could we disempower the shackling chains of emotional paralysis, gain buoyancy in the swamp of thoughts and restore vitality into one’s behaviour when depression is approached in the light of a symptom?
Can we utilise it as foresight with direction to what may require attention and care within our body and how we live?
This paradigm shift allows more of a harmonious level of awareness with the experience of depression and what possibilities it may bring.
References:
Asberg M, et al. Arch Gen Psychiatry. 1976
Mol Psychiatry. 2010 March
Della FP, et al. Pharmacol Biochem Behav. 2012
Della FP, et al. Behav Brain Res. 2012
Della FP, et al. Metab Brain Dis. 2013
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Are you currently exposed to phthalates on a regular basis? Were you exposed during early developmental stages—for example, through maternal exposure such as a mother working in a hair salon while pregnant? Have you noticed symptom improvement after reducing phthalate exposure?
Higher phthalate levels have been associated with a two-fold increase in the rate of endometriosis. Phthalates are present in almost anything fragranced and are widely used in soft plastics, vinyl, cleaning products, nail polish, and perfumes. As early as 2002, environmental groups reported that over 70% of personal care products contained phthalates. Today, according to the Environmental Protection Agency, more than 470 million pounds of phthalates are produced each year.
Phthalates are now officially recognised as reproductive toxins throughout both the European Union and the United States. Animal studies show that rats given high doses of certain phthalates stopped ovulating altogether. Phthalates reduce oestrogen production by ovarian follicles—oestrogen being one of the primary drivers of follicle growth and egg development in both animals and humans. Suppression of oestrogen by follicle cells would be expected to impair follicle growth, helping explain why women with endometriosis often exhibit significantly higher phthalate levels than those without the condition.
Potential sources of exposure are extensive. Plastics can leach into food, particularly when food is packaged while hot or stored in plastic for long periods. Personal care products are a major contributor, including cosmetics, hair products, lotions, infant care products, medications, medical devices, nail polish, and perfumes.
Vinyl products are another source, such as shower curtains, flooring, wallpapers, blinds, diaper mats, rain gear, inflatable mattresses, school supplies, car interiors, and yoga mats. Additional exposures may come from air fresheners, electronics, plastic jewellery, sex toys, and children’s toys.
Given their prevalence and biological impact, understanding and minimising phthalate exposure is an important consideration in hormone and reproductive health.
Below are alternative methods which have been studied for their efficacy and effectiveness in combating postpartum depression.
Saffron
A double-blind, randomised, placebo-controlled trial was conducted on 60 new mothers diagnosed with PPD. After 8 weeks, results showed that the saffron group experienced a 96% remission rate for postpartum depression from just 15-mg Saffron per day, more than double the remission rate of placebo group ‘Researchers concluded that saffron can have a safe and significant mood-elevating impact for those suffering from postpartum depression who want to safely breast-feed their newborns’ (8)
When compared with antidepressant medications, saffron has been found to have similar efficacy – without the side effects.
Folate
In placebo-controlled trials, folate has been used as an adjunctive treatment to fluoxetine. Findings indicated significantly greater improvement in the folate group, a difference most pronounced in women (14)
94% of women who received fluoxetine, with the addition of folate 500 mcg per day, were treatment responders, compared with 61% of those who received fluoxetine and placebo
It is recommended that women of reproductive age consume 0.4–1 mg folate daily to reduce the risk of neural tube birth defects.
Exercise
Exercise is integral to optimal health in pregnancy, as well as in the prevention of heart disease, obesity, and diabetes, along with other comorbid diseases. Regular physical activity (after selectively auditing through 216 studies) during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, was found to reduce the risk of developing depression in pregnant women and after the birth of a child (6)
Massage
A meta-analysis of 17 RCTs of massage therapy in depressed people concluded that massage therapy is significantly associated with reduced depressive symptoms (11), decreased urinary levels of cortisol (12); and increased urinary levels of serotonin and dopamine (13)
The purpose of this post is to raise awareness and display the vast array of possible paths one could take in supporting their own mental well-being when combatting PPD.
Infant Massages
Infant massage improves mother-infant interaction for mothers with postnatal depression (7)
Seafood
In a large Danish prospective cohort study of more than 54,000 women, participants who were in the lowest quartile of self-reported fish intake during pregnancy were at increased risk of being treated for depression with an antidepressant up to 1-year postnatally (9). Rather than extrapolating this solely to benefits Omega-3, it is important to take into account that sociodemographic characteristics not only influence food availability in house-hold diets but also emotional statue
Bright Light Therapy
In participants who received at least three weeks of bright light therapy each morning for 1-hr had improvements in their depression scores by a mean of 49%; among participants who completed at least 5 weeks, scores improved by 59% (10)
Caveats in this field of research are that the study pools are low most likely due to the ‘cost vs return’ of investing into studies in this sector
Strom M, Mortensen EL, Halldorsson TI, et al. Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort. Am J Clin Nutr 2009; 90:149–55.
Oren DA, Wisner KL, Spinelli M, et al. An open trial of morning light therapy for treatment of antepartum depression. Am J Psychiatry 2002;159:666–9.
Hou WH, Chiang PT, Hsu TY, et al. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin Psychiatry 2010;71:894–901.
Field T, Diego M, Hernandez-Reif M, et al. Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behav Dev 2009;32:454–60.
Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol 2004;25:115–22.
Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. J Affect Disord 2000;60:121-30.
Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr 2002;76:1158S 61S.
Roder C, Schaefer M, Leucht S. Meta analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John’s Wort [in German]. Fortschr Neurol Psychiatr 2004;72:330–43.
The lymphatic system is becoming increasingly more talked about but is still, in my opinion, one of the least appreciated and under-utilised systems in the restoration of movement dysfunctions and chronic health complaints.
Everybody, including health practitioners and those in the fitness industry, could benefit from understanding and implementing lymphatic techniques. You can consider that a homeostatic balance of the internal environment can be a true measure of health.
Lymphatic techniques can, therefore, aid the body in moving towards more of an internal state of homeostasis.
How does the lymphatic system function?
The lymphatic system is, in essence, the sewage system of the body.
It has the incredible ability to trap nearly all soluble antigens, roughly 99%, with its role in waste removal. This is significantly important for the other body systems to not become overwhelmed and develop issues as well.
The lymphatic system contains the thymus, an endocrine organ which is responsible for the development of T-lymphocytes, immune cells that are involved in fighting infection through the process of cell-mediated immunity.
The spleen plays a key role in the lymphatic system as the largest lymphatic organ, having a vital role in a host of detox processes, such as:
Filtering blood
Removing old dead red blood cells
The maturation of lymphocytes and macrophages to aid in fighting infection
The splenic communication of the tenth cranial nerve, the Vagus nerve, is crucial in reducing inflammatory cytokine production.
The tonsils also form part of the structure of the lymphatic system. With the tonsils formed of lymphatic tissue, housing lymphocytes and macrophages, they protect the digestive system and lungs from pathogens entering through the nose or mouth.
There is also a deep association with the gastrointestinal system through gut associated lymphoid tissues (GALT) known as Peyers Patches, with the role of the gastrointestinal system intrinsically linked to the immune system. Estimates suggest that roughly 70-80% of immune function is beholden to gastrointestinal health.
This amazing system also comprises millions of lymphatic vessels which, if placed end to end in a continuous line, would circle the earth four times! Alongside these vessels there are over seven hundred lymph nodes within the body, with the most populated areas being the neck, skin and the intestines.
This mass of lymphatic vessels works in uniform direction towards the heart, with valves interspersed to prevent any backflow from occurring. This one-way system is aided by the structure of the vessels which allow fluids to flow in the direction of clearance, but with numerous valves preventing backflow. Allowing the system to be cleared, very much how a filtration device on a fish tank would work.
The ability to regulate fluid homeostasis is a key aspect of the lymphatic system. The body contains fifteen litres of lymphatic fluid, predominantly of water, and roughly 10% of proteins, hormones and waste products. Comparing this to the five litres of circulating blood that we have, the body wouldn’t contain three times more lymphatic fluid than blood if it wasn’t a critical component of our survival!
From the five litres of circulating blood, over the course of a day, three litres of plasma leaks out into the interstitial space.
If not appropriately removed through the lymphatic system this can lead to swelling outside of the cellular space due to the increased fluid concentration and alterations in pressure.
Without effective drainage this can create stagnation in the fluids; Let’s go back to the fish tank analogy above, we know that stagnation of fluids is detrimental to the ecosystem, the same being the case for our health.
In a system with appropriately functioning lymphatics, this plasma is removed from the interstitial space into the lymphatics system and circulated upwards towards the subclavian vein. This is where it flows into the venous system, before returning to the liver, detoxifying and purifying the blood.
Taking a deeper look into the pathway of the lymphatic vessels will give an understanding into the application of treating the lymphatic system.
As a one way system drains into the venous system at the bilateral sites of the subclavian veins, all lymphatic vessels are required to flow in this direction. The right upper quadrant of the body drains through the right lymphatic duct and into the right subclavian vein, whilst the remainder of the body drains through the thoracic duct into the left subclavian vein.
The thoracic duct is responsible for the majority of lymphatic flow and also houses the largest lymph node, the cisterna chyli, which is a major site of drainage for the liver. It’s crucial to keep this node functioning well as between 25-50% of the returning lymphatic fluid through the thoracic duct is returned from the liver.
There is an important bidirectional relationship between the cisterna chyli and the liver, with an overburdened liver that can’t move or function optimally placing more load on the cisterna chyli. Having a lymphatic system that can’t drain well, especially at the cisterna chyli, increases the potential to create stagnation around the liver. A lymphatic vessel that is unable to drain will not be able to receive fresh supply creating this backlog.
A fairly recent discovery reveals that the lymphatic system also continues up into the central nervous system through the glymphatics, more commonly known as the glymphatic system.
The glymphatic system has the same role as the lymphatic system, however it is only situated in the brain. This helps to reduce inflammation and drive the removal of waste products which is essential for overall brain health. Additionally, the protective benefits of this system helps to distribute fuel sources and various other vital components around the brain.
