Depression is not a single, uniform condition but a multifactorial disorder influenced by biological, psychological, environmental, and social factors. While diagnostic criteria help identify symptoms, the underlying causes can vary greatly from one individual to another, requiring a personalised and systems-based approach to understanding and treatment.
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Depression is a complex disease with multiple contributing factors. The diagnostic criteria for depression include:
Depressed or irritable mood
Decreased interest in pleasurable activities and ability to experience pleasure
Significant weight gain or loss (>5% change in a month)
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Diminished ability to think or concentrate
Recurrent thoughts of death or suicide (Berton O, et al. Nat Rev Neurosci. 2006)
Chances are that you have felt several of the above criteria but yet you may not have associated it with depression.
This is because depression is a broad term that may affect one person differently to the next, along with having a diverse range of possible causations.
Below is a list of some of the factors that can lead to depression and apathy:
Trauma
PTSD
Abuse
Post-natal depression
Adverse childhood exposure
Lack of safety
Economic struggles
Autoimmunity
Social isolation
Heartbreak
Social media
Lack of purpose
S.A.D – Seasonal Affective Disorder (Vitamin D deficiency)
Mold exposure
Anaemia
Sex hormone imbalances (Low/high oestrogen, low testosterone)
Hypo/hyper thyroidism
Stress
Pain
Chronic illness
Genetic traits
Methylation issues
Heavy metal toxicity
Parasites
Nutrient deficiencies (B6, etc)
Nutrient excess
Artificial light exposure
Poor sleep
Mitochondrial dysfunctions
Poor gut health
Gut/brain axis inflammation
Cytokine model of depression
Medication
Loss of a loved one
Divorce
Substance abuse
Neurotransmitter imbalances
Lyme
Toxic and ambivalent relationships
Each reason, being so unique, may require a completely different approach for therapy from the next.
This reverberates a quote of William Osler, stating ‘It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has’. Unfortunately, society generally neglects the beauty of individuality whilst overlooking the crucial interplay and synergy from the multifactorial systems essential for optimal function within our body.
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Endometriosis is costing women, and Australia, an estimated total of $9.7 billion per year in medical bills and lost productivity, according to new research. This equates to an average cost of $30,000 per sufferer per year, both personally and to society.
Around 20–40% of this cost sits directly within the health sector: – Medications – Doctor visits – Assisted reproductive technology (e.g. IVF) – Transport costs to attend appointments
The remaining 60–80% is due to lost productivity, either from absenteeism or presenteeism—being physically present but unable to perform due to severe pain and discomfort.
Reducing pain caused by endometriosis by just 20% could save Australia billions.
This condition affects more than 830,000 women—over 10% of Australia’s female population.
Symptoms vary widely, contributing to the condition being overlooked or misdiagnosed for 7–12 years, with 1 in 5 doctors missing the diagnosis. At least 50% of patients experience fertility issues.
Given the scale, one would expect significantly more research, education, awareness, investment, and progress in this field.
Yet many men remain unaware of what endometriosis even is.
This is not necessarily the fault of men. It is a failure of the system to provide adequate education and visibility.
Women are not being treated with the care, respect, or urgency this condition demands.
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.
How many of the following symptoms for iron deficiency do you have?
Non-Physical Symptoms
Anxiety
Cognitive dysfunction
Dizziness
Fatigue
Headaches
Lowered attention
Light-headedness
Mood swings
Post-partum depression
Physical:
Atrophy or enlargement of the taste buds
Compromised immune function
Hair loss
Koilonychia (Brittle, spoon-shaped nails)
Leg cramps / heavy legs
Lowered body temperature
Mouth sores
Pale skin complexion
Palpitations
Poor thyroid function
Skin problems
Shortness of breath
Swollen tongue
Restless legs
Pregnancy complications
Here are some of the mechanisms behind the above symptoms:
Iron is required for tryptophan hydroxylase activity, this enzyme converts tryptophan to 5HTP, the precursor for serotonin – the chemical brain messenger responsible for our happiness. Therefore with inadequate iron levels, serotonin production will be reduced.
Iron is also needed for tyrosine hydroxylase, this enzyme is essential for the production of dopamine – the chemical brain messenger that is responsible for our drive and motivation.
Iron is essential for the intracellular reception of T3. This reduces the activity of the main thyroid hormone thus lowering metabolism, energy, whilst leading to hair loss and other related factors.
Iron is required to make hemoglobulin. Hemoglobulin helps carry oxygen within the blood to tissues, an integral part of energy production. If iron is low, the body’s ability to produce energy is hindered therefore increasing the likelihood for fatigue. This same mechanism leads to reduced oxygen availability to the brain giving reason as to why headaches are also linked to iron deficiency.
The paling of the skin and inside of the eyelids is due to less hemoglobulin within the blood, as hemoglobulin gives blood its red pigmentation.
Reduced hemoglobulin levels result in less oxygen within the body. As a compensatory mechanism, the body will start to increase breathing and heart rate in hope to get more oxygen, thus leading to a shortness of breath and increased heart palpitations.
