Depression: is it on the rise?

Prescriptions for antidepressants have risen by a staggering 43% in the past four years, to nearly 23 million a year, NHS figures reveal. This rise in the number of antidepressant medications being prescribed is thought to be partly due to stress and financial worries arising as a consequence of the current UK recession. Certainly, depression rates appear higher in deprived areas, where people struggle with unemployment and poverty. Recent indications go as far as suggesting a very clear north-south divide in prescription trends, with doctors prescribing antidepressants far more heavily in northern regions of England than in much of the rest of the country.

Guidelines from the National Institute for Health and Clinical Excellence (NICE) dictate that talking therapies should first be tried for mild to moderate depression and that if these do not work, or the patient is seriously depressed, then antidepressants can be prescribed. The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs) such as Prozac, which act by increasing the level of the neurotransmitter serotonin in the brain. One of the major issues with antidepressants is that the side effects often counteract any benefits and can result in poor compliance to treatment. However, other than talking therapies, are antidepressants the only treatment option, and if not, what else is there?

Given that one in four individuals will experience some degree of clinical depression or mood disorder in their lifetime, the need for successful treatments to lower the current burden on the NHS, not only financially, but also on resources, stands to reason. Depression is a both a complex and multifaceted condition, with symptoms often unique to the individual. Organic factors which may contribute to depression might include nutrient deficiency or excess, medication use – both recreational and pharmaceutical, candidiasis, alcohol use, hormonal imbalance, excessive stress products and so on. Whilst diet is a key area that has profound influence on mental health, surprisingly few GPs will ask about diet, or advise a patient on nutritional changes that could help towards avoiding the route to prescription. Certainly, in some cases deficiencies of specific vitamins, minerals, amino and fatty acids do seem to directly relate to our emotional well-being and can therefore easily be rectified.

Take, for example, the strong connection between daily fish consumption and depression. It has long been known that countries with the highest levels of fish consumption, such as Japan, have the lowest rates of depression and that women who consume very little fish during pregnancy have the highest risk of developing postpartum depression compared to women who eat fish regularly. In the last few years alone, many studies have confirmed the link between omega-3 and depression, with pooled data highlighting the benefits of one particular long-chain omega-3; eicosapentaenoic acid (EPA) found in fish and fish oil.1

There is certainly increasing, and quite overwhelming, evidence that there is a clinical role for omega-3 and, in particular, of EPA, in the treatment of depression. But how exactly does EPA reduce symptoms? Depression is now recognised as a disorder of both immune and inflammatory function, and clinical depression, certainly in its recurrent, chronic form, is being recognised as a complex interaction of stress-coping mechanisms and exaggerated inflammation, coupled with decreased levels of neurotransmitters known to regulate mood, with levels of omega-3 directly correlated with depressive symptoms.2 Treatment with EPA has been shown to reduce levels of inflammatory products associated with stress, regulate neurotransmitter levels and normalise omega-3 levels.3

EPA, therefore, moderates mood in two ways: firstly, it regulates the mood-influencing hormones serotonin and dopamine; secondly, it addresses the inflammatory element of depression by switching off inflammation pathways, as well as EPA itself being converted to anti-inflammatory substances. It is also responsible for a range of other health benefits, from combating heart disease to improving the appearance of your skin, nails and hair.
There is so much information on the Internet about self-help, as well as advice for people with depression, that it can be quite overwhelming! That’s why Igennus has formulated a straightforward, easy to read, info pack that people can download, read online or print. It brings together facts about depression, various treatments available (including conventional treatments) and dietary changes that are known to help, as well as recognised drug-free alternative treatments to pharmaceutical drugs. To download simply click here.

1. Martins, J.G. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr 28, 525-542 (2009).

2. Logan, A.C. Omega-3 fatty acids and major depression: A primer for the mental health professional. Lipid Health Dis 3, 25-25

3. Ross B.M. The Emerging Role of Eicosapentaenoic Acid as an Important Psychoactive Natural Product: Some Answers but a Lot more Questions. Lipid Insights 2, 89–97 (2008)

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