Studies show that depression is more common in women than men when we look at hospital admissions, population studies, suicide attempts, and the prescription of antidepressants. There is a preponderance of evidence to show that it relates directly to the levels of a woman’s hormones.
The peaks of depression occur at times of hormonal fluctuation during these times:
1. The premenstrual phase (8-10 days before the menstrual period begins)
2. The postpartum phase (after childbirth)
3. The perimenopausal phase, particularly in the one or two years before the periods cease.
Often it can occur in the same woman in all three of these phases.
Low levels of thyroid, estrogen, or progesterone can be major contributors to depression. For example, immediately after a woman gives birth to a baby, her progesterone levels begin to drop naturally. The problem comes when the levels drop too far. This is the main reason women get the “baby blues” (the medical term is “post-partum depression”). During pregnancy, progesterone levels skyrocket. This is why many women say that they feel the best mentally when they are pregnant (excluding the morning sickness of course!). Other women report that their lupus or rheumatoid arthritis goes away temporarily while they are pregnant. This is the miracle of having high progesterone levels. (Just a side note: pregnant women with severe morning sickness will benefit by using high doses of progesterone when no other remedies work.)
Let’s look at thyroid. If your thyroid is low, one of your main complaints will be chronic fatigue. If you are tired all the time, despite getting 10 hours of sleep the night before, it can become a little depressing. Constant fatigue can cause a depressed state of mind, which then leads to further fatigue. This is the downward spiral so many women complain about when they come to our clinic.
In 2004, we kept tract of the number of women that came to the Utah Wellness Institute (www.utahwellnessinstitute.com) that were taking antidepressant medication. Seventy-one percent of them were taking either Prozac, Wellbutrin, Lexapro, or Celexa. When we asked them, “Do you think you are depressed?” most of them said, “No, I’m just tired all the time, and that’s depressing.” They aren’t depressed women, they just have no energy to do anything but try and keep up—but they’re not doing it very well anymore. We would estimate that of that 71% of patients on antidepressants, maybe 20% of them needed to be on them. In most cases, they felt their personal physician put them on the medication because they couldn’t find anything else wrong with them.
If this sounds familiar, don’t be surprised, and don’t be mad at your doctor. Most general practitioners are not trained to spot hormonal imbalances masquerading as depression. It is also much easier for them to write a prescription for an antidepressant drug than it is to look deeper into the cause of the problems you are having. If you are reading this and are currently taking an antidepressant, do not stop taking your medication without consulting your doctor. That can be dangerous. Your brain has become dependent on those medications and there is a process for getting off of those types of medications. To read more about that, go to www.theroadback.org. Our goal at the Center for Hormone Therapy is to have you on the least amount of medications possible and to use natural, bio-identical hormone therapy, nutrition, and proper exercise to alleviate your depression.
One of the biggest things we see with women coming into our clinic is that most of them are what I call “protein deficient.” They are not getting enough protein in their diets. Every woman at our clinic has an assignment to eat 30 grams of protein within the first hour after getting out of bed. This can dramatically improve her energy levels and her depression. For example, one egg equals 6 grams. Well, nobody is going to eat 5 eggs for breakfast, but you could eat an egg, a cup of low fat cottage cheese, and a small protein shake. (Remember, protein shakes should be whey protein—not soy—and should never have any aspartame, Nutrisweet, Splenda, sucralose, acesulfame, sugar, or high fructose corn sweetener. The only good sweeteners are stevia or xylitol).
I’ve had women come back saying that the protein in the morning was “like a miracle” after doing it for several weeks. That is usually the same woman that previously said she doesn’t eat breakfast because she is never hungry in the mornings! The best way to gain weight is to skip breakfast. Then your blood sugar drops, you crave sweets for the rest of the day, and you fight depression for the rest of your life.
In conclusion, get your hormones checked if you struggle with depression. Tell your doctor you want your free T3 checked (not just TSH); you want your progesterone, estadiol, and testosterone checked, because low levels of these hormones can lead to long term depression. The main side effects of taking antidepressants are loss of sex drive, weight gain, and refractory depression (the “zombie” feeling). There are much better ways of affecting the brain positively without the worrisome side effects of these antidepressants. If you have other questions, go to www.utahwellnessinstitute.com and browse around. And eat your protein!
(Dr. Robert Jones is the Clinical Director at the Utah Wellness Institute in Draper, Utah. 801.576.1155)