How probiotics and fish oil pills helped me tackle depression

What Causes Depression? For a long time we thought it was purely an imbalance of brain chemicals, but this was firmly refuted last year by researchers reviewing decades of findings.

The team, from University College London, concluded that the psychiatrist profession “must bear some responsibility for spreading an unsupported theory and the massive use of antidepressants that goes with it.” This story made headlines worldwide.

But then, a few weeks ago, this view was challenged by another group of leading psychiatrists, who argued that this review was flawed and should never have been published in the first place because it was dangerous, because people who need antidepressants can stop with its use. . So what’s going on – and what does it mean for patients?

As an ER physician, I see the deteriorating state of our nation’s mental health at every shift: depression, anxiety, self-harm, and suicide. I also see more and more patients taking antidepressants.

Something isn’t right here. Sure, if they were treated and managed well with medication, we shouldn’t see more and more people popping up in the emergency room.

I also know, as someone who has used antidepressants myself before, that they are not the whole answer, but part of a package – and a recent study points to an exciting new add-on approach, using probiotics, and that definitely helped me (more on that later).

Pharmaceutical companies design their products based on biology: The theory is that increasing specific chemicals in the brain will reduce depression and anxiety.

The most targeted chemical to handle this is serotonin, which carries messages between nerve cells in your brain. Drugs such as Prozac increase serotonin levels in the brain, which is expected to reduce depressive symptoms.

But the more we learn about depression, the more this biological, oversimplified explanation becomes unfit for purpose. Other physiological factors are now also known to play a role, such as inflammation.

And when we look at a condition, we have to look at it in three dimensions: the biological, the psychological, and the social. They are interrelated and treatments should target all areas.

For example, someone with a heart attack may need physical treatments, such as a stent, as well as psychological (for example, smoking cessation) and social treatments to exercise and improve their diet.

This three-pronged approach is especially true for depression.

We know that simple talk therapies like CBT can be incredibly powerful for depression. Exercise is also known as one of the best antidepressants.

And crucial to any mental illness treatment are the patient’s social interactions and support.

But sometimes medicines are also needed. Even if the serotonin theory is wrong, there is some evidence that drugs help some people. For others, they just don’t work and have possible side effects.

So are there other effective ways to deal with depression?

It’s increasingly looking like probiotic supplements could be the answer.

A study published last month by South London and Maudsley NHS Foundation Trust – one of the world’s leading psychiatric hospitals – revealed some potentially important data on the impact of probiotics on depression. Admittedly, it was a small study (only 100 patients) and it didn’t make national headlines (this week’s column could have been called “What Should Have Made Health Headlines”)—possibly because it didn’t have the backing of the major pharmaceutical companies PR teams.

But from my reading, it could help significantly change the way we deal with depression in the future.

There have been seven previous high-quality studies on probiotics for depression.

The numbers in each trial were small, but when the results were collected and analyzed last year in the Journal of Clinical Medicine, they showed that probiotics had a significant positive effect on patients’ levels of depression, as evidenced by reductions in their depression scores .

But one problem was that many of the studies were conducted outside Western countries – and as a dietary supplement, this is key.

Three were from researchers in Iran, for example, where diets can be very different, so the results may not apply to the patients here.

But the study published last month in the Journal of the American Medical Association Psychiatry is different: It’s the first of its kind in British patients to show improvements in depression levels after eight weeks of taking probiotics (containing 14 strains of good bacteria) compared to a study published last month in the Journal of the American Medical Association Psychiatry. placebo.

Importantly, the treatments had no side effects. Interestingly, this trial also showed improvements in anxiety and depression.

The study involved patients who were already taking antidepressants and continued to take them.

So how can “good” bacteria help with depression? The first scientific evidence that the gut and brain are connected came in 2004.

Mice raised in sterile environments — which left them deprived of normal gut bacteria — showed exaggerated physiological responses to stress, such as increased heart rate. But these reactions stopped when they were taken out of the sterile environment and given normal food, so their guts contained bacteria again.

This was the beginning of ‘psychobiotics’ – exploiting the beneficial influence of good bacteria (both probiotic supplements and prebiotics – food sources that stimulate their growth, such as kefir) on mental health problems, via the so-called ‘gut-brain axis’.

We now know that gut bacteria are involved in the regulation of numerous systems in the body, including inflammation, with studies showing that probiotics and prebiotics significantly lower levels of CRP (C-reactive protein, a marker of inflammation).

Depression is associated with higher CRP levels, and these psychobiotics may help lower inflammation levels.

But psychobiotics are not the only dietary supplement that can have an impact.

Other major reviews in recent years (published in prestigious journals such as Nature) have shown that vitamin D can improve symptoms of depression, as can omega-3 fatty acids (i.e. fish oil) compared to a placebo.

Both are thought to have anti-inflammatory properties.

So where does this leave us?

Depression is a terrible condition and antidepressants can be life saver. But these studies have shown that supplements such as fish oil, probiotics, and vitamin D can help if you’re on antidepressants.

A few years ago, when I was going through a difficult period in my private life, I was prescribed antidepressants. (I had persuaded my GP to give them to me – it was when I believed in the pure chemical theory: my views have since changed.)

I have a family history of mental health problems, and whether I suffered from depression (a medical condition that required treatment) or whether I was just miserable because of my personal circumstances, I’m still not sure.

I definitely felt better on the antidepressants, but I found the side effects difficult, such as weird electric shock sensations and sexual dysfunction.

Within six months I wanted to get rid of it, but without endangering my mental health.

I looked at the evidence of what else I could do.

There is very good evidence that, if needed, weight loss can help – and frankly, I was overweight. Losing 10 kg (by cutting processed and junk food from my diet) has helped me a lot, both physically and emotionally.

I also reduced my alcohol intake and started exercising a lot more, with a 5 km run every day. Both lifestyle changes have good evidence for reducing levels of depression and anxiety, and within weeks I noticed a difference.

I also took fish oil, vitamin D (400 IU) daily, as well as probiotics and prebiotics. I felt better and was able to gradually come off the antidepressants within a few months. I hope I never need antidepressants again.

I have continued to take these supplements – despite there being no evidence that they can prevent depression. (Proving this would require studies involving thousands upon thousands of patients, costing millions, and which pharmaceutical company would fund this?)

Still, there are good explanations why these supplements might work; they have other beneficial effects and have no side effects unless you overdo it.

So I will keep taking them and will try to keep eating right and exercising – because the mind and the physical body are intertwined, and by taking care of our physical health, we take care of our mental well-being.

But if you’re concerned about your mental health, talk to your GP. Sometimes we need more than supplements and healthy living to deal with this horrible condition.

• twitter: @drobgalloway