Thirty-year-old Kate had been feeling increasingly depressed. She had consulted a psychiatrist who told her (in an echo of my own case) that she had a “chemical imbalance.” She was prescribed an anti depressant and when small doses didn’t help her mood, her prescription was increased to the maximum dose. This high dose bothered Kate, who mentioned she felt uncomfortable taking medication for her sadness at all—but at least the pain in her heart and the anxiety that made breathing difficult at times had subsided. It was a secondary, but equally upsetting problem that had brought her to me. She had gained twenty-five pounds while on the medication, and the shame about that was starting to be as painful as the sadness that the antidepressant had improved.
I told Kate that her antidepressant is part of a group of drugs called selective serotonin reuptake inhibitors (SSRIs). They are designed to help with low serotonin levels—not by increasing the amount produced, but by letting the amounts available in the body stick around longer before being inactivated. Although they can be very beneficial in cases of moderate depression to kick-start someone to a more stable place, they can sometimes mask the real problem: something in the factory of the intestines, where the majority of the serotonin is produced, has gone awry.
Instead of relying forever on an outside source for something Kate was designed by nature to make in her own body, we wanted to correct whatever was causing her to underproduce the neurotransmitter. In addition, I told her that one of the most common issues I see among women her age is a sluggish thyroid gland, due to mental stress, allergies, and inadequate nutrition. This influences both weight gain and depression. By giving her body a recharge and a “reset” through a cleanse, the inner serotonin production gets a chance to improve and the thyroid can bounce back into full action, helping to regulate weight again. Kate ended up doing six weeks of Detoxification, because she was feeling so great that she didn’t want to change anything. In total she lost thirty pounds and looked better than ever. I worked in conjunction with her psychiatrist to slowly taper her off the antidepressant.
When your intestinal environment is damaged and inflamed, there is a slow reduction of natural serotonin levels, because so much of your serotonin is made in the intestines under the right conditions. When this happens, it physically changes the way you are getting signals about what to feel and how to respond to the world. Your experiences of moods and feelings will change for the worse, shifting to apathy, a dulled anesthetized state, or serious lows. This explanation could be seen as a modern scientific understanding of amma’s torpor of the spirit. Both are caused by toxicity.
As anyone with a more complex understanding of the psyche and physiology knows, the picture of depression is far more intricate than this. For one thing, many other neurotransmitters are involved that may also be out of balance, whether from a lack of nutrients or subtler imbalances in other parts of the body. Then add to this the toxins from the problems of the heart and soul that evade a physical examination, and it is impossible to say that there is ever a single cause of depression. I would never have presumed to tell Kate whether the root of her suffering started in the body (that low neurotransmitter production was causing her low spirits) or in the spirit (that her spirit was generating a physical symptom to get her attention).
But serotonin levels are something we can optimize just in case and work with that. Time and time again, I’ve witnessed how restoring intestinal integrity reactivates the major serotonin factory in the intestines and causes the mental fog, sadness, or distress to melt away. This can be the massive first step toward real healing of the spirit. Frequently, as Kate experienced, the patient who is already on an antidepressant is able to reduce the dosage and often stop taking it entirely. (This should always be done under the care of the prescribing physician and never on your own.)
Antidepressants, when used conscientiously, can serve an important purpose. In cases of moderate or severe depression they can be the “bridge” that helps patients shift from a place where they are floundering to a place where they feel some solid ground. Like any drug, they need to be neutralized and eliminated by the liver, so they add to the toxic load. But antidepressants can be a good tool to use while repairing the intestinal flora during and after a detox program. Since the brain is “plastic,” meaning it is always changing and modifying, antidepressants can help create some new neural pathways through which your experience of the world gets processed. You are creating a new and improved memory of what it’s like to feel better over the few months it might take to restore your intestinal flora and get your intestines to manufacture their own serotonin, reestablishing the pathways to a happier perception of the world.
Because most antidepressants only work for a while and many people build up a tolerance after six months to a year, to treat depression without restoring the conditions in the body is negligent. Often patients are simply put on higher doses or on a second or third antidepressant. To rely on antidepressants as the only course of action long-term is like whipping a weak horse to make it run. It may run, but it will collapse after a while. Meanwhile the side effects of the medications—from decreased libido, impotence, insomnia, and weight gain or loss to dry mouth and more—can accumulate. (The most tragic side effect of all is suicide, which is little discussed in the medical world.) When, however, patients increase their serotonin naturally, it’s as if we brought a hundred new horses into the race and let the weak one go out to pasture and enjoy the grass.
Serotonin production is greatly influenced by diet. Like everything in the body, serotonin is built from the nutrients we obtain from food. It uses certain amino acids as building blocks, especially the one known as tryptophan, which comes from high-protein foods. Levels of tryptophan have hugely declined in the modern diet. When we ate wild animals that foraged on grasses and other plants, we got more tryptophan in our diets. Grain-fed animals have much less of it, just as they have less omega-3 fatty acids. In addition, the natural production of serotonin is inhibited by caffeine, alcohol, and aspartame; a lack of sunlight; and a lack of exercise. After repairing the damaged intestinal environment, creating a Wellness Plan with a nutrient-balanced diet and possibly a regime of supplements that include probiotics (foods supplying beneficial intestinal bacteria) is an important step in sustaining more stable serotonin levels.
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