The subject: Kim Hartig
Age: 41
Occupation: Gardener
Health goals: Determine what is causing her depression and treat the symptoms naturally

During the last several years, Kim Hartig has hit some rocky roads in her travels through life. She ended a long-term relationship and lost her job, her house, and her cat of many years. As she’s tried to deal with and recover from these losses, the 41-year-old gardener says she’s frequently felt blue and overwhelmed by her situation. “I often feel lethargic, foggy-minded, and without the energy to make positive changes—even though I very much want things to change,” Hartig says. “It is a strange place to be because I’ve always been full of energy and a hard worker.”

Hartig says her health has generally been good, though she was diagnosed with hyperthyroidism when she was 29 and given a radioactive treatment to destroy her thyroid. She has been on the prescription thyroid medication Synthroid ever since. Hartig says she would rather not go on an antidepressant drug to boost her mood and energy. “I want to feel better and be more productive, but I would prefer to do it naturally.”

Kim Hartig: Would you characterize what I’m feeling as depression?

The natural health expert: Laurie Steelsmith, ND, LAc, licensed naturopathic physician, acupuncturist, and practitioner of Chinese medicine in Honolulu; author of Natural Choices for Women’s Health (Three Rivers Press, 2005)

Laurie Steelsmith, ND, LAc: You do have some signs of depression, such as your lack of motivation and energy. Depression falls along a spectrum and ranges from dysthymia, which is a mood disorder characterized by a mild feeling of malaise, to severe depression, which is often accompanied by suicidal thoughts and the inability to function or even get out of bed. It sounds to me like you have dysthymia. Usually doctors will diagnose a person with depression when symptoms have been present for at least two years, as yours have been.

Q. Clearly, such things as losing my job, relationship, and cat are contributing to my feeling sad and overwhelmed. But could other issues be at play, too?

A. The causes of depression are numerous, but among the most common are stressful life events—such as you’ve experienced over the last few years—and imbalances in brain chemicals, especially serotonin. These two causes can be linked because stress can alter serotonin levels. If your serotonin level is low, you can experience symptoms of depression, including changes in appetite, fatigue, insomnia, feelings of hopelessness, or low self-esteem. Hormonal changes associated with menstrual cycles, pregnancy, and menopause also can influence mood in women.

More natural help for depression

  1. 5-HTP boosts the body’s ability to manufacture serotonin.
  2. Flower essences, such as wild rose, can have a powerful effect on the mind and emotions and provide another way to lift the spirits.
  3. St. John’s wort (Hypericum perforatum) can help treat mild cases of depression.
Source: Laurie Steelsmith, ND, LAc.
Note: Consult your health care provider for appropriate doses and safety information.

Low thyroid function, or hypothyroidism, is a common cause of depression in women. Your medication provides you with only one of the thyroid hormones, T4 (thyroxine). Even though your blood work may show normal thyroid hormone levels, your body may be having a problem converting the inactive thyroid hormone T4 to the active thyroid hormone T3 (triodothyronine). T3 is important because it regulates the metabolism of every cell in your body. Also, if you aren’t converting T4 to T3 effectively, your adrenal glands could be taxed because they have had to work a little harder to make up for where your thyroid hormones aren’t doing their job. This also could be contributing to your symptoms of depression.

Q. What should I do?

A. Ask your doctor to do a blood test called a thyroid panel that measures various thyroid hormone levels, including testing for free T4 and free T3. You also can assess your thyroid function by taking your basal, or core, body temperature first thing in the morning using a basal thermometer, available at most drugstores. If your temperature is consistently below 97.8 degrees, your body may be poorly converting T4 to T3. Physical symptoms can signal poor thyroid hormone conversion as well, including dry skin, constipation, easy weight gain, joint and muscle pain unrelated to exercise, and heavy menstrual periods. If you have these signs, a naturopath can help you develop a natural regimen for thyroid support.

Q. Are there supplements that could help improve my mood and energy level?

A. Supplements geared toward supporting your adrenal glands could potentially benefit you. Adrenal support would include taking vitamin C, which is important because you lose a lot of this nutrient in your urine when you experience acute and chronic stress. Vitamin C also is essential in the manufacturing of adrenal hormones. Vitamin B5, also known as pantothenic acid, plays an essential role in the manufacturing of adrenal hormones, as well. Foods high in pantothenic acid include whole grains, legumes, broccoli, cauliflower, salmon, sweet potatoes, and tomatoes.

Chinese herbs also can be very helpful with the adrenals because they can support the kidney qi (pronounced “chee”), or life force. This kidney nourishment will give you more energy and help you feel better. I would recommend Siberian ginseng (Eleutherococcus senticosus) because it fights fatigue, boosts the immune system, and helps your body cope with the effects of stress. (For additional recommendations, see “More Natural Help for Depression,” above.)

Q. Can food affect mood?

A. Certainly, which is why it is important to eat a healthy diet that includes lots of whole grains, nuts and seeds, and fresh fruits and vegetables—all of which help keep blood sugar levels steady. If your blood sugar drops too low, your body will increase stress hormones that can cause mood changes.

You also need protein for good adrenal function throughout the day. Healthy protein sources include eggs, turkey, chicken, tofu, tempeh, nuts, nut butters, beans, and legumes. Strive to eat protein at least twice a day. Each serving should be at least the size of the palm of your hand. This will help your body avoid producing spikes of the stress hormone cortisol, which happens when you become very hungry. You should avoid refined sugars and simple carbohydrates, as these foods will bring your blood sugar level up and then make it crash. Another thing to remember is that you need to eat three to four meals a day. Don’t skip meals, because that will put additional stress on your adrenals.

Q. Are there other things you recommend I do?

A. Whether you want to or not, get out first thing in the morning and walk or do some other exercise for at least 20 minutes each day. This will help increase your serotonin levels and boost your ability to move oxygen through your body. Yoga could also be beneficial because it can help you feel more centered and in touch with your body. In addition, I think psychotherapists can be great catalysts for change. You might want to consider working with someone who will listen but also give you tools for positive change.

Carlotta Mast is a frequent contributor to Delicious Living.

Photo by Rob Hawthorne