(From "Alcoholism--The Biochemical Connection" by Joan Larson).

Week Five:  Good-bye Depression

If you have been unsuccessfully battling depression, you are not
alone.  At least 40 percent of all alcoholics in the United
States are affected.  I say at least because our Health Recovery
Center study found that almost two-thirds of our clients are
depressed at entry.  In fact, most alcoholics I have treated
suffered from some degree of depression.
     It is tempting to pin the blame for hopelessness and despair
on the external events that can be triggered by alcoholism, such
as the deterioration of a marriage or the loss of employment.  To
be sure, some of the depression alcoholics report is a result of
the negative course life can take when you drink too much.  You
will be relieved to learn that this type of situational
depression is self-limiting and will pass when your life begins
to improve.  Counseling or group therapy can be of enormous value
here.
     But depression among alcoholics usually runs much deeper
than the situational variety I have just described. Depression,
like the other emotional problems discussed in Chapter 8, often
has biochemical roots that stem from the destructive effect of
alcohol on the normal chemisty of the brain.  Research has
verified the relationship between biochemistry and depression. 
Autopsies of people who have committed suicide have revealed
biochemical disruptions that may be unique to suicidal
depression.  In this chapter you will learn to recognize the
warning signs of this tragedy in the making.
     No amount of counseling or psychotherapy can help people who
suffer from biochemically induced depression.  I learned this the
hard way:  watching my son fight the deep sadness and feelings of
hopelessness that descended upon him as his depression worsened. 
The counseling he received was excellent, but words have no power
to reverse the biochemical disruption caused by alcoholism and
drugs. In fact, therapy's focus on the unhappy or unsatisfactory
external events marring the lives of such seriously depressed
people only creates more misery.
     My search for an explanation for Rob's suicide led me to
studies that confirmed the connections between brain biochemistry
and depression and offered methods of repair that succeed far
more reliably than any form of talk therapy.  I learned that
there is no single biochemical glitch that explains all
depression.  At HRC, we treat seven different sources of
depression affect alcoholics.  In this chapter, you will learn
which of the seven may underlie your depression, (in some cases,
two or more may be to blame).  You will also learn how to
overcome your particular chemical problem or problems.  This may
mean taking even more nutrients.  It may require further changes
in your diet.  Or you may need drug treatment to correct a
medical condition that can precipitate depression.  First, of
course, you'll have to confirm that you are depressed.  Then you
can evaluate the severity of your case.

How Can You Tell if You are Depressed?

Although two-thirds of the clients at HRC are severely depressed
when they enter the program, many do not realize they are
affected.  Men in particular are inclined to attribute the
feelings induced by depression to other causes.  Some blame their
inability to handle stress well.  Others reject being labeled
depressed because of the social stigma often unjustly attached
to this condition.  Some are simply so overwhelmed by alcoholic
symptoms that their depression is masked. Even so, depression is
not difficult to spot if you know that certain behaviors are red
flags to the condition:

-Withdrawal from activity; isolating yourself
-Continual fatigue, lethargy
-Indecisiveness
-Lack of motivation, boredom, loss of interest in life
-Feeling helpless, immobilized
-Sleeping too much; using sleep to escape reality
-Insomnia, particularly early morning insomnia (waking very early
and being unable to get back to sleep)
-Lack of response to good news
-Loss of appetite or binge eating
-Ongoing anxiety
-Silent and unresponsive around people
-An "I don't care" attitude
-Easily upset or angered, lashing out at others
-Inability to concentrate
-Listening to mood music persistently
-Self-destructive behavior
-Suicidal thoughts or plans

How to Tell if Your Depression is Psychological or Biochemical

Biochemical depression has certain symptoms that distinguish it
from the depression stemming from negative life events.  You have
reason to suspect that you are biochemically depressed if any of
the markers listed below describes your depression:

-You have been depressed for along time despite changes in your
life.
-Talk therapy has little or no effect; in fact, psychological
probing--questions life "Why do you hate your father?"--leave you
as confused as Alice at the Mad Hatter's tea party
-You don't react to good news
-You awaken very early in the morning and can't get back to sleep
-You cannot trace the onset of your depression to any event in
your life
-Your moods may swing between depression and elation over a
period of months in a regular rhythm (this suggests bipolar, or
manic-depressive, disorder)
-Heavy drinking makes your depression worse

How Serious Is Your Depression?

As important as identifying the cause of your depression is
determining the depth of your feelings.  If you often have
suicidal thoughts, please confide in your physician and a close
friend or relative.  You will recover, but in your present state
you need the support of someone you trust.  Share this
information and together do the detective work needed to discover
what is responsible for your continued depression.

The Seven Kinds of Alcoholic Depression

As I noted earlier, at HRC we have identified seven sources of
biochemical depression affecting alcoholics:

1. Neurotransmitter depletion
2. Unavailability of prostaglandin E1
3. Vitamin/mineral deficiency
4. Hypthyroidism
5. Hypoglycemia
6. Food an chemical allergies
7. Candida-related complex

     Where do you fit in?  Let's begin with the most likely
biochemical scenario.

Neurotransmitter Depletion and Depression

In earlier chapters you became acquainted with neurotransmitters,
the natural chemicals that facilitate communication between brain
cells.  These substances govern our emotions, memory, moods,
behavior, sleep, and learning abilities.  Neurotransmitters are
manufactured in the brain from the amino acids we extract from
foods, and their supply is entirely dependent on the presence of
these precusor amino acids.
     Alcohol destoys these essential precusor amino acids which
is probably why alcoholics seem so emotionally muddled and
depressed.  Without adequate amino-acid conversion,
neurotransmitters are no longer produced in sufficient amounts;
this deficiency causes "emotional" symptoms, including
depression.
     The two major neurotransmitters involved in preventing
depression are serotonin (converted from the amino acid L-
tryptophan) and norepinephrine (converted from the amino acids L-
phenylalanine and L-tyrosine).  You can resupply these vital
neurotransmitters and reverse depression by taking daily amino-
acid supplements.
     Your symptoms will determine which amino acid you will take
for depression:  tryptophan if your symtoms are sleeplessness,
anxiety, or irritability; L-tyrosine or L-phenylalanine if your
symptoms are lethargy, fatigue, sleeping too much, or feelings of
immobility.

Tryptophan to Serotonin

The amino-acid tryptophan found in large amounts in milk and
turkey is the nutrient needed to form serotonin, which controls
moods, sleep, sex drive, appetite, and pain threshold.  Eating
disorders and violent behavior have also been traced to serotonin
depletion.  Replacing serotonin can lift depression and end
insomnia.  In one notable study, a medical researcher in Holland
demonstrated that a combination of tryptophan (2 grams nightly)
and vitamin B6 (125 milligrams three time a day) could restore
patients with anxiety type depression to normal in four weeks. 
Depression accompanied by anxiety and sleep disturbances is most
likely to respond to tryptophan.

How to Take Tryptophan

Until the U.S. Food and Drug Administration prohibited the
manufacture and sale of tryptophan in the United States in the
fall of 1980, we used it for ten years at HRC without any ill
effects.  This amino acid has also been widely used in England
and Canada.  Last year, however, a number of deaths and illnesses
in the United States were traced to batches of tryptophan
manufactured in Japan.  In response, the FDA removed tryptophan
from the U.S. market.  At the time of this writing, the ban
remains in effect.  I want to caution you against using any
tryptophan purchased before the FDA barred its sale.  I am
confident that eventually tryptophan will again be freely
available in this country.  At that point, you can purchase a
fresh supply.  Here are guidelines for its use:

-Tryptophan alone will not be converted to sertonin.  To insure
that it is properly used, you must also take vitamin C and
vitamin B6 (Table 25)
-Tryptophan is converted to niacin before its final conversion
into serotonin.  If your body is deficient in niacin, the
tryptophan you take will supply you with niacin, not serotonin.
For this reason, it is a good idea to take a B-complex vitamin
daily.  This will give you both vitamin B6 and niacin and allow
the tryptophan to be converted to serotonin.

     Of all the amino acids, tryptophan is least able to cross
the blood-brain barrier.  It must pass this biological hurdle in
order to be converted to serotonin.  Always take your tryptophan
on an empty stomach.

Safety and Side Effects

Orthomolecular physicians have safely used tryptophan in doses of
one to six grams daily.  Since it is not stored in the body, it
cannot accumulate to toxic levels.  However, taking high levels
of tryptophan can produce some side effects:

-Drowsiness the next morning
-Bizarre or strange dreams (rare)
-Increased blood pressure in persons over age sixty who already
have high blood pressure
-Aggressiveness (this rare side effect can occur in the absence
of sufficient supplies of the nutrients needed for normal
conversion of tryptophan to serotonin.)

_______________________________________________________________
Table 25. The HRC Formula for Depression Due to Serotonin
Depletion

Nutrient                      Dose           Directions

L-Tryptophan* **              500 mg         2 to 8 capsules per
                                             day in divided doses
                                             (1 or 2 midmorning,
                                             1 or 2 midafternoon,
                                             2 to 4 at bedtime)
                                             on an empty stomach

Vitamin B6*                   50 mg          1 capsule 3 times
                                             per day

Vitamin C*                    1000 mg        1 capsule per day

Niacin or Niacinamide         500 mg         1 capsule per day
(non-time released)*
_______________________________________________________________
*This level was partly or completely established in your adjusted
nutrient plan or in other formulas you may be taking.  Refer to
your nutrient replacement list (Chart 6 or 7) to determine
whether you need to add more of this nutrient to achieve the
level suggested here.
**Use tryptophan only if the FDA lifts the current ban on its
sale.
______________________________________________________________

Who Should Not Take Tryptophan

-Anyone who takes an MAO (monoamine oxidase) inhibitor for
depression; do not take tryptophan until ten days after giving up
MAO inhibitors
-Anyone with severe liver disease (a damaged liver cannot
properly metabolize tryptophan or any other amino acid)
-Pregnant women (you may be able to take five hundred to a
thousand milligrams of tryptophan, but only with the approval and
supervision of your physician)

Tyrosine to Norepinephrine

The amino acid tyrosine, found in large amounts in  cheeses, has
an amazing effect on depression.  A number of studies have found
that it can succeed where antidepressant drugs fail.
     In the brain, tyrosine is converted into the
neurotransmitter norepinephrine, which has been described as the
brain's version of adrenaline.  You can appreciate the power of
norepinephrine when you realize that the effect produced by
cocaine comes from the drug's ability to activate norepinephrine
while inhibiting serotonin.  This chemical reaction causes the
brain to race until the supply of norepinephrine is depleted. 
The crash leaves addicts exhausted, depressed, extremely
irritable, and craving more cocaine.  Large doses of tyrosine can
reduce withdrawal symptoms and prevent serious depression among
cocaine addicts.
     We have used tyrosine at the Health Recovery CEnter for the
past few years with no adverse effects.  The usual dose is three
to six grams per day, taken on an empty stomach.  You must take
vitamins B6 and C to facilitate conversion of tyrosine to
norepinephrine (Table 26)

L-Phenylalanine to Norepinephrine

As an alternative to tyrosine, you can take the amino acid L-
phenylalanine, which also can be converted into norepinephrine. 
A number of studies have confirmed L-phenylalanine's amazing
antidepressant effects.  In one, this potent amino acid was found
as effective an antidepressant as the drug imipramine (Tofranil)
     L-Phenylalanine has one important advantage over tyrosine in
treating depression.  It can be converted to a substance called
2-phenylethylamine or 2PEA.  Low brain levels of 2-PEA are
responsible for some depression (before it converts to tyrosine,
which then converts to norepinephrine).
     If you are affected, L-phenylalanine will be better for you
than tyrosine.  The only way to find out is by trial and error. 
I recommend that you start by taking L-phenylalanine.  If you
find that it makes your thoughts rush (an effect that is often
described as the brain "racing"), you don't need 2-PEA and should
switch to tyrosine.  The only other disadvantage to taking L-
phenylalanine is its slight potential for raising blood pressure.

There is also some evidence that excess L-phenylalanine can cause
headaches, insomnia, and irritability.   For these reasons, it is
important to start with a low dose.
     L-Phenylalanine doses can range from 500 milligrams to 1500
milligrams daily taken on an empty stomach.  Overdose symptoms
are headaches, insomnia, and irritability.

_____________________________________________________________
Table 26.  The HRC Formula for Depression Due to Norepinephrine
Depletion

Nutrient                 Dose      Directions

L-Tyrosine               500 mg    4 to 10 capsules per day in 2
                                   or 3 equal doses on an empty
                                   stomach

OR

L-Phenylalanine*         500 mg    1 to 3 capsules per day in
                                   equal doses on an empty
                                   stomach

Vitamin B6*              50 mg     1 capsule 3 times per day

Vitamin C*               1000 mg   1 capsule per day
_____________________________________________________________
*This level was partly or completely established in your adjusted
nutrient plan or in other formulas you may be taking.  Refer to
your nutrient replacement list (Chart 6 or 7) to determine
whether you need to add more of this nutrient to achieve the
level suggested here.
_____________________________________________________________

Who Should Not Take Tyrosine or L-Phenylalanine

-Anyone with high blood pressure should avoid phenylalanine or
take very low doses (one hundred milligrams) at first and monitor
blood pressure as dosage is increased.
-No one taking an MAO inhibitor for depression should take either
tyrosine or L-phenylalanine
-No one with severe liver damage should take any amino acid.
-Do not take any amino acids during pregnancy except with the
approval and supervision of your physician.
-No one with PKU (phenylketonuria) should use L-phenylalanine.
-No one with schizophrenia should take either amino acid (except
with a physician's approval and under their supervision.)
-No one with an overactive thyroid or malignant melanoma should
take either amino acid.
-If you are being treated for any serious illness, consult your
doctor before taking these amino acids.

Unavailability of Prostaglandin E1 and Depression

Another biochemical cause of depression is a genetic inability to
manufacture enough prostaglandin E1 (PGE1), an important brain
metabolite derived from essential fatty acids.  The problem is
the result of an inborn deficiency in omega-6 essential fatty
acid (EFA).  Alcohol stimulates temporary production of PGE1 and
lifts the depression.  If you have been depressed since
childhood, your introduction to alcohol was probably an extreme
relief.  But this relief is short-lived.  When you stop drinking,
PGE1 levels fall again and depression returns.  To banish it, you
turn again to alcohol.  Thus a deadly spiral begins toward
alcoholism.  During the last fifteen years, researchers have
learned to restore normal PGE1 levels in alcoholics and eliminate
both the depression and the need to drink for relief.  A
substance called gamma-linolenic acid (GLA) is easily converted
to PGE1.  I have seen some amazing recoveries from depression
within three weeks of GLA treatment.
     Take the case of Colleen, a high school English teacher. 
Colleen described her childhood and teenage years as withdrawn
and lonely, "I can't remember not being depressed," she told me. 
In college, she drank alcohol for the first time and received the
shock of her young life.  Her world brightened in a way she had
never before experienced.  She felt different.  Friendly.  Happy.
The effects lingered into the next day, and then gloom closed in
again.  After experiencing the dramatic lift in her spirits, she
was convinced that she had discovered a magic elixir in alcohol. 
In a short time she was drinking a few beers every day.  The
alcohol never failed to banish her depression.
     As her college years passed, Colleen's alcohol consumption
escalated.  She needed to drink more and more to get the lift she
sought.  She also began to experience deep depressions in the
days following heavy drinking.  After college, she began teaching
high school English.  Controlling her depression with alcohol
became a real balancing act.  Eventually, her drinking came to
the attention of her peers and her students.  Colleen was
appalled at the idea that she was a problem drinker.  She decided
to prove she could live without alcohol.
     The next ten years were some of the most miserable of her
life. She joined AA and sought psychiatric help for her severe
depression. Sadly, no antidepressant drug relieved her misery. 
It was hard to keep teaching, hard to keep living. Her depression
had reached the suicidal stage when she reasoned that alcohol
could put an end to her despair. Her decision to resume drinking
didn't take much reflection. Predictably, her alcohol intake
began to escalate rapidly. This time, no one sympathized. Her
principal ordered her to treatment. Three weeks after completing
an inpatient program, she was back at employment and drinking
again to medicate her depression. A second round of treatment
left her temporarily dry and depressed.  Colleen was on a merry-
go-round she couldn't get off. When she called the Health
Recovery Center, she was crying, "I have alienated everyone
because I won't stay sober, but being drunk feels better than
being depressed."
     I often think someone up there does watch over people, it
seems more than coincidence that Colleen found her way to one of
the only treatment centers in the country that would run tests
and restore her chemistry to normal. Within three weeks, her
depression had vanished. She no longer needed nor craved alcohol.
     Colleen's was a classic case of chronic depression caused by
too little PGE1. Although alcohol blocks production of additional
amounts of this metabolite, its active effect is to enhance what
little is available in the brain. Eventually, a no-win situation
develops and alcohol becomes the only way to prevent depression.
The solution, of course, is to provide the brain with the PGE1
needed to reverse the depression. Figure 9 shows how essential
fatty acids are converted into PGE1 and other brain metabolites.
If your body can't do this normally, you can correct the problem
by taking gamma linolenic acid (GLA) in the form of Efamol (
a trade name for oil of evening primrose). The formula for EFA
deficient depression (Table 27) includes three supportive
nutrients in addition to Efamol: zinc, needed for formation of
gamma-linolenic acid (GLA); vitamin B6 for metabolism of cis-
linolenic acid; and vitamin C, to increase production of PGE1.
When you take GLA and its cofactors, depression magically lifts
and won't return as long as you continue to take the formula.
Colleen now uses this natural substance daily instead of alcohol,
and her world has brightened up permanently.

Do You Have an EFA Deficiency?

In his book "Essential Fatty Acids and Immunity in Mental Health,
Charles Bates, Ph.D., provides a list of factors that suggest an
essential fatty acid deficiency:

-Ancestry that is one-quarter or more Celtic, Irish,
Scandinavian, native American, Welsh, or Scottish.
-A tendency to abuse alcohol or feel that it affects you
differently from others; trouble with alcohol in your teenage
years.
-Anxiety or depression during hangovers
-Depression among close relatives
-A family history of alcoholism, depression, suicide,
schizophrenia, or other mental illness.
-Depression that persists while you are abstinent from alcohol.
-A personal or family history of Crohn's disease, hepatic
cirrhosis, cystic fibrosis, Sjogren-Larsson syndrome, atopic
eczema.
-A personal or family history of ulcerative colitis, irritable
bowel syndrome, premenstrual syndrome, scleroderma, diabetes, or
benign breast disease.
-Experiencing an emotional lift from certain foods or vitamins.
-Winter depressions that lighten in the spring.
______________________________________________________________
Table 27. The HRC Formula for Depression due to EFA Deficiency

Nutrient            Dose      Directions

Efamol              500 mg    3 capsules 3 times per day with    
                          meals (9 per day); can be reduced      
                        to 6 per day after 1 month

Zinc picolinate     20 mg     1 capsule with food

Vitamin B6          50 mg     1 capsule 3 times per day

Vitamin C           1000 mg   1 capsule per day

Niacin              100 mg    1 capsule with food daily
______________________________________________________________

Vitamin and Mineral Deficiency and Depression

The effect of nutritional deficiencies on brain chemisty can
cause depression, anger, listlessness, and paranoia. 
Unfortunately, the connection between depression and vitamin and
mineral deficiencies is often missed. At Johns Hopkins
University, sixty-nine cases of scurvy (total vitamin C
depletion) were discovered at autopsy, and yet the disease had
not
been diagnosed before death in 91 percent of these patients.
     One of the most dramatic cases of vitamin and mineral
deficiencies I have seen involved a man I'll can Paul. He had
been arrested four times for drunken driving but continued to
drink daily. His probation officer brought him to the Health
Recovery Center. The three of us had to decide if an outpatient
program would be proper for someone as depressed as Paul. The
court had just ordered him back to treatment, judging by the
miserable look on his face,it was the last place he wanted to be.
     Paul was thirty, divorced and living alone. He rarely ate
more than one meal a day, usually fast food or junk food. He
lived on coffee, cigarettes, and beer. Paul confided that he was
probably going to lose his sales job because he could no longer
motivate himself. He blamed all of his troubles on depression.
There were so many aspects of his life-style that suggested a
real
depletion of the natural chemicals he needed to recover from
alcoholism and depression that I urged Paul to let us work with
him.
     Two days later, after receiving his B-complex shots, Paul
remarked that we must have injected him with an amphetamine. The
effect of restoring these life-giving substances was dramatic. He
also made many life-style changes that contributed to his
recovery, but one of the most important was the replacement of
certain key natural substances that helped relieve his
depression.

The B-Complex Vitamins

The B-complex vitamins are essential to mental and emotional well- being.
They cannot be stored in our bodies, so we depend entirely on our daily
diet to supply them. B vitamins are destroyed by alcohol, refined sugars,
nicotine, and caffeine--the very substances that most alcoholics consume
almost to the exclusion of everything else. Small wonder that deficiencies
develop. 

Here's a rundown of recent finding about the relationship of
B-complex vitamins to depression: 

-Vitamin B1 (thiamine):  Deficiencies trigger depression and
irritability and can cause neurological and cardiac disorders
among alcoholics.
-Vitamin B2 (riboflavin): In 1982 an article published in the
British Journal of Psychiatry reported that every one of 172
successive patients admitted to a British psychiatric hospital
for treatment of depression was deficient in B2.
-Vitamin B3 (niacin): Depletion causes anxiety, depression,
apprehension, and fatigue.
-Vitamin B5 (pantothenic acid): Symptoms of deficiency are
fatigue, chronic stress, and depression. Vitamin B5 is needed for
hormone formation and the uptake of amino acids and the brain
chemical acetylcholine, which combine to prevent certain types of
depression.
-Vitamin B6 (pyridoxine): Deficiency can disrupt formation of
neurotransmitters. Vitamin B6 is a coenzyme needed for conversion
of tryptophan to serotonin and phenylalanine and tyrosine to
norepinephrine. I have discussed the relationships of these
neurotransmitters to depression earlier in this chapter.
-Vitamin B12:  Deficiency will cause depression.
-Folic acid: Deficiency is a common cause of depression.

Vitamin C

Continuing vitamin C deficiency causes chronic depression,
fatigue, and vague ill health.

Minerals

Deficiencies in a number of minerals can also cause depression.
If this is at the root of your problem, you should already be on
the road to recovery; your adjusted nutrient plan contains
sufficient amounts of all the minerals necessary to overcome any
deficiencies. But I would like you to familiarize yourself with
the minerals that can underlie depression so you can better
understand the rationale for taking large doses of so many
supplements:

-Magnesium:  Symptoms of deficiency include confusion, apathy,
loss of appetite, weakness, and insomnia.
-Calcium: Depletion affects the central nervous system. Low
levels of calcium cause nervousness, apprehension, irritability,
and numbness.
-Zinc: Inadequacies result in apathy, lack of appetite, and
lethargy. When zinc is low, copper in the body can increase to
toxic levels, resulting in paranoia and fearfulness.
-Iron: Depression is often a symptom of chronic iron deficiency.
Other symptoms include general weakness, listlessness,
exhaustion,
lack of appetite, and headaches.
-Manganese: This metal is needed for proper use of the B-complex
vitamins and vitamin C. Since it also plays a role in amino-acid
formation, a deficiency may contribute to depression stemming
from low levels of the neurotransmitters serotonin and
norepinephrine. Manganese also helps stabilize blood sugar and
prevent hypoglycemic mood swings.
-Potassium: Depletion is frequently associated with depression,
tearfulness, weakness, and fatigue. A 1981 study found that
depressed patients were more likely than controls to have
decreased intracellular potassium. Decreased brain levels of
potassium have also been found on autopsy of suicides. You can
boost your potassium intake by using one teaspoon of Morton's
Lite-Salt every day.

The Safety of Supplements

Vitamin C and the B-complex vitamins discussed above are all
water soluble. This means that they can't accumulate in your body
or he stored for future use. Amounts above and beyond your
current nutritional needs are dumped into your urine. As a
result, there is no danger of overdose.
     Unlike water soluble vitamins, minerals can be stored in
your tissues. Refer to Table 24 for the RDAs and therapeutic
treatment levels. Do not exceed the recommended therapeutic
doses, since accumulation of minerals in the body can be
dangerous.

Hypothyroidism and Depression

The stress showed on Mary's face as she described how weary and
depressed she felt. Her husband and children demanded to much of
her, and she drank to escape the pressures and responsibilities.
Mary had been in our program for two weeks. She was now alcohol
free and making life-style changes. Still, she had very little
energy and didn't seem to be recovering very fast.
     As we talked, she inadvertently offered several clues to the
source of her problem. She complained that even on her restricted
diet she simply couldn't lose weight. Exercise was out of the
question. She was just too tired, even though she slept up to ten
hours a night. She was wearing a heavy sweater even though it was
a warm spring day. She said she had a hard time keeping warm and
was very susceptible to catching colds. By the end of our
session, I had heard enough to refer her to our physician for a
thyroid test.
     Symptoms of hypothyroidism (low thyroid function) include:

-Depression
-Mental sluggishness
-Confusion
-Poor memory
-Fatigue
-Low sex drive
-Brittle hair
-Dry skin
-Puffiness around the eyes
-Cold hands and feet
-Sleeping more than eight hours a night
-Susceptibility to colds and infections

     Researchers speculate that hypothyroidism causes depression
because there is an insufficient supply of oxygen to the brain,
since people with low thyroid function do not use oxygen
efficiently. Linus Pauling contends that all depression could be
eliminated if brain cells received sufficient oxygen.

Testing

If you have any of the symptoms listed above, you can test
yourself for hypothyroidism with a procedure first described in
the Journal of the American Medical Association by thyroid expert
Broda Barnes, M.D. The test could not be simpler. People with low
thyroid function have lower than normal temperature because they
are not burning up as much food as they should.  All you have to
do for this test is determine whether your body temperature is
lower than normal.
     Use a digital or basal thermometer, not a fever thermometer.
The basal type is commonly used by women trying to get pregnant--
or trying to avoid pregnancy--to determine when ovulation occurs
on the basis of an increase in body temperature.  Basal
thermometers are available in most drugstores.
     Place the thermometer snugly under your armpit for ten
minutes. If it registers below 97.8 degrees and if you have
symptoms of hypothyroidism, you probably need thyroid hormone.
     This home test can give you a fix on your thyroid status. If
you haven't yet been tested, you can ask your doctor to check
further. The usual laboratory tests for thyroid (T3, T4, and TSH)
do not always tell the whole story. But a new test, the
fluorescence activated microsphere assay (available from
ImmunoDiagnostic Laboratories in San Leandro, California) will
often reveal abnormalitites less sophisticated tests miss.
     In Mary's case, standard lab tests indicated low-normal
thyroid function, but her morning temperature never rose above
96.9 degrees. We treated her with Armour Thyroid, a prescription
drug. It relieved her depression and eliminated her mental
sluggishness and fatigue. She also lost weight.
     If your home thyroid test shows that your temperature is
consistently below 97.8 degrees, see your physician to discuss
treatment. If the doctor wants more information on your testing
method, refer him or her to Dr. Barnes's book "Hypothyroidism:
The Unsuspected Illness". Another useful book is "Solving the
Puzzle of Illness" by Steven Langer, M.D.
     Dr. Barnes has published more than a hundred papers and several books
on the role of the thyroid gland in human health. He treats thyroid
disorders with natural desiccated thyroid rather than synthetic thyroid
preparations. The advantage of natural thyroid over synthetic is that all
thyroid hormones are replaced with the natural product, whereas synthetics
have not yet been able to duplicate nature completely and do not affect
two troublesome symptoms of hypothyroidism, dry skin and water retention. 

Hypoglycemia and Depression

In his studies of twelve hundred hypoglycemic patients, Stephen
Gyland, M.D., found that 86 percent were depressed. More
recently, positron emission tomography (PET) scans have verified
that glucose metabolism is often reduced in the brains of
patients suffering from depression.
     Table 28, which is based on Dr. Gyland's studies, compares
the symptoms of hypoglycemia and depression. It is no accident
that both conditions are so common among alcoholics. If
hypoglycemia under-lies your depression, you should begin to
notice an improvement soon after you adopt the hypoglycemic diet
recommended in Chapter 7.




_____________________________________________________________
Table 28. Symptoms of Hypoglycemia and Depression

Hypoglycemia                            Depression

Nervousness                             Nervousness
Irritability                            Irritability
Exhaustion                              Exhaustion
Faintness, cold sweats                  ---
Depression                              Depression
Drowsiness                              Drowsiness
Insomnia                                Insomnia
Constant worrying                       Constant worrying
Mental confusion                        Mental confusion
Rapid pulse                             Rapid pulse
Internal trembling                      Internal trembling
Forgetfulness                           Forgetfulness
Headache                                Headache
Unprovoked anxieties                    Unprovoked anxieties
Digestive disturbances                  ---
_____________________________________________________________

Food and Chemical Allergies and Depression

The connection between food allergies and depression was a
revelation to me I was treating a young woman who was both
alcoholic and depressed. I expected to find some food or chemical
sensitivities because she had a terrible withdrawal hangover when
she stopped drinking, indicating an allergic/addicted response to
alcohol.  But I was not prepared for the Jekyll and Hyde changes
that I witnessed.  By the end of the week-long modified fast,
Carol was feeling much better.  Her depression was gone, and her
energy had returned.  Then she tested wheat.  Within two hours
she crashed.  Crying over the telephone, she told me she was too
depressed to continue the program.  The next day she apologized. 
We were both grateful to find a major trigger to her depression. 
     After her severe reaction, I expected Carol to avoid wheat
religiously. At the time, I didn't understand the addiction
aspect of the allergic/addicted response. Carol had enormous
cravings for breads and pasta, so her resolve lasted only a few
days. Then she succumbed to temptation and ate pizza for lunch.
An hour later, she arrived at her treatment group sobbing
inconsolably while the others groped for emotional explanations
for her behavior. After her wheat reaction wore off, her
depression again lifted.
     Wheat is not the only substance capable of triggering a
maladaptive reaction within the brains and nervous systems of
sensitive people. Alcohol, certain foods (particularly the grains
from which alcohol is made), and many chemicals (particularly
hydrocarbon-based products like gasoline and paints) can also
cause reactions. Food addiction keeps us coming back for more of
certain foods. We love the initial mild energy they provide as
they bring us out of our withdrawal state. We don't understand
that the downside of this addiction is depression, anxiety, and
mental confusion, the result of the inevitable withdrawal in the
nervous system and the brain.
     If you are an allergic/addicted alcoholic, consider the
possibility that substances other than alcohol may be affecting
your brain and causing depression. In Chapter 11 you'll learn how
to identify and eliminate these culprits.

Candida-Related Complex and Depression

During the last five years, we have seen a steady parade of
clients who are fighting an internal war with an overgrowth of a
common intestinal yeast called Candida albicans. I can usually
tell on the basis of a first interview who is a probable
candidate for treatment of candida-related complex (CRC). People
suffering from this problem appear depressed, tired, anxious, and
so spacey that they can't follow what I'm saying. They tell me
they continually crave sugar as well as alcohol, and they have
telltale signs of yeast invasion throughout their bodies. Their
immune systems are so depressed that most foods cause bloating
and produce allergic/addictive responses. If you suffer from CRC,
your depression won't lift until these yeast colonizers are
brought under control.
     In Chapter 11 you'll find a full discussion of CRC and its
symptoms, as well as an explanation for why some people are
particularly susceptible to this yeast. There is also a
description of the tests and treatment for CRC.

Suicide and Depression

Before we leave the subject of depression, I want to discuss a
painful subject: suicide, the final solution to depression. If
your life, like mine, has been seared by the suicide of a family
member, you may find the answers you have been seeking. And if
you have been trying to cope with overwhelming depression and are
plagued with thoughts of suicide, you will find a welcome warning
that can help you avert tragedy.
     Over the years, I've learned that alcoholics often conceal
the fact that family members have taken their own lives. But if I
tell them about my son's suicide, the truth comes rushing out:
"My father shot himself" or "Several times, my mother took a
deliberate overdose of pills" or "My son hung himself." The pain
of these tragic deaths is often compounded by a family code of
silence. Often, those touched by the tragedy are tormented by
guilt. They can't stop wondering whether they could have done
anything to prevent the suicide, whether they missed warning
signs that tragedy was approaching. Recent scientific findings
provide some of the answers to these agonizing questions and
offer comfort and insight.
     Most people experience some major disappointment or stress
in the course of life, but suicide is rarely the outcome. And,
there is no good evidence suggesting that most depression
predates alcoholism or that any personality traits underlie
alcoholism. Indeed, researchers have so far failed to find
genetically transmitted depression among most alcoholics.
Instead, studies suggest that the prolonged use of alcohol causes
biochemical changes in the brain associated with depression and
suicide. The most striking of these findings (from the National
Institute of Mental Health) shows that the neurotransmitter
serotonin is almost depleted in all the brains of suicides
examined during autopsies. Since alcoholism causes the
destruction of tryptophan and other precursor amino acids needed
for production of the antidepressant neurotransmitters, it's not
surprising that many alcoholics are prone to depression and even
suicide. As I have explained earlier in this chapter, alcohol can
also precipitate depression by destoying a number of other
natural chemicals, including

-The neurotransmitter norepinephrine, formed from the amino acids
phenylalanine and tyrosine
-Endorphins
-Essential fatty acids needed to form brain metabolites,
including prostaglandin E1 (PGE1)
-B vitamins, which supply the brain's energy and maintain mental
and emotional balance
-Trace elements and enzymes that govern the body's hormonal
balance

     A cerebral allergic reaction to alcohol or other substances
can cause suicidal depression. You'll find a full discussion of
this effect in Chapter 11. High levels of toxins from Candida
albicans overgrowth can also affect the brain and central nervous
system and induce suicidal depression. Alcoholism promotes both
proliferation of candida and escalation of cerebral allergies.
     Since alcohol can inflict so much biochemical damage on the
brain and nervous system, it should not be surprising that many
alcoholics attempt suicide. One recent study found that up to 40
percent of all alcoholics try to take their own lives at east
once; another study found that 265 percent of the deaths of
treated alcoholics were suicides.
     If you feel that you or someone close to you is a suicide
risk, please reread this chapter carefully and make the changes
recommended to restore normal balance and banish depression once
and for all.

Where Do You Fit In?

Now that you are familiar with the various problems that can
underlie depression, it's time to determine what to do about the
one(s) responsible for your own bleak state of mind. Here are the
options. Check all the categories that apply to you:

_______________Restoring the neurotransmitters serotonin and/or
norepinephrine (formulas in this chapter)
_______________Replacing essential fatty acids to create PGE1
(formula in this chapter)
_______________Restoring key vitamins and minerals (review the
list of vitamins and minerals earlier in this chapter)
_______________Treating hypothyroidism (consult your physician)
_______________Correcting hypoglycemia (review Chapter 7)
_______________Avoiding foods/chemicals responsible for cerebral
allergy/addition (see Chapter 11)
_______________Treating candida related complex (see Chapter 11)

     Don't be surprised if you fit several of these seven
categories. Heavy alcohol use wreaks havoc on your biochemical
balance. But with the HRC repair program you can restore your
health. In some cases you'll need a physician's help. I can't
overemphasize the importance of expert medical advice when you
are dealing with depression, especially if it is severe. It is
equally important to choose a doctor attuned to your special
needs.
     Orthomolecular MDs are experts in both allopathic and
nutritional science who treat disorders at the cellular level
with biological weapons--nutrients that nature has provided in
its own system of defense for millions of years. An
orthomolecular psychiatrist or physician can help you address the
following problems:

-Restoration of neurotransmitter levels via amino-acid therapy
-Hypoglycemia testing and treatment
-Vitamin, mineral, and essential fatty acid testing and
restoration
-Thyroid testing and treatment

     A clinical ecologist will be able to test you for food and
chemical allergies and candida-related complex. For a list of
such physicians in your area, contact the American Academy of
Environmental Medicine, P.O.Box 16106, Denver, CO 80216, (303)
622-9755.