DEPRESSION: A DISEASE OF ENERGY PRODUCTION
By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr
The incidence of depression in Australia has often be underrated.
According to a report by the Australian Bureau of Statistics of 21
April 2004, over 18% - that is one in nearly five adults - of all
Australian adults had experienced a mental disorder during the
The prevalence of mental disorder was similar for men and women, but
there were differences in the types of disorder suffered: 12% of
women and 7% of men had anxiety disorders, while 7% of women and 4%
of men had affective disorders (which include depression). Some 11%
of men and 4% of women had substance use disorders (such as drug or
Standard treatment for depression is usually by either
antidepressant medications such as Selective Serotonin Reuptake
Inhibitors (SSRIs) and/or psychotherapy.
A study in January 2006 by TR
showed that only about 40% of patients have some benefits from AD
medication as per quote here:
¡°For each of these interventions, one can say with some confidence
that at least 40% of a cohort with depression will show
statistically significant reductions in unbiased ratings of
depression. This information, while entirely commendable in the
world of research, is far from satisfactory in the world of practice
where an individual clinician needs to make treatment decisions to
help an individual patient.¡±
Of course, it should be realized that drugs - even though they
benefit some patients - do not address the the biological causes of
depression which may leave them taking drugs on a long term basis..
This would leave about 60% of depressed with
depression. Conventional treatment would suggest that depression is
on the assumption that the
¡®mind is at all time in control of the body¡¯.
If indeed depression is mainly due to an underlying biological
disorder, meaning it is
then one could not expect that talk therapy will cure what is after
all a biochemical disorder. With the inevitable side effects of
drugs it does not provide an optimistic future. Thus according to
the drug and/or psychotherapy model, depression is incurable. The
problem appears to be that so far medicine has not come up with a
treatment program that would not involve the use of drugs.
Depression is often considered complex problem, but mainstream
medicine and psychology often overlook and ignore the nutritional
aspects of depression. One wonders why, because it is well known
that the precursors to the neurotransmitters in the brain, their
enzymes and coenzymes (vitamins and minerals) all derive from the
food we eat.
The alternative is to look and investigate an alternative model that
relies less on the drug/psychotherapy model. The
model aims to look at the causes of depression from both a
nutritional and biochemical point of view.
We could start off with the idea that all biochemical machinery in
our body - including brain cells - is driven along by energy. The
molecule of energy is called
that could be compared to a biological battery. An active cell in
the body may use up as much as 2 million molecules of ATP per
second, and hence biological energy is very important to us. When it
gives up its energy it becomes adenosine diphosphate (ADP). The only
way to recharge that battery is through nutrition.
The source of all energy is ultimately glucose found in food
sources, that is then converted along a biochemical pathway - called
- by 10 biochemical reactions to form first pyruvate and then ATP.
At each step proteins, enzymes, coenzymes, all derived form food,
are necessary to complete the biochemical conversion to the next
step. Thus there may be many biochemical reasons why the body has
problems manufacturing its energy sources, to produce for instance
serotonin - our happy hormone. And without energy we become
For example, if we have an imbalance between zinc and copper, zinc
deficiency can cause a blockage in the glycolytic pathway, although
blood sugar levels may appear to be normal.
The following illustration shows a simplified version of how one
molecule of glucose is converted to two molecules of pyruvate, then
converted to two molecules of Acetyl-CoA, which then enters the
Krebs cycle (Citric Acid Cycle) to produce 38 molecules of ATP.
Thus one molecule of glucose can produce a net total of 36 molecules
of ATP via glycolysis and the Krebs Cycle. This all takes place in
of cells. It takes place in the twinkling of an eye.
Please note that alcohol (ethanol) can be anaerobically fermented
from pyruvate from plant sources. People addicted to alcohol may
have an obstruction in glycolysis and resort to alcohol as a source
of energy. See:
Alcoholism is a Treatable Disease.
Biological energy is required to produce the feel good
and others. This is clearly demonstrated when we study how
(S-Adenosylmethionine) can act as a an antidepressant nutrient. It
provides an insight as to how nutritional therapy can be useful.
SAM-e is found in every cell of the body.
The body makes SAM-e from the combination of a molecule of
methionine and ATP.
Methionine + ATP = SAM-e
This is illustrated in the following diagram:
It shows that SAM-e contains a methyl group (CH3).
When it donates this methyl group to another molecule, it will
change its shape, size and function and this is how SAM-e helps to
form and reform molecules and is instrumental in the formation of
serotonin and many other neurotransmitters. The process is called
After methylation, SAM-e becomes S-Adenosylhomocysteine, which is
then converted to
which is a toxic waste products. It is said to be responsible for
cardiovascular and other degenerative diseases. However homocysteine
can be converted to cysteine under the influence of vitamin B6
(Pyridoxine). Cysteine is an important chemical forming part of
which helps to detoxify the body.
Homocysteine can also be converted back into methionine with the
help of folic acid and vitamin B12 or
Because SAM-e formation depends on biological energy, people with
insulin resistance (hypoglycemia) are likely to be inadequate in in
SAM-e concentrations, and this could be responsible for depression
and other forms of mental illness.
Of course it should be realized that SAM-e
cannot produce the feel good brain chemicals. If the body is
from which serotonin is made, it cannot methylate the feel good
neurotransmitter. Nor can SAM-e do so, if the body lacks vitamin B6,
B3 ( niacin), magnesium, zinc, chromium and a host of other
nutrients that are necessary in the production of serotonin.
We need total nutritional support, that can be supplied with the
Hit or Miss Supplements for Depression.
The universal source of biological energy is derived form the sugars
we eat in our food. These sugars are converted to glucose, which
enters the glycolytic pathway to form pyruvate. Pyruvate enters the
Krebs Cycle to create energy in the form of ATP. Many other
nutrients, such as amino acids and fatty acids can be converted to
pyruvate thus contributing to the generation of biological energy.
If we have an abnormality in the absorption and metabolism of
glucose - such as
and hypoglycemia - then we cannot produce SAM-e and other chemicals
involved in methylation.
The following illustration shows how insulin resistance causes
unstable blood sugar levels and thereby interfering with energy
Please note that when receptors for insulin fail to respond to
insulin, blood sugar levels initially tend to rise above the normal,
This triggers the release of more insulin,
which is usually followed by a sudden crash in glucose
The brain senses these hypoglycemic dips as a threat to its glucose
supply on which it entirely depends as its only source of energy.
Although only two per cent of the body by weight, the brain requires
about 60-70 per cent of all available glucose in the body to
energize the brain biochemistry, whether asleep or awake!
When the brain is threatened with energy starvation it will send a
hormonal message to the
to pour adrenaline into the system. Adrenaline is a hormone that
- strings of glucose molecules stored in the body - back into
glucose, so as to feed the brain again. Again this happens as quick
as a flash.
These adrenergic reactions are considered the cause of most symptoms
of ¡®mental¡¯ illnesses, from anxiety attacks, depression, insomnia,
addiction (alcohol, drugs), compulsive behaviours and thoughts.
The hypoglycemic syndrome can develop into full-blown
if no steps are taken to prevent it. We owe it to
Dr George Samra,
of Kogarah, Australia, that doctors have a diagnostic test for
hypoglycemia and prediabetes. Doctors are thus able to assess the
risk of a person developing diabetes, well
it is too late for proper treatment. See:
Test for Hypoglycemia.
The good news is that depression and many other forms of ¡®mental¡¯
illness can be treated without recourse to drugs by the adoption of
This model also makes it clear that the idea that depression is
caused by some malfunctioning in the brain itself is a
misconception. The molecules of emotions - adrenaline, ATP,
serotonin, dopamine, acetylcholine and so on are produced throughout
the body, starting from the digestive system, and controlled by the
liver, adrenal glands, pancreas, pituitary and hypothalamus.
Thus anywhere along the glycolytic pathway, digestive illnesses can
interfere with the production of biological energy and cause
And if this sounds all very complicated we can reduce it to a simple
formula which says:
HYPOGLYCEMIC DIET + PSYCHOTHERAPY = RECOVERY FROM MENTAL ILLNESS.
A good book with a similar theme is
Pert, Candace B (1988),
MOLECULES OF EMOTIONS:
Why you feel the way you feel, London: Simon & Schuster
The body runs the brain!!