By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr

If you ever wonder why so many people are suffering from ¡®treatment resistant¡¯ depression it is because mainstream medicine and psychology can offer only ¡®palliative¡¯ remedies. They treat symptoms only and not causes.

Drug therapy can only suppress the symptoms of depression, but does nothing to address the underlying biochemical abnormality that is responsible for depression. Once a patient is on the drug band wagon, they usually go on the merry-go-round from one drug to another for maybe the rest of their lifes.

Similarly, mainstream psychologists believe that talk therapy can alleviate the symptoms of depression. They assume that our irrational thoughts, unpleasant childhood experiences or ¡®¡¯bad parents¡¯ - hidden in a mythical ¡®subconscious mind¡¯ - have caused us to be depressed. They have us believe that by changing our attitudes and beliefs (for instance by RCBT) we can overcome the underlying biochemical disorder. They truly believe that psychology is a question of ¡®mind-over-matter¡¯. We only have to bring these ¡®unconscious¡¯ thoughts into consciousness and voila we become better. Thus they seem to confuse symptoms with causes. This is palliative treatment¡¯ without addressing the underlying biochemical disorder.

True, when we experience a stressful situation in life - such as divorce, bereavement, rejection by a loved-one or any other trauma - stress hormones interfere with the synthesis of our feel-good neurotransmitters and we become depressed. This is called ¡®¡¯environmental¡¯ depression, where a person is fully aware of the external source of stress. Sometimes such person can be helped by changing their coping skills or lack of self-esteem that could be at the root of their problems.

And, when the source of stress is removed people soon start to produce the happy hormones again and life resumes.

Unfortunately, many depressed people do not fall into that category, because after the removal of the external trauma, they continue to feel depressed and often cannot understand why, which brings them into the hands of a therapist.

The majority of people seeking advice and information at this web site are people with ¡®endogenous¡¯ depression; that is to say that their depression is due primarily to a chemical imbalance in the brain. Mainstream medicine and psychology fail to help these people, because they have no proper explanation as to the causes ¡®endogenous¡¯ depression. Consequently, they are not in a position to help depressed people.

Thus we need a different interpretation of endogenous depression as an alternative to the prevailing narrow drugs and/or psychotherapy model: AND which is based on scientific knowledge.

I will propose the psycho-nutritional model which says that depression - and for that matter any other non-psychotic mental illness - is a disease of energy production.

For the brain to change one molecule into another - as in the conversion of tryptophan into serotonin - it needs a disproportionate amount of biological energy called ATP. That energy is derived from the sugars in our food in the form of glucose. It is transformed into biological energy as a result of a complex biochemical pathway, called glycolysis.

The brain although 2 per cent of the body requires about 60-70 percent of all available energy, whether we are asleep or awake. A normal healthy cell requires about 2 million molecules of energy (ATP) per second to fuel biochemical reactions inside the cell. This is all derived from glucose in our food.

Thus if the brain is deprived of that energy, it cannot synthesize the feel-good neurotransmitters such as serotonin, norepinephrine, dopamine or acetylcholine, to make us feel happy and relaxed when we normally should.

Without serotonin the body cannot produce melatonin - the sleeping neuro-chemical that makes us sleep - and so we see that depression is usually associated with insomnia. Because serotonin is also associated with the appetite mechanism, depression is often accompanied with weight problems. Not only energy, but a host of other nutrients are required to bring about these biochemical reactions in the brain. They could well be deficient.

If the universal source of energy is derived from glucose in our food, one may wonder why it is, that in a high sugar consuming society in the Western world, people would suffer from energy starvation? Could this be responsible for the exponential increase in depression and mental illness?

Excessive sugar consumption, when converted to glucose, can expose the body to free radical attack upon the immune system and DNA. Glucose is easily oxidized into peroxides and other toxins. The body has a defence mechanism against excess sugar consumption: it shuts down receptors for insulin that controls the amount of glucose (and other nutrients) getting across cell membranes into cells. This is called Insulin Resistance, which may result in hypoglycemic symptoms.

With insulin resistance blood sugar levels tend to rise, triggering more release of insulin - called hyperinsulinism - and this may provoke a sudden descent in blood sugar level called hypoglycemia. Thus the brain tends to be exposed to wildly fluctuating blood sugar levels, responsible for many ¡®psychological¡¯ symptoms.

When the brain is starved of energy it could lead to the death of brain cells in a matter of minutes. In reaction to this threat, the brain triggers the release of stress hormones - such as adrenaline and cortisol - that function to convert sugar stores in the body (glycogen and amino acids) back into glucose so as to feed the brain again.

But these stress hormones, generated within the body are also responsible for the varied symptoms of mental illness, from depression, anxiety attacks, phobias, insomnia, compulsive behaviours and thoughts, alcoholism, drug addiction, hypochondria, PTSD, OCD and so on and on.

Thus hypoglycemia is characterized by unstable blood sugar levels feeding the brain, causing excess stress hormones to flood the system.

The non-drug treatment for hypoglycemia is the adoption of the Hypoglycemic Diet - a virtual panacea for depression - which is a natural diet, but specifically designed to regulate blood sugar levels, stress hormones and insulin levels.

Thus depression is in fact a NUTRITIONAL DISORDER.

This concept is difficult to accepts for those who have believed for so many years that mental illnesses is one of ¡®mind over matter¡¯. This perception is still held by the majority of practitioners in the field. But scientific truth is not very democratic and is not determined by majority rule.

This disorder can be medically tested with a special Glucose Tolerance Test for Hypoglycemia (GTTH) designed by Dr George Samra of Kogarah (Australia) and as described at our web site at:

¡°Testing for Hypoglycemia and How your Doctor can help¡±.

We also have a paper-and-pencil test called the NBI that can indicate a metabolic disorder if you score high on that test.

The scientific basis of this new nutritional approach is supported by numerous scientific studies, that have shown a significant association between Depression and Insulin Resistance.

See: ¡°Research Evidence for Hypoglycemia¡± at this web site.

Thus patients do have a choice, if mainstream medicine and psychology have failed to help them.