Although a deficiency of virtually any nutrient can cause depression, the most pronounced varieties are caused by deficiencies in vitamin C, biotin, vitamin B12, folic acid, niacin (B3), pantothenic acid (B5), pyridoxine (B6) and thiamine (B1) (L Mahan and M Krause. Food, Nutrition and Diet Therapy, Philadelphia, PA: W B Saunders & Co Inc, 1984). Deficiencies of zinc, magnesium, iron, manganese, chromium or potassium, an excess of vanadium, copper, aluminium, lead or mercury, and either too much or too little calcium can all cause depression or even more serious psychiatric problems (Stephen Davies and Alan Stewart.
The vitamin like co-enzyme tetrahydrobiopterin is essential for the proper manufacture of neurotransmitters like serotonin, which regulate mood. Many patients with unexplained depression have been shown to have a reduced formation of tetrahydrobiopterin (Lancet, 1984, i: 163). Supplementing with vitamin C, folic acid and B12 can stimulate the production of this enzyme (J Ment Def Res, 1982; 26: 21-5).
Perhaps the most famous alternative remedy for depression is St John's wort (Hypericum perforatum), which has been demonstrated to be safe and effective in numerous trials in prestigious medical journals. It has also been combined with Indian snakeroot (Rauwolfia serpentina), which reduces blood pressure, in a preparation marketed under the trade name 'Hyperforat' (Klein, FRG). (Arzneimittel-Forschung, 1971; 21: 1999).
However, even St John's wort is not without unwelcome side effects; one constituent of the herb causes patients to be photosensitive, and so users should exercise caution in going out in the sun.
Siberian ginseng (Eleutherococcus senticosus) has been proven to help a variety of psychological disturbances, including clinical depression (Econ Med Plant Res, 1985, 1: 156-215).
In Oriental medicine, shiatsu may help to improve a deficiency in lung energy, which may be present in depression when there is hyperventilation or panic attacks (Ray Ridolfi, Alternative Health: Shiatsu, London: Optima/Macdonald & Co, 1990: 78-9).
In naturopathic medicine, kava kava, a beverage made from the root of the pepper plant (Piper methysticum), is widely consumed in Pacific Islands. In one randomised, double blind study, a group of patients with depression showed a significant reduction in anxiety, compared with a group of matched controls taking a placebo, after only one week. This difference between the two groups increased over the four week course of the study, demonstrating the effectiveness of kava kava in patients with anxiety disorders (Arzneimittelforschung, 1991; 41: 584-8). Do beware, though, that liberal, long term consumption of kava kava can affect the skin, causing peculiar fish scaly eruptions, possibly due to its interference with cholesterol metabolism (J Am Acad Dermatol, 1994; 31: 89-97).
The Touch Research Institute at the University of Miami School of Medicine is conducting studies of the effect of massage on depressed patients. Preliminary results show reductions in anxiety levels and a measurable decrease in depression (D di Domenico in L Bassman, The Whole Mind, Novato, CA: New World Library, 1998: 377-88).
In my own practice, the best results without adverse reactions or contraindications have been achieved with a French homoeopathic combination remedy, called 'L.72 drops' (Lehning, France). In an extensive, controlled double blind trial, this combination remedy compared favourably against diazepam (Valium) for many symptoms of anxiety and insomnia (Depis et al, Centre for Therapeutic Research and Documentation, Paris: Dr B Heulluy, 1998).
L. 72 is available at the NutriCentre in London (436-5122); Hyperforat may be obtained through Ludwig's Apotheke in Germany (Fax: 49 89 260 4322).
Harald Gaier is a registered homoeopath, naturopath and osteopath