Anxiety and Depression from the perspective of functional and integrative medicine

Anxiety and depression - from the functional medicine perspective

There's an accelerating mental health crisis with rising rates of anxiety, depression, and other conditions. Traditional psychiatric diagnoses are mainly descriptive rather than focusing on root causes. Current psychiatric medications (like SSRIs) often have limited effectiveness and carry side effects

Unlike traditional approaches that focus solely on the symptoms, the functional & integrative medicine approach emphasizes the importance of addressing the underlying factors that contribute to mental health conditions. Anxiety and depression are often the result of imbalances in various bodily systems, including the brain, gut, hormones, and immune system. Below are the primary causes of anxiety and depression:

1. Nutrient Deficiencies

Nutrient imbalances or deficiencies can significantly contribute to mood disorders like anxiety and depression. Several essential nutrients play key roles in brain function and emotional regulation. Deficiencies in the following nutrients have been linked to mental health issues:

• B Vitamins: B6, B12, and folate are critical for the production of neurotransmitters like serotonin and dopamine. Low levels of these vitamins are often associated with depression and anxiety.

• Magnesium:  The "relaxation mineral," involved in 600+ enzyme reactions. Magnesium deficiency is strongly linked to feelings of anxiety, stress, and irritability. Magnesium helps regulate the nervous system and modulate the stress response.

• Omega-3 Fatty Acids: These essential fats are necessary for healthy brain function. The lack of omega-3s can lead to mood instability and an increased risk of depression.

• Vitamin D: More than 80% of the population is deficient/insufficient. Low levels of vitamin D have been associated with depression, especially during the winter months when sunlight exposure is limited. I recommend testing vitamin D levels and supplementing if necessary.

• Zinc: Zinc is involved in neurotransmitter function and has been shown to support mood regulation. Zinc deficiency can worsen symptoms of depression and anxiety.

• Iron: Deficiency is common in women and linked to anxiety

The standard American diet, especially ultra-processed foods, may be contributing to mental health issues. Post-pandemic, there's been a 25% increase in anxiety cases, partly related to dietary changes. I recommend a nutrient-dense diet rich in whole foods, along with targeted supplementation when deficiencies are identified.

2. Role of Gut Health and Dysbiosis in Anxiety and Depression

There is a strong connection between gut health and mental health, often referred to as the gut-brain axis. A disrupted gut microbiome, known as dysbiosis, can contribute to both anxiety and depression. The gut produces a large amount of serotonin, a neurotransmitter crucial for mood regulation. When the gut microbiome is imbalanced, it can interfere with serotonin production and contribute to mood disorders.

• Leaky Gut Syndrome: A compromised gut lining can allow toxins and undigested food particles to enter the bloodstream, leading to inflammation and immune system activation, which can impact brain function and contribute to mental health issues.

• Inflammation: Chronic inflammation in the gut can spread to the brain, exacerbating conditions like depression and anxiety. I believe that addressing gut health through diet, probiotics, and healing foods can significantly improve mood.

• The Gut-Brain Connection:

  • The gut microbiome plays a crucial role in mental health

  • Certain gut bacteria produce important neurotransmitters like GABA (natural anti-anxiety compound)

  • Different foods can either support beneficial bacteria or promote harmful ones

  • The gut microbiome influences neurotransmitter production and inflammation levels

  • Short-chain fatty acids produced by gut microbes are beneficial for brain and mental health

  • The standard American diet produces toxic metabolites that damage gut lining

  • Unhealthy gut bacteria produce endotoxins (lipopolysaccharides) that trigger inflammation

• Dietary Factors Affecting Mental Health

  • Processed foods and industrial agriculture practices create inflammatory foods

  • Food additives like carboxymethylcellulose can disrupt gut health

  • Modern wheat varieties (dwarf wheat) contain more inflammatory gluten

  • Ultra-processed foods can trigger dopamine pathways similar to addictive drugs

    
    

3. Chronic Inflammation

Chronic inflammation is another key factor that contributes to both anxiety and depression. When the body is in a state of constant low-grade inflammation, it can affect brain function and mood regulation. Inflammatory cytokines, which are proteins released by the immune system during inflammation, can impair the function of neurotransmitters and increase the risk of developing mood disorders.

• Systemic Inflammation: Factors such as a poor diet, stress, and environmental toxins can contribute to systemic inflammation, which can spread to the brain and impair cognitive and emotional function.

• Neuroinflammation: Inflammation in the brain, or neuroinflammation, is particularly damaging to the areas of the brain involved in mood regulation, such as the hippocampus and prefrontal cortex.

I recommend addressing inflammation through anti-inflammatory diets, stress management, and lifestyle changes, such as getting enough sleep and exercising regularly.

4. Hormonal Imbalances

Hormonal fluctuations and imbalances are common triggers for both anxiety and depression. The brain and hormones are closely connected, and changes in hormone levels can significantly affect mood. Several hormonal imbalances are associated with mood disorders:

• Thyroid Imbalances: Hypothyroidism (low thyroid function) and hyperthyroidism (high thyroid function) can both contribute to depression and anxiety. Low thyroid function, in particular, can cause symptoms like fatigue, sadness, and brain fog.

• Adrenal Fatigue and Cortisol Imbalance: Chronic stress can lead to adrenal fatigue, where the adrenal glands become depleted of cortisol, the stress hormone. Elevated cortisol levels from prolonged stress can cause feelings of anxiety, while insufficient cortisol can lead to fatigue and depression.

• Sex Hormones: In both men and women, imbalances in sex hormones such as estrogen, progesterone, and testosterone can play a significant role in mood disorders. For example, low estrogen levels during menopause or perimenopause can trigger anxiety and depression in women. Testosterone imbalances in men can also contribute to feelings of depression.

I advocate for testing and treating these hormonal imbalances using a personalized approach to restore balance and improve mood.

5. Blood Sugar Imbalance and Insulin Resistance

Blood sugar imbalances are a major contributor to mood swings, anxiety, and depression. Fluctuating blood sugar levels, often due to poor diet, lead to unstable energy levels and can cause irritability, fatigue, and even feelings of depression.

• Insulin Resistance: Insulin resistance, a condition where the body becomes less responsive to insulin, often leads to high blood sugar levels. This can result in inflammation, oxidative stress, and disruptions in brain function that contribute to mood disorders.

• Blood Sugar Spikes and Crashes: Eating a diet high in sugar and refined carbohydrates can lead to rapid spikes in blood sugar, followed by crashes that cause irritability, anxiety, and low mood.

To address blood sugar imbalances, I recommend a diet low in refined carbohydrates and sugar, and rich in whole foods, healthy fats, and lean protein, which can help stabilize blood sugar levels and improve mood.

6. Toxin Exposure

Exposure to environmental toxins, such as heavy metals, pesticides, and chemicals in everyday products, can contribute to brain dysfunction and mental health issues. I must highlight the impact of toxins on brain health and mood regulation, particularly in people with genetic sensitivities or compromised detoxification systems.

• Heavy Metals: Accumulation of heavy metals like mercury, lead, and aluminum can affect neurotransmitter function and brain health, leading to anxiety, depression, and cognitive decline.

• Chemical Toxins: Chemicals found in household products, plastics, and personal care items can disrupt the endocrine system, which regulates hormones linked to mood.

• Mold: whether current or past exposure mold can wreck havoc on your body, hormones and nervous system.

I advocate for reducing exposure to toxins by using natural and non-toxic products, eating organic foods, and supporting detoxification pathways in the body with specific supplements like glutathione and activated charcoal.

7. Chronic Stress

Chronic stress is a major driver of both anxiety and depression. When the body is constantly in a state of stress, the overproduction of cortisol can disrupt the balance of other hormones, impair neurotransmitter function, and cause neuro-inflammation. This, in turn, increases the risk of mood disorders.

• Fight-or-Flight Response: Chronic stress keeps the body in a constant "fight-or-flight" mode, leading to physical and emotional exhaustion, anxiety, and depression.

• Cortisol Imbalance: High cortisol levels can lead to burnout, brain fog, and feelings of depression. Conversely, a lack of cortisol due to adrenal fatigue can lead to fatigue and low mood.

I recommend managing stress through techniques like meditation, yoga, deep breathing exercises, and regular physical activity. He also stresses the importance of sleep and social connections in managing stress.

8. Poor Sleep

Sleep is crucial for mental health: sleep disturbances are a significant contributor to both anxiety and depression. Poor-quality sleep or insufficient sleep can affect the regulation of neurotransmitters and stress hormones, leading to mood disorders.

• Sleep Deprivation: Chronic lack of sleep can impair brain function, increase stress levels, and cause irritability, anxiety, and depression.

• Sleep Disorders: Conditions like insomnia, sleep apnea, and restless leg syndrome can also interfere with mental health and contribute to mood disturbances.

To improve sleep, I recommend focusing on sleep hygiene practices, creating a relaxing bedtime routine, and addressing underlying issues such as sleep apnea or hormonal imbalances.

Conclusion and Recommendations:

Anxiety and depression are complex conditions with many contributing factors. By identifying and treating underlying issues such as nutrient deficiencies, hormonal imbalances, gut health problems, chronic inflammation, blood sugar imbalances, toxin exposure, and chronic stress, individuals can significantly improve their mental health. I advocate for personalized care, combining dietary changes, lifestyle modifications, supplementation, and stress management techniques to promote long-term well-being and mental clarity:

• Focus on whole foods and a "kaleidoscope of colors"

• Include foods rich in essential nutrients (dark chocolate, avocados, leafy greens, fatty fish)

• Consider elimination diets to identify food sensitivities

• Address both nutritional deficiencies and gut health for optimal mental health

There is a need to reimagine psychiatric care by incorporating functional nutritional psychiatry and understanding the complex relationships between diet, gut health, inflammation, and mental health. Psychiatry must shift from purely pharmaceutical treatments toward understanding the biological and nutritional foundations of mental health. If you, or a loved one struggles with anxiety or depression, please reach out to Xenia, your go to functional and integrative medicine provider in Austin to get started with holistic treatment to get you back to your healthy self!

Your Functional Med NP, Xenia

in Austin, Texas