A trip to the health food store can be
daunting these days. The consumer is typically confronted by shelf after shelf
of vitamins, minerals, herbs, and other so-called natural substances, all
touted as enhancing well-being in some way. Many of these over-the-counter
products make subtle claims about their effects on mood, thinking, or energy --
without providing scientific data to back up those claims.
Because many of these preparations are classified as
"food substances," the U.S. Food and Drug Administration (FDA) cannot
regulate them as real drugs. In effect, it's up to the FDA to prove that a food
substance is unsafe, rather than the job of the manufacturer to show it is
safe. What is the evidence that vitamins, minerals, or similar substances have
an effect on mood disorders? And can these substances actually improve moods or
even treat depression?
Seeking help for depression -- and following through with antidepressant medication -- is a courageous and important first step on the road to recovery. But too often, those who take that step find themselves faced with another troubling problem: weight gain.
Experts say that for up to 25% of people, most antidepressant medications -- including the popular SSRI (selective serotonin reuptake inhibitor) drugs like Lexapro, Paxil, Prozac, and Zoloft -- can cause a weight gain of 10 pounds or more.
Vitamin deficiencies are rare in the United States and other
developed countries. In fact, vitamin excess may now be more common than
vitamin deficiency. When deficiencies do occur, they're usually due to food
fads that lead to medical conditions from poor absorption of nutrients in the
intestine, or inborn errors in the way nutrients are handled. Alcoholism is
also a major cause of vitamin deficiencies, owing to poor nutrition, impaired
absorption of nutrients, and other factors. The elderly and those with mental
illness or mental retardation are also at risk, usually due to poor nutrition
Occasionally there are individuals whose depression,
anxiety, or memory problems are caused by a deficiency in some vitamin,
mineral, or trace element -- most commonly, one of the B complex vitamins.
Deficiencies of thiamine (vitamin B1), niacin, pyridoxine (B6), or cobalamin
(B12) sometimes produce mental or emotional problems, including depression.
Folic acid deficiency may cause problems with mood and mental function. While
only a small minority of severely depressed persons suffer from such vitamin
deficiencies, this problem must be ruled out when the clinical picture raises
suspicions -- for example, when a depressed individual has a history of bowel
surgery that may have led to malabsorption of B vitamins. If depression is due
to a vitamin deficiency, treatment must include replacement or supplementation
of the vitamin before the patient can fully recover.