According to the World Health Organization, depression is the leading cause of disability worldwide. Approximately 300 million suffer from depression, with more women affected than men. A Mayo Clinic study found that 70% of Americans are prescribed medications and -depressants are the second highest prescription given. Only 1/3 of these people are helped by anti-depressants. It is no wonder we are looking for alternatives like turmeric for depression.
Anxiety and depression are complex disorders because there are numerous factors including social, environmental, psychological and physical manifestations.
- Our interpersonal relationships and career can lead to chronic stress and the suppression of our feel-good neurotransmitters.
- Imbalanced estrogen and progesterone levels in women and low testosterone in men can lead to depression.
- The environment can be a source of toxicity depending on the air, water, and your home, leading to inflammation-induced depression. The climate can affect your mood, with some people feeling worse in heat and others in colder climates with less sun.
- Your digestive health plays a major role in your psychological health due to the gut/brain axis, affecting both nutrient absorption and toxicity levels. Probiotics in your gut are vitamin factories and balance all your neurotransmitters. There also be a connection to your gut bacteria and turmeric for depression.
- A lack of exercise and the extreme end of exercise affect numerous genes that can lead to depression.
The Estrogen and Serotonin Connection to Depression
Prescribed antidepressants target the monoamine (MAO) systems, which are in the estrogen pathway, targeting the neurotransmitters dopamine, serotonin or norepinephrine. While the complexity makes it difficult to pin down the full scope of higher rates of depression, I do want to highlight the serotonin and estrogen pathway because the MAO pathway may help explain how turmeric helps for depression.
In the estrogen pathway, MAO, COMT, and CYP1B1 all govern the speed at which serotonin, estrogen, dopamine, and epinephrine are increased and decreased. Low and high levels of any of these neurotransmitters will lead to depression or anxiety. Turmeric has been found to be a natural MAO inhibitor, increasing the amount of circulating serotonin, dopamine, and norepinephrine. This is an important point to note if you are already taking a MAO inhibitor because you want to be careful not to cause serotonin syndrome (high levels of serotonin that causes extreme panic and anxiety).
For females, the menstrual cycle gives a rise and fall in estrogen, progesterone, and serotonin. As estrogen rises, so does serotonin. As it goes down, so does serotonin. Estrogen influences pain transmission, headache, dizziness, nausea, and depression through serotonin signaling. When these swings happen in extremes, the feelings of anxiety and depression can be amplified. While serotonin is mainly thought of as a mood-elevating neurotransmitter of the brain, only 1% of serotonin is found in the central nervous system. The remaining 99% is found in the gut and immune tissues regulating gut motility, vasodilation, clotting, immune cells and uterine contractions.
The cravings for sugar and carbohydrates right before your period is your digestive brain’s attempt to bring serotonin levels back up. Add poor gut flora to the equation, and estrogen can become deconjugated, reabsorbed and reactivated in the blood leading to estrogen dominance and wide swings in serotonin. IBS is a condition of serotonin (and glutamate) rushes and shortages and the consequential estrogen dysregulation. Fibromyalgia is another condition believed to be linked to estrogen and serotonin levels due to altered tryptophan metabolism (precursor to serotonin), and is observed in more females than males.
Female Cycle Chart
What about post-menopausal women you may be asking? The loss of estrogen at menopause results in a lower activity of serotonin, likely connected to hot flashes and night sweats. Increasing foods high in phytoestrogens like flax seeds during this time period helps bring relief due to phytoestrogens binding to estrogen receptors and upregulating serotonin receptors. Maintaining a diet high in phytoestrogens may assist throughout the post-menopausal period for estrogen and serotonin levels.
The Inflammation Connection and Why Turmeric May Work for Depression
Inflammation is another reason why we may look towards turmeric for depression. Have you noticed that your cold and flu symptoms also bring depression? We may think that this is an obvious symptom of feeling sick, but what if your immune system is actually dictating how you feel? If you have a chronic illness or low-level inflammation, those inflammatory compounds are going to depress your digestive system (80% of your immune system is in your gut) and the neurotransmitters in your brain (gut/brain axis).
Research has shown that “patients with increased inflammatory cytokines due to a variety of medical illnesses have increased rates of depression compared to the general population.” Therefore, we can consider inflammatory depression as another subtype.
Research has also shown that mania, and to a less extent, depression, occurs in a pro-inflammatory state and that the immune system should be a target for treatment. In this study, the pro-inflammatory cytokines, IL-2, IL-4 and IL-6, were increased in mania subjects in comparison with healthy subjects. Patients in depressive episode showed only increased IL-6 levels. Mood symptoms showed a positive correlation with IL-6 and IL-2. Other studies have also found elevated levels of TNF-alpha and C-Reactive Protein.
Chronic exposure to elevated inflammatory cytokines alters the neurotransmitters, which can lead to neuropsychiatric disorders and depression. This includes the serotonin, dopamine, epinephrine, glutamate, and decreases in the brain-derived neurotrophic factor (BDNF). What is causing chronic inflammation? It can be your diet, digestive inflammation, physical or emotional trauma, obesity, chronic stress, poor sleep and genetic polymorphisms.
Mice studies on the gut microbiota have found that manipulation of probiotics altered behavior and BDNF levels independent of changes in inflammatory cytokines. It is almost as if your gut flora circumvents external inflammation, overrides the negative neural signals and improves mood despite elevated cytokines. This may help explain why obesity influences depression due to altered gut flora and high adipose tissue that leads to elevated cytokines.
Past Trauma and Depression
When the system has been under extreme duress, there appears to be a hyper response to stressors. Individuals with early life stress have responded to stressors with higher levels of the cytokine IL-6, NF-kB and a decreased ability to inhibit inflammatory cytokines compared to non-depressed controls. This may be rooted in evolutionary survival in that a heightened cytokine response confers greater protection against bacteria and viruses, however, when chronically stimulated, it leads to depression.
Interesting enough, research has found that patients who did not respond to antidepressant treatment had higher concentrations of circulating cytokines than patients who respond to antidepressant treatment, extenuating the role of turmeric for depression by lowering inflammation.
How Does Turmeric Work for Depression?
There are many products that claim to be a supplement for depression based on their influence on certain neurotransmitters. It has been my experience that people with chronically low serotonin levels respond best to turmeric. This is the same 33.3 percent group that respond positively to SSRI’s.
Research indicates that turmeric may provide benefit by acting on gut microbiota. Currently there is limited evidence to support this hypothesis, but since 90% of serotonin is made in the gut, there is likely an interaction here along with the MAO serotonin pathway.
How do you know if low serotonin levels are the primary cause of your depression and not issues with dopamine, epinephrine, glutamate and GABA? It isn’t always just one neurotransmitter, and some people take SSRI’s and a medication like Lamictal to target both serotonin and glutamate.
The hint that turmeric will work depression is poor gut health (chronic use of antibiotics, candida overgrowth, periods of constipation and diarrhea), sugar and flour-based carbohydrate cravings, low motivation to exercise, and simply a lack of motivation to do much at all.
Turmeric has a full spectrum of mechanisms at work for depression, unlike drugs that trick the body and lead to nutrient depletion and tolerance.
- Moderates hypothalamus–pituitary–adrenal disturbances
- Lowers inflammation
- Protects against oxidative stress and mitochondrial damage
- Protects against neuroprogression and intestinal hyperpermeability
Is Turmeric One of the Alternatives to Prozac?
A study from 2014 took 60 patients diagnosed with major depressive disorder and were randomized in a 1:1:1 ratio for six weeks given fluoxetine (20 mg) and curcumin (1000 mg) individually or their combination. The proportion of the responders were highest in the combination group (77.8%) while the Prozac group showed 64.7%and the curcumin group 62.5%. The researchers, however, concluded that the data was not statistically significant, there was a higher risk of the placebo effect due to the subjects not being blinded, and they were also allowed to take benzodiazepines.
This study should serve to influence further research using a double-blind placebo model. Based on the research to this point, there is evidence that turmeric may be one of the alternatives to Prozac without the side effects.
Should You Use Turmeric or A Curcumin Extract for Depression?
Turmeric is a member of the ginger family (Zingiberaceae) and is prescribed abundantly for ailments in both traditional Chinese and Indian medicine. Curcumin is the isolated, active compound (up to 5%) of the spice turmeric. This is the compound you see in the majority of research studies.
Major phytoconstituents of turmeric are diarylheptanoids, which occur in a mixture.
- Curcuminoids that generally make up approximately 1−6% of turmeric. Curcumin [1, (1E,6E)-1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione, typically 60−70% of a crude extract
- Demethoxycurcumin (3, 20−27%),
- Bisdemethoxycurcumin (4, 10−15%)
- Numerous and less abundant secondary metabolites
A fascinating mechanism known as neurohormesis is when low doses of a substance activates adaptive cellular stress-response pathways in cells and neurons. Phytochemicals such as such as resveratrol, sulforaphanes and curcumin might protect neurons against injury and disease through a neurohormetic response to a low dosage that stimulates the production of antioxidant enzymes, neurotrophic factors, and more. I suspect alcohol in the right dosage also has this effect. Scientists reported in the Chemical Research in Toxicology that phytochemicals in high supplement doses could actually be detrimental to health, especially when combined with certain medications or genetic polymorphisms.
The implications of this understanding his huge. This means that instead of isolating resveratrol, sulphoraphane and curcumin and taking large isolated doses, it is likely that small amounts like those found in wine (resveratrol), broccoli (sulphoraphane) and the spice turmeric (curcumin) are more advantageous. Overloading the body with isolated extracts may suppress neurohormesis. Therefore, a low dose of curcumin working in proportion of the whole root makes more sense than high amounts of isolated curcumin.
What do the Studies Say About Turmeric for Depression?
A 2017 meta-analysis of 6 clinical trials with a total of 377 patients comparing the active ingredient curcumin to a placebo found significant clinical efficacy of curcumin in ameliorating depressive symptoms and anxiety in 3 of the trials. There were also zero reports of adverse events in any of the trials.
How Much Turmeric Per Day for Depression?
How much turmeric for depression is the key question. Researchers have found that high doses of curcumin do not necessarily equal more benefits. In fact, low doses of curcumin are believed to be preferable. An oral dose of up to 12 g/day has been given with no adverse effects, but the absorption of the compound has been found to be negligible. A dosage between 500-1000mg of a full spectrum product is likely how much turmeric to use for depression. Since turmeric has a notoriously poor absorption profile, a fat carrier, and black pepper is necessary to increase absorption.
How Long Does It Take for Turmeric to Work?
If you are not noticing any effect from turmeric, make sure you are using a quality full spectrum formulation with a fat carrier and black pepper. There are a lot cheap, poorly made isolated curcumin products on the market. You should notice a difference within 1-2 weeks if turmeric is the right fit for you.
The Health Beat’s Recommend Turmeric Products
Gaia’s formula uses a whole plant profile of turmeric with non-GMO lecithin oil carrier and black pepper.
Synergy uses a triple spectrum extract of the whole plant with an essential oil carrier. This one does not contain black pepper, but is still a superior formula.