It may be surprising to know that the leading disorders in the U.S. are not diabetes, cancer or cardiovascular disease, but rather mental disorders, such as stress and depression. According to the National Institute of Mental Health (NIMH), nearly 19 million American adults suffer from a depressive disorder.
Stress and depression are as prevalent on a global basis as they are in the U.S. In fact, the World Health Organization (WHO), Geneva, Switzerland, says depression is the leading cause of disability as measured by YLDs (Years Lived with Disability) and the 4th leading contributor to the global burden of disease as determined by DALYs (Disability Adjusted Life Years). By 2020, depression is projected to reach 2nd place of the ranking of DALYs calculated for all ages and both sexes. Today, depression is already the 2nd cause of DALYs in the age category 15-44 years for both sexes combined.
The Physical Impact of Poor Mental Health
Depression is a mental disorder, which includes symptoms like of loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of everyday responsibilities. In the worst cases, depression can even lead to suicide. On top of that, stress and depression can also impair the body's ability to function properly.
"Stress affects the immune system making it difficult to fight off viruses and harmful bacteria," said Julie Thibeau, director of sales and marketing, NutriScience Innovations, LLC, Fairfield, CT. "In addition, it over-stimulates the nervous system, can contribute to high blood pressure, cause hormonal imbalances, affect sleeping patterns and cause weight gain and/or weight loss."
Stress also affects sleeping patterns. "According to the National Sleep Foundation, nearly seven out of 10 Americans experience sleep problems. Scientists have found those that suffer from insomnia and other related sleep disorders also experience high levels of stress hormones in the blood. Insufficient sleep can lead to abnormal hormone secretion, lack of concentration and focus, and cardiovascular problems," said Ms. Thibeau.
"Of course," pointed out Scott Smith, vice president, Taiyo International, Minneapolis, MN, "eating a healthier diet consisting of fruits and vegetables, incorporating exercise into our daily lives and getting plenty of sleep helps the body deal with stress. Unfortunately, most of us fall short of such basic requirements."
Pharmaceuticals have been the traditional first choice for consumers looking to alleviate stress and depression. But consumers are becoming wary of pharmaceuticals due to possible side effects-the most serious being an increased risk of suicide. One drug in particular, Paxil, has recently been in the news due to findings that it may be associated with birth defects. Consumers are now left wondering if these effects apply to other antidepressants, such as Zoloft and Prozac, as well.
These concerns, among others, have pushed consumers to look for natural alternatives to drugs typically prescribed for stress and depression. "With controversy surrounding chemical-based antidepressants and mood alleviators, consumers are looking for a more natural approach," said Steve Siegel, vice president, Ecuadorian Rainforest, Belleville, NJ. "Skepticism, while an issue for herbals in the past, is diminishing because consumers are weighing in many factors such as the long-term effects of drugs, expected prolonged use, and side effects of both traditional herbal remedies versus allopathic treatments."
All in Your Head?
There are two types of depression: reactive depression describes a response to life events; and endogenous depression is biologically caused depression due presumably to either genetic causes or a chemical imbalance in the brain. Both types of depression have origins in the brain.
Scientists continue to examine the causes of various mental disorders caused by biological factors. Findings indicate that depression correlates to neurotransmitters being out of balance-specifically, serotonin, which is a natural mood stabilizer, and norepinephrine, which is a natural energizer and mental focuser. These neurotransmitters carry nerve signals and messages throughout the brain and the rest of the nervous system. They have a profound effect on mood and self-esteem, as well as many other important functions within the body.
Since a deficiency in these neurotransmitters can lead to such conditions as depression, anxiety, insomnia, anger, obesity and other serious ailments, many companies are developing products that increase serotonin in the brain. Antidepressant drugs have been known to influence the functioning of certain neurotransmitters, primarily serotonin and norepinephrine. But many consumers do not want to deal with the drug's common side effects, such as constipation, bladder problems, sexual problems and drowsiness. One solution that may help consumers maintain proper brain function is omega 3 fatty acids, particularly docosahexaenoic acid (DHA).
DHA is the key component in the membrane of brain cells, enhancing the way our brain is able to utilize various chemicals and can turn on the genes that make serotonin to help reduce mood swings and depression. "The brain is comprised of 50-60% fat," said Jeanette Fisher, RD, national education manager, Soft Gel Technologies, Inc., Los Angeles, CA. "The type of fat one eats alters the fat molecules in the brain, affecting thoughts and feelings."
Ms. Fisher added, "Brain cells need a certain degree of flexibility to function properly. This is accomplished by maintaining a balance of different types of fatty acids in cell membranes. The goal is to keep the brain cell structures malleable, so that communication is enhanced. The brain needs omega 3 fatty acids to form healthy nerve cells. They are also a component of the myelin sheaths, which cover the nerves and help send messages properly."
DHA levels in Americans are among the lowest in the world. Countries with the highest DHA consumption have the lowest rates of depression. Marine-based foods have the highest levels of DHA, but unfortunately consumers have been scared away due to reports of fish containing high levels of mercury, a toxic heavy metal.
Researchers are also currently studying the effects of how omega 3 fatty acids can benefit women-according to NIMH, women suffer from depression twice as often as men. Many hormonal factors may contribute to the increased rate of depression in women, particularly menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause and menopause.
However, although there are more documented cases of women suffering from depression, there are plenty of men that suffer as well-they are just less likely to admit it because they do not share their emotions as readily as women. Interestingly, the rate of suicide in men is four times that of women, though more women attempt it.
One recent clinical trial investigated the positive effects of omega 3 fatty acids on postpartum depression. Postpartum depression is a serious issue that affects 10-15% of new mothers.
This double-blind, dose-ranging trial utilized EPAX omega 3 oil (a combination of EPA and DHA), provided by Epax AS, previously a division of Pronova Biocare AS, Oslo, Norway. Sixteen subjects in the trial were selected to receive either 0.5 grams, 1.4 grams or 2.8 grams per day. Among all three doses, patients with postpartum depression improved substantially during the trial. Scores on depression measures decreased by approximately 50%.
Researchers have also found that DHA levels in lactating mothers are significantly low. During breastfeeding, the mother transfers DHA to the baby, decreasing the amount of DHA left for the mother to utilize. A high dose of DHA can combat the effects of depression for women during lactating, as well as during pregnancy.
A SAD Diet
In a country known for its fast food chains and super-sized meals, the quality of food in the U.S. is poor. Consumers are constantly bombarded with TV commercials promoting processed foods that are loaded with fat and sugar. With food playing a major role in mental function and mood, it's no wonder that the Standard American Diet (SAD) has made the U.S. one of the most depressed countries in the world.
"Brain chemistry can be changed significantly by a single meal," said Soft Gel's Ms. Fisher. "While all foods eaten modify brain function, some are specifically directed at altering mood, energy or state of consciousness (like chocolate, for example). Even though certain foods act to relieve or prevent depression, there are some foods, such as sugar, saturated fats, cholesterol, and refined foods, that interfere with proper brain function." Without neurotransmitters working properly, the normal compounds that make an individual happy can't get the message to the brain.
There are certain types of food that can increase serotonin levels in the brain. "Serotonin can be increased by eating foods that are rich in carbohydrates," said Ms. Fisher. "Carbohydrates increase blood levels of the amino acid tryptophan, which acts as a precursor to serotonin." However, not all sources of carbohydrates are created equal.
Ms. Fisher continued, "Complex carbohydrates, found in whole grains, fresh vegetables and fruits, tend to provide a long lasting flow of glucose, which stimulates the release of tryptophan to the blood and brain. This promotes a constant high level of serotonin. Refined carbohydrates, on the other hand, enter the bloodstream immediately. As a result, blood sugar rises instantly, causing an initial burst of tryptophan and serotonin. The body burns these simple sugars rapidly, causing hypoglycemia, or low blood sugar. When glucose levels are low, the brain does not function properly." And once the sugar levels drop, serotonin levels also fall.
Mood-Enhancing Ingredients: A Focus on Adaptogenic Solutions
(The following information was compiled from ibiblio.org/pfaf and interviews conducted with NutriScience Innovations, Next Pharmaceuticals, Soft Gel Technologies, National Bioscience, Renaissance Herbs and Ecuadorian Rainforest.)
The new buzzword in the mood health market is "adaptogens." Knowledge about this group of herbs dates back thousands of years in China, but comprehensive scientific study did not really begin until the 1950s when Soviet scientists started looking at them more closely
One of the benefits the scientists discovered about adaptogens was their ability to fight stress. These natural anti-stressors maintain health by increasing the body's ability to adapt to environmental and internal stress.
Adaptogens generally work by strengthening the immune system, nervous system and/or glandular systems. They are able to regulate the chemicals that your body produces during times of stress, thereby reducing the severity of symptoms you experience. When stress stops, the adaptogens help adrenals shut down more quickly.
In order to be classified as an adaptogen, an herb should help the body adapt to all kinds of stress. Further, it shouldn't cause side effects in treating a wide variety of illnesses. It should also help return an organism to balance no matter what may have gone wrong.
There are several popular ingredients that the mood health market is now working with to help alleviate stress and depression. They include the following, many of which are considered adaptogenic.
Ashwagandha (Withania somnifera): This evergreen shrub is used in India and China to provide energy. It acts mainly on the reproductive and nervous systems, distributing a rejuvenative effect on the body. The whole plant, especially the leaves and root bark, acts as a strong tonic. The root extract and a number of its constituents were recently found to stimulate the growth of brain neurons.
Aralia manchuric (A. mandshurica): This is a shrub that grows throughout Russia, China and Korea. An extract from its roots was thought to be a general strengthening tonic that promotes increased physical capacity and mental acuity. It is currently used to improve physical and mental performance.
Schizandra (Schisandra chinensis): This plant has been used for centuries throughout the Far East, China, Japan and Russia, and according to ancient lore, was a general tonic in times of fatigue and exhaustion. Today, schizandra is known to help with depression due to adrenergic exhaustion. It is capable of increasing the body's resistance to stress by optimizing energy in times of stress, increasing stamina, improving the health of the adrenals, energizing RNA-DNA molecules to rebuild cells and producing energy.
L-theanine (L-glutamic acid-y-monoethylamide): A nonessential amino acid that comes from tea leaves (Camellia sinensis), L-theanine is noted for its ability to reduce stress and anxiety without tranquilizing effects. As it is digested in the small intestine, L-theanine stimulates the brain's production of alpha waves, which makes a person feel relaxed but alert. L-theanine also helps with relaxation by stimulating the body to produce other calming amino acids, such as dopamine and tryptophan. "A recent study conducted at Harvard University showed that L-Theanine helped to prime the immune system to attack invading viruses, fungi and bacteria," said NutriScience's Ms. Thibeau. "L-theanine is broken down in the liver to ethylamine, a molecule that primes the response of gamma-delta T cells."
Magnolia bark: This herb is recognized in traditional Chinese medicine for its therapeutic properties of aiding in relaxation, increasing energy levels and relieving anxiety. Natural chemicals present in the bark, magnolol and honokiol, are thought to be responsible for the anxiety-reducing effects. These two compounds have been shown to help regulate levels of the body's primary stress hormone, cortisol. Excessive levels of cortisol are associated not only with causing stress and anxiety, but also a number of other conditions, including stress-related obesity, diabetes, osteoporosis, memory problems and suppression of the immune system.
Apocynum venetum L.: This wild plant grown in Asia is traditionally used in Japan and other Asian countries as an anti-hypertensive and antidepressant. Soft Gel's Posinol ingredient is made with an extract from the leaves of Apocynum venetum L. According to the company, Posinol promotes healthy mood and positive mental outlook. The two primary active compounds are hyperoside and isoquercitrin, which are both flavonoid-based. Hyperoside is efficacious in mental relaxation by working with the brain's neurotransmitters.
And of course there is the adaptogenic Alpine plant, Siberian Rhodiola rosea L. The root extract has been shown to possess anti-fatigue, anti-stress and antidepressant properties. It also increases the bioelectrical activity of the brain, which improves memory and brain energy.
Newer herbs in the stress and depression market include the Rooibos extract. "Rooibos is an African cape botanical not found anywhere else in the world," said Ecuadorian's Mr. Siegel. "It contains many calmative properties which in fact can aid not only adults, but also children in achieving a balanced nervous system. Some claim that Rooibos may assist in such afflictions as ADHD (attention deficit hyperactivity disorder), hypertension, mood swings, and may even be used in conjunction with bi-polar therapies. This truly will be a breakthrough as studies and clinical trials are conducted."
"Although widely touted in network marking channels, the use of Mangosteen for depression has not yet been well researched," said Alex Moffett, president of Renaissance Herbs, Inc., Chatsworth, CA. "It may well be eventually proven but the research needs to be done."
Mr. Moffet added, "A lesser known ingredient that seems promising is Bacopa (Bacopa monnieri) for use as an anti-anxiolytic." Bacopa has been used in the Ayurvedic system of medicine for centuries. It was traditionally used as a brain tonic to enhance memory development, learning and concentration. Animal research has demonstrated Bacopa reduces both anxiety and depression due to an enhancement of the effects of the neurotransmitters acetylcholine and possibly serotonin or GABA (gamma aminobutyric acid). Bacopa extracts also appear to have significant antioxidant activity in the brain, in addition to other effects that may help protect brain cells. Further research, however, is needed to substantiate these effects.
According to Zakir Ramazanov, president, National Bioscience Corp., Chester, NY, the effectiveness of all these ingredients depends on the method of extraction. "The way and how we make an extract, whether the material is freeze dried or spray dried, whether the material is water extract or alcohol extract, are all important factors to consider," he said. "In the end, side effects could occur as a result of how the product was manufactured."
Mr. Ramazanov pointed out that an alcohol extract is less effective than a water extract. "Unlike water, using alcohol to obtain a dried extract will lower the needed amount of raw material-the active compound responsible for anti-stress/anti-depression is diluted," he stated.
In most cases, Mr. Ramazanov recommended companies use a water extract and a freeze drying process to ensure that the molecules remain intact and are not degraded. "The reason why St. John's Wort was not effective in the U.S. in mild depression is because St. John's Wort was extracted using alcohol, not a traditional water extract. It is very important to make an extract using water and freeze dry. In this case, you will retain the quality of the material," he said.
An Uplifting Future
As the demands of society continue to grow, so too will the number of cases of overstressed and depressed individuals. Experts agree that the mood health market has a tremendous potential for growth in the future, as consumers prefer products that can safely and naturally improve mood health.
"Most consumers that I know and deal with want to have a natural product at least equally effective or as close to pharmaceutical effectiveness as possible, and without side effects," said National Bioscience's Mr. Ramazanov. One way to achieve this, he said, is to have the industry purify the natural active compounds from herbs-equaling the effectiveness of synthetic drugs minus the side effects.
Mr. Moffett also said the future looks bright as research establishes the value of a variety of standardized herbal extracts for regulating serotonin, giving consumers an alternative to antidepressants.
U.S. consumers in the past have leaned toward supplements rather than functional foods and beverages to achieve mood-enhancing results. But as Mr. Siegel explained, consumer preferences are quickly changing. "We have been noticing while supplements are widely popular, manufacturers are responding to consumers needs by supplementing their every day foods," he said. "Why just have a beverage that just satisfies thirst? That same beverage can now in fact be formulated to alleviate one's mood, enhance concentration, and provide a balance of vitamins and minerals."NW