Underlying Causes of Depression

As physicians, we see depressed patients in our practices every day. Add the numbers who have been diagnosed with anxiety and bipolar disorder, and we begin to feel a little anxious ourselves! In Integrative Medicine, (as it should be in all medicine), we look for potential underlying causes of depression instead of choosing which SSRI (selective serotonin reuptake inhibitor) to use. One interesting cause is MTHFR deficiency.

As physicians, we see depressed patients in our practices every day. Add the numbers who have been diagnosed with anxiety and bipolar disorder, and we begin to feel a little anxious ourselves! In Integrative Medicine, (as it should be in all medicine), we look for potential underlying causes of depression instead of choosing which SSRI (selective serotonin reuptake inhibitor) to use. One interesting cause is MTHFR deficiency.

MTHFR stands for methylene tetra hydro folate reductase. Say that five times fast! Basically, MTHFR is the enzyme needed to process folate (also called folic acid, a B vitamin found in many vegetables, grains and supplements) and allow it into the brain. Folate in the brain is the necessary building block for many neurotransmitters (including serotonin), which helps regulate our MOODS!


As many as 20% of the population has inherited a defective copy of the gene that makes this MTHFR, a condition that makes it harder for folate to get into the brain. These patients have an increased risk of depression, anxiety, bipolar disorder and schizophrenia; it also predisposes them to be resistant to medical treatment. Usually, they have a strong family history of psychiatric disorders as well.

Fortunately, the treatment is easy once the defect is found, which can be done by simple blood testing. Patients can be prescribed folate which is already processed! After 2-4 weeks, patients usually feel much better, and can often be weaned from their antidepressant, or the dose can be decreased.

Will you ever feel comfortable in your own skin? That is, if you don't make an effort to protect it? Although 64% of adults do report wearing sunscreen when outside for prolonged periods of time, it turns out that only about 10% of people surveyed actually protect themselves daily, according to a recent review.

No matter what your skin tone is, unless you live in a cave with no sunlight, daily protection with either sunscreen, sunblock or protective clothing can not only protect you from developing sunburns (ouch!) but can significantly reduce your risk of developing skin cancer, particularly the deadliest type called melanoma. In addition, for those of you wanting to keep your youthful looks, daily sunscreen has been shown to reduce the development of wrinkles. A great teacher once told me that the best way to not have wrinkles is not to get them in the first place (think of how much money you can save on useless creams that claim to diminish wrinkles).

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