Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest to Dr. Weyrich that may be of interest to the world wide audience. Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is published here. Dr. Weyrich welcomes financial contributions to support specific research topics, as well as copies of non-free access journal articles for him to review on a topic. Constructive criticism is also welcome.

Overview of Depression and Seasonal Affective Disorder

Complimentary and alternative treatments for depression that are considered below include:

  • Ketamine
  • Low Dose Naltrexone
  • Neuro-Gen High Performance Neuromodulation (HPN)
  • Conventional Neuro-feedback
  • Neurotransmitter Balancing

Etiology of Depression and Seasonal Affective Disorder

Elevated urinary levels of 3-hydroxyphenyl-3-hydroxypropionic acid (HPHPA) and other markers of dysbiotic overgrowth with Clostridia spp. are common in depression [GP].

Some practitioners have noted an association between hypothyroidism and depression (akinetic and agitated); treatment of these disorders appears to also benefit depression [DeGroot1996], [ Zondek1944a], [Starr2005, pg 124].

Some practitioners have noted an association with inflammatory process mediated by homocysteine [Rogers2008, pg 9]. Note that the common diuretic hydrochlorothiazide (HCTZ) increases homocysteine levels [Westphal2003].

Diagnosis of Depression and Seasonal Affective Disorder

  • Basal body temperature below 97.8 degrees F, elevated TSH, or depressed T3 (suggests hypothyroidism).
  •  >   
    Organic Acid Test (elevated markers for gut dysbiosis).

Differential Diagnosis of Depression and Seasonal Affective Disorder

  •  >   
    Lyme Disease
  •  >   
    Disthymia
  •  >   
    Bipolar Disorder
  •  >   
    Cyclothymia
  • Seasonal Affective Disorder (SAD)
  • Depression may be misdiagnosed when the underlying disorder is actually bipolar or cyclothymia, if only depressive states have been observed.
  •  >   
    Hypothyroidism
  •  >   
    Adrenal Insufficiency or Fatigue
  • Vitamin B12 deficiency [Pacholok2011].
  • Copper toxicity can cause depression; This may especially be a problem in "red-rock" areas of Arizona, where the soil/water may be high in copper.

Treatment of Depression and Seasonal Affective Disorder

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed below.

Naturopathic, Complimentary and Alternative Treatments

Low Dose Naltrexone (LDN)

According to the Low Dose Naltrexone home page [LDN], LDN has been seen to benefit major depression. Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN). However, Dr. Weyrich has not treated any cases of depression with LDN.

Please see What is Low Dose Naltrexone? for more information.

Neuro-Gen High Performance Neuromodulation (HPN)

HPN has been reported to be useful for treating depression [Snook]. Dr. Weyrich has been trained in the use of Neuro-Gen High Performance Neuromodulation system by it's inventor, Corey Snook. However, Dr. Weyrich has not treated any cases of depression with this technique.

Please see What is Neuro-Gen High Performance Neuromodulation? for more information.

Conventional Neuro-feedback

Neuro-feedback has proven useful for treating depression. Dr. Weyrich has been certified in Neuro-feedback since 2008, and more recently completed an additional residency training program at ADD Clinic of Scottsdale, AZ. While at the ADD clinic, he treated numerous cases of ADD and ADHD.

Please see What is Neurofeedback? for more information.

Hormone Balancing

Depression may also be due to hormonal imbalances, especially post-partum depression. Dr. Weyrich is trained in balancing of both male and female hormonal imbalances using bio-identical hormone replacement therapy and herbal supplements.

Neurotransmitter Balancing

Neuro Research [Hinz2015] reports that depression can be benefited by balancing neurotransmitter levels in the body.

Dr. Weyrich has been trained in neurotransmitter balancing protocols, but has not treated depression using this technique.

Please see What is Neurotransmitter Balancing? for more information.

Very Low Dose Ketamine

There are some reports of the use of the prescription drug ketamine in treating depression [Ketamine_Advocacy]. This is an off-label use. Ketamine is classified by the DEA as a Schedule III Controlled Substance. Its on-label use is for inducing dissociative amnesia in the hospital surgical setting, in which case it is carefully metered in as an IV injection. [Palliative_Ketamine] presents guidelines for the use of ketamine to treat neuropathic pain, and recommends that ketamine should only be prescribed by "a doctor experienced in Pain Management or Palliative Care." In particular, concurrent use of extended release opiates is a relative contraindication, and all opioid doses must be reduced and the patient carefully monitored, especially during initiation of treatment and titrating up.

[Lara2013] has reported that very low dose (10 mg) sublingual ketamine once per 2-7 days had a 77% response rate in cases of major depression.

Dr. Weyrich does not prescribe Ketamine.

Hypotheses regarding Depression and Seasonal Affective Disorder

Seasonal Affective Disorder (SAD) has often been attributed to inadequate exposure to full-spectrum light (e.g. sunlight) in the winter. However, hypothyroidism is also associated with SAD, and it has been proposed that cold weather places additional demand on the thyroid [Starr2005, pg 103].

ICD-10 Codes related to Depression and Seasonal Affective Disorder

  • F32.0 Depression, major, single episode, mild
    F32.0 Depression, major, single episode, mild
  • F32.1 Depression, major, single episode, moderate
    F32.1 Depression, major, single episode, moderate
  • F32.2 Depression, major, single episode, severe without psychotic features
    F32.2 Depression, major, single episode, severe without psychotic features
  • F32.3 Depression, major, single episode, severe with psychotic features
    F32.3 Depression, major, single episode, severe with psychotic features
  • F32.4 Depression, major, single episode, in partial remission
    F32.4 Depression, major, single episode, in partial remission
  • F32.5 Depression, major, single episode, in full remission
    F32.5 Depression, major, single episode, in full remission
  • F32.8 Depression, episodes, other
    F32.8 Depression, episodes, other
  • F32.9 Depression, major, single episode, unspecified
    F32.9 Depression, major, single episode, unspecified
  • F33.0 Depression, major, recurrent, mild
    F33.0 Depression, major, recurrent, mild
  • F33.1 Depression, major, recurrent, moderate
    F33.1 Depression, major, recurrent, moderate
  • F33.2 Depression, major, recurrent, severe
    F33.2 Depression, major, recurrent, severe
  • F33.3 Depression, major, recurrent, severe with psychotic symptoms
    F33.3 Depression, major, recurrent, severe with psychotic symptoms
  • F33.40 Depression, major, recurrent, in remission, unspecified
    F33.40 Depression, major, recurrent, in remission, unspecified
  • F33.41 Depression, major, recurrent, in partial remission
    F33.41 Depression, major, recurrent, in partial remission
  • F33.42 Depression, major, recurrent, in full remission
    F33.42 Depression, major, recurrent, in full remission
  • F33.8 Depression, recurrent, other
    F33.8 Depression, recurrent, other
  • F33.9 Depression, major, recurrent, unspecified
    F33.9 Depression, major, recurrent, unspecified
  • F53 Puerperal psychosis (post-partum depression)
    F53 Puerperal psychosis (post-partum depression)

References for Depression and Seasonal Affective Disorder