By 2030, depression with be the number one cause of disability.
Unless your physician has elected to do extra training, it’s likely they received 20-40 hours of classroom training with a 4-6 week clinical rotation in psychiatry.
If your doc happens to be a naturopathic doctor, you’re in luck, they received a year of counseling training.
Either way it’s not sufficient for those experiencing depression.
Because of my prescriptive authority in Washington State, I’m able to prescribe anti-depressants as well as manage clients on these medications.
My goal is to not keep anyone on medications and to get to the source of the depression.
Since the pandemic I have seen a rise in depression and the need for the support of medical or herbal therapy.
But here’s the thing…not everyone responds to antidepressants or herbal therapy for depression…
…and more often than not hormones can be at play.
So what do you do?
Look outside the traditional tool box.
It’s common in conventional medicine to give women anti-depressants “off label” for hormone symptoms.
And sometimes they can help, but the key here is looking at the entire picture and addressing the whole person.
But how do you know if your symptoms are a need for medication versus an estradiol or serotonin boost?
Estradiol can regulate serotonin production by increasing tryptophan hydroxylase, the enzyme needed to produce serotonin.
You can supplement with bio-identical estradiol from creams to patches.
Serotonin can influence the hypothalamus, which plays a role in regulating reproductive hormones.
You can boost serotonin with 5-hydroxy-tryptophan – “5-HTP” – 50-300 mg a day.
Both are tied into mood and both levels influence how someone feels before a period, in peri-menopause and menopause.
Now that hormone replacement therapy is gaining popularity many women are finding a little estradiol can keep the blues away.
While others are finding a mix of hormones and antidepressants useful, others are blending hormones and herbal mental health support such St. John’s Wort, Siberian Ginseng and other adaptogenic herbs.
But what if you aren’t feeling depressed all the time, it’s on and off?
Many women in peri-menopause who are still cycling note depression tendencies around ovulation, especially afterwards and a few days into the cycle.
Some women feel it more mid-flow to before ovulation.
Then there are others who notably feel a shift in their mood and personality the week prior to their period.
It’s not uncommon for women in menopause to still feel like they are cycling with moods.
Either way you look at it – moods are not a one size fits all solution.
The key to tackling mid-life depression?
- track your symptoms and see if you can identify a pattern (moon is a great cycle tracker)
- depressive symptoms often correlate with dips in the hormone estradiol
- identifying food sensitivities like wheat, dairy, corn, soy and addressing them
- assessing and improving the health of your nervous system
- addressing your relationship with your self and self talk
- letting go of anything that doesn’t bring you joy
Medication, hormones or herbs alone rarely resolve depressive tendencies.
It’s crucial to evaluate your mental, physical and environmental health as one.
If something isn’t working in one area, it can throw off your entire eco-system.
For the last few years many of my clients have been raving about the benefits of ketamine and plant medicine to help them overcome their challenges.
I recently sat down with Dr. Will Van Derveer from the Integrative Psychiatry Institute to discuss psychedelic medicine’s benefits for depression. (listen in to our podcast HERE).
His knowledge as well as participation in MDMA studies shed a lot of light on these two meds.
Turns out like anything the medicine is the catalyst and you are the tool.
The medicine won’t fix you, but it will open your mind to reach your solution.
Ketamine has been found to turn around severe depression in 6 sessions over 3 weeks with extensive integration therapy.
Note – it’s key to have therapy with the ketamine as ketamine alone will not resolve depression.
Unfortunately, many clinics are set up to only provide ketamine, no therapy to discuss what’s discovered in the session.
This is a disservice to the medication and the clients.
If you’re looking for a ketamine clinic to test out, I highly recommend seeking out one that provides pre, during and post ketamine integration therapy to help you get the most out of this powerful therapy.
My recommendation is the same for any psychedelic experience you aim to try out – know what you’re getting into and invest in someone that can prepare you, guide you and work on what you learn from your journey.
I’m very interested in the benefits psychedelics have on mental health conditions and their potential to resolve trauma while helping to rewire thought patterns.
Plus I’m curious if they may be a catalyst to help women move through peri-menopause and menopause smoothly.
The bottom line – you don’t have to suffer with depression – there are solutions.
And if you’re curious about how I’m blending hormones and herbal medicine for peri-menopause, menopause and beyond – click the button below to check out my January article in the Naturopathic Doctor News & Review (you’ll find it starting on page 57).
Here’s to better moods in 2025,
Dr. Jannine Krause
