Besides the oxygen we breathe, all that we need to survive comes from what we eat. Food nourishes both the body and the brain. In fact, the brain has first call on the available supply of nutrients. Therefore, the first effects of nutritional deficiencies are often mental symptoms.

When orthomolecular psychiatrists refer to a nutritional deficiency, they are not necessarily talking about the prevention of a traditional deficiency disease, such as beriberi, a once-common illness that is fortunately now rare due to vitamin B1 food supplementation. However, lesser subclinical deficiencies are quite common. While not enough to bring on overt physical symptoms, they are often sufficient to stimulate changes in brain chemistry, and affect mood. Antidepressants, including St. John's wort, are not likely to be successful in treating these cases until the specific deficiency is corrected.

In this chapter, I will introduce you to someone who was helped by nutritional therapy, and present information on vital depression-fighting nutrients. I'll then discuss other possible causes of depression-including illnesses that St. John's wort can help alleviate.

Treating the Entire Person
When treating depression, it is important to address all of a patient's problems, both biochemical and psychological, if healing is to take place. Jeff is a good example.

Jeff, a 19-year-old college freshman with no prior history of emotional problems, was brought to see me by his concerned father. "I don't know what to think. Jeff has been withdrawing more and more lately, won't join us at the dinner table, hasn't been finishing his assignments, and says there's nothing wrong." Further questioning revealed that Jeff had been popular in high school, a good student, and a member of the basketball team. Yet he was now failing at the local college he was attending, and according to his father, was "not his old self."

As his father talked, the tall, somewhat thin, young man sat across from me, looking sullen. I asked his father to leave the room so I could see Jeff alone. There was little change in his demeanor. A series of questions went through my mind: Was he depressed? Was he psychotic, hearing voices that he would not admit to? Or, putting on my orthomolecular hat, was he eating a typical teenage diet of fast food and soft drinks, which could leave him deficient in nutrients needed for adequate brain function?

I determined from his rather brief answers that he was not in any immediate danger, but that he would need more time before he trusted me enough to talk more freely. Given his good prior history, I was willing to wait another week or so before doing anything more definitive, such as prescribing medication. My philosophy is "natural is preferable," since it addresses the root of the problem, and not the symptoms. Also, young people often feel stigmatized by a psychiatric diagnosis, especially when it is accompanied by a prescription.

Jeff agreed to take some daily vitamins, minerals, and herbs. When he came alone to see me two weeks later, he was far more communicative, and appeared to have gained some weight. He had indeed been going through a difficult time, with inner conflict about life issues that he had not had to deal with in high school. He was also feeling that he had let down his parents in some way by not being as competent, decisive, and independent as he expected himself to be. This confusion and depression is not unusual for first-year college students, who face a radical change from familiar high school surroundings. However, he admitted that he had been helped by my advice despite himself. While he had "resented my Dad's dragging me to some shrink," he had followed my instructions by taking the vitamins and herbs three times daily with meals. This instruction also assured that he would eat regularly, and likely, with the family. He said that the supplements seemed to calm his worried mind, and gave him energy and clarity at the same time. He turned out to be quite bright and articulate, in contrast to our initial contact.