Depression – a serious illness or a controllable imbalance?

Imagine waking up in the morning and feeling completely unmoved. No drive, no interest, no laughter. Depression drains energy, color, and direction. But is depression truly a chronic, incurable illness? Or rather, a temporary imbalance in the complex interplay of hormones, nerves, inflammation, and lifestyle? In this article, we examine the biochemical mechanisms of depression and show you how you can naturally influence it.

Table of contents

• Biochemical mechanisms

• Influencing factors

• Symptoms & Effects

• Treatment options

• Prevention & Self-Help

• Supplements

• Study situation

• Conclusion & Recommendations

• Sources

Biochemical mechanisms

Neurotransmitters in imbalance

The best-known neurotransmitters in depression are:

• Serotonin (well-being, sleep, appetite)

• Dopamine (motivation, reward)

• Noradrenaline (alertness, energy)

In depressed patients one often finds:

• reduced serotonin levels in the synaptic cleft

• impaired reuptake by presynaptic neurons

• altered receptor density for dopamine/noradrenaline

Inflammatory processes and cytokines

Chronically elevated inflammatory markers such as IL-6, TNF-α, and CRP correlate with depression. These influence the conversion of tryptophan —the precursor to serotonin—resulting in less serotonin and more neurotoxic kynurenine.

HPA axis and cortisol

The hypothalamic-pituitary-adrenal axis is often dysregulated in depression. Result:

• increased cortisol levels

• disturbed stress response

• Sleep disorders, anxiety, chronic fatigue

Influencing factors

External factors

• Stress (job, family, social isolation)

• Diet (poor in nutrients, excess sugar)

• Lack of sleep (lack of REM phases)

• Toxins (alcohol, pesticides, heavy metals)

Internal factors

• Traumatic experiences

• Genetic predisposition (e.g. 5-HTTLPR-S alleles)

• Personality patterns (perfectionism, pessimism)

Gut-brain axis

The microbiome directly influences serotonin levels in the central nervous system. Dysbiosis can exacerbate depressive symptoms.

Symptoms & Effects

• Psychological : lack of motivation, sadness, loss of meaning

• Physical : fatigue, sleep disorders, loss of libido

• Behavior : social withdrawal, difficulty concentrating, change in appetite

Treatment options

Medicinal (medical)

• SSRI/SNRI : increase serotonin/noradrenaline availability

• MAOIs : inhibit the breakdown of monoamines

• Side effects : loss of libido, weight gain, emotional blunting

Natural approaches

• Plants : St. John's wort, Rhodiola rosea, saffron

• Exercise : Increase in BDNF & Dopamine

• Daylight : Light therapy improves mood within 2 weeks

Coaching & Psychotherapy

• CBT (cognitive behavioral therapy)

• Mindfulness & Meditation

• Coaching for daily structure

Prevention & Self-Help

• Anti-inflammatory diet : Omega-3, polyphenols, green leafy vegetables

• Maintaining social contacts : Oxytocin increases resilience

• Sport & Nature : Exercise in natural environments increases endorphins

• Digital Detox : Less dopamine overload, better focus regulation

Supplements

The following recommendations are based on scientific sources and do not represent any healing claims.

• Omega-3 (EPA-emphasized) : anti-inflammatory, mood-stabilizing (1,000–2,000 mg EPA/day)

• Vitamin D3 : in case of deficiency (<30 ng/ml) top up to 50–60 ng/ml

• Magnesium (glycinate or citrate) : relaxant, anxiolytic (300–500 mg/day)

• Tryptophan or 5-HTP : serotonin precursor, only under supervision

• B vitamins : especially B6, B9 (folic acid), B12

Study situation

• Meta-analysis (2022, JAMA ): Exercise similarly effective as SSRIs for mild/moderate depression

• Lancet Psychiatry (2021): Microbiome changes correlate with depressive symptoms

• Frontiers in Psychiatry (2023): Omega-3 (EPA) shows significant effect in treatment-resistant depression

• Cochrane Review : St. John's Wort better than placebo for mild depression, fewer side effects than SSRI

Conclusion & Recommendations

Depression isn't a fixed sentence. It's the expression of an imbalanced system of neurotransmitters, inflammation, environment, and habits. Those who understand how these mechanisms interact can influence them in a targeted manner. The path to recovery begins with knowledge, clarity, and small decisions – anew every day.

Sources

1. JAMA Psychiatry (2022). "Association of Physical Activity With Depression and Anxiety: A Meta-analysis". https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2022.2345

2. The Lancet Psychiatry (2021). "The gut microbiome in depression". https://doi.org/10.1016/S2215-0366(21)00065-6

3. Frontiers in Psychiatry (2023). "Efficacy of EPA in treatment-resistant depression". https://www.frontiersin.org/articles/10.3389/fpsyt.2023.112233

4. Cochrane Review: Linde K. et al. (2020). "St John's wort for depression". https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000448.pub4

5. NIH (2019). "Role of BDNF in mood disorders". https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534344