Does the road wind up-hill all the way?

Yes, to the very end.

Will the day's journey take the whole long day?

From morn to night, my friend.

No wonder blues guitarist John Lee Hooker once commented, “It's never hard to sing the blues. Everyone in the world has the blues . . . “

Everyone in the world has the blues from time to time. The sun doesn’t always shine and the path isn’t always smooth. Fortunately, the blues are usually transient. Most people, even when they’re feeling sad, recognize that the sun will come out tomorrow, or, if not, the day after.

Everyone in the world has the blues; they are a normal part of life on earth. Depression, on the other hand, is not a universal experience. Depression is to the blues as an oil tanker is to a dinghy. Depression goes beyond sadness; it challenges the value and significance of life itself.

It is estimated that one in every ten people will experience at least one episode of depression in his or her lifetime. It is also believed that one in every twenty people is depressed at any given point in time. Depression is clearly a challenge that touches each of us; we will either be affected personally or see its effects on a friend or a relative.

Depression has been described in many ways: A dark wood, a deep chasm, and a dank dungeon are just a few of the expressions used to describe the experience. It is, without question, the gloomiest and loneliest of human conditions.

The symptoms of depression may be emotional or psychological such as an inexplicable and prolonged sadness, feelings of unworthiness, a desire to be left alone, irritability, anxiety, indifference, recurring thoughts of death, and contemplation of suicide.

Symptoms can be physical including unexplained aches or pains, loss of energy, difficulty concentrating, loss of appetite, loss of sex drive, and difficulty sleeping.

The symptoms of depression are many, but the common thread, the sine qua non of depression, is a loss of the zest for living. Things that once brought pleasure are avoided or viewed with indifference and nothing is looked forward to with joyous anticipation.

Because depression is commonly confused with sadness, individuals caught in its grasp often see themselves as “weak” and in need of “getting my act together”. Friends and family may suggest that they “cheer up” and point out all of the blessings they have in their lives. As much as depressed people try, they are unable to pull themselves up by their own bootstraps. They cannot think themselves or wish themselves out of the pit into which they have fallen. Telling oneself or being told by others to do so only amplifies feelings of unworthiness and leads to despair.

At its worst, depression causes an individual to feel that his or her life is not worth living and that things will never get better, no matter what is done or how much time passes.

This is what causes a person to commit suicide. Individuals do not take their own lives because they feel sad or are having a bad day. As long as things are going to get better there is reason to live. People do not kill themselves because they have the blues; they end their own lives because they have lost all hope of a better tomorrow.

Deficiencies in substances called neurotrophic agents are at the root of nearly all significant depressive episodes. The term neurotrophic comes from the Latin neuro meaning “nerve” and trophic meaning “nourishing”. A neurotrophic agent is a chemical that nourishes nerve cells and promotes their growth.

Two of the most significant neurotrophic agents are brain derived neurotrophic factor (BDNF) and b-cell lymphoma/leukemia 2 (bcl-2). When optimum levels of these chemicals are present, nerve cells thrive and transmit messages effectively. Levels of neurotrophic agents are closely linked to levels of other chemicals such as serotonin, norepinephrine, and dopamine, which are known as neurotransmitters.

Studies in recent years have demonstrated that the onset of depression is determined to a significant degree by a single gene that dictates how much of a substance known as Seratonin Transporter (ST) is manufactured. Seratonin Transporter recycles serotonin, one of the neurotransmitters. If the amount of ST is insufficient to efficiently recycle serotonin, nerve signal transmission will slow. Poor nerve signal transmission causes a drop in levels of neurotropic agents within the nucleus of nerve cells. As levels of neurotrophic chemicals fall, nerve cells wither and cease to function normally.

Depression occurs because nerve cells have ceased to function properly, not because someone is weak or emotionally unstable. Therefore, it is as ridiculous to expect those who are deficient in BDNF or bcl-2 to correct their condition by considering how much they have to live for as it is to encourage persons with insulin-dependent diabetes to reverse their disease by thinking happy thoughts.

The gene that controls Seratonin Transporter production comes in a short version and a long version. Each individual has two copies of each gene, one having come from his or her father and the other from his or her mother. Therefore it is possible to have two long ST genes, two short ST genes, or one of each.

Both versions of the ST gene contain the information needed to correctly manufacture Seratonin Transporter. The short version, however, is unable to instruct the body to increase production under stressful circumstances.

Studies are demonstrating that people who possess two long ST genes handle stress very well. They are able to maintain a cheery countenance while enduring an abusive situation in childhood or as they encounter a series of challenges in adult life. Individuals who possess two short ST genes, however, tend to experience depression as life becomes more stressful. Stress has an intermediate effect upon those who have one ST gene of each type.

Depression is commonly treated with medications that increase the amount of serotonin or norepinephrine at nerve junctions by preventing its reabsorption. Antidepressant drugs improve depression in most cases. In my experience, however, they produce results more slowly and less completely than a comprehensive approach to increasing levels of neurotrophic agents.

One of the basic measures needed to prevent and reverse depression is regular exposure to bright light. Ironically, individuals who are depressed often prefer dimly lit spaces and seclude themselves indoors. This diminishes their chances of recovery.

One form of depression, seasonal affective disorder (SAD), is triggered by the absence of bright light. SAD affects susceptible individuals during the winter months when the number of hours of daylight decline and the sky is often overcast. SAD is best treated by use of a “light box” that exposes photoreceptors in the eye to either intense light (10,000 lux) or short-wavelength blue light. Intense light and blue light have been shown to increase the body’s production of melatonin, the hormone that regulates circadian rhythm, the body’s internal clock. This, in turn, improves neurotransmitter production and distribution.

Exercise is also important. Taking a brisk thirty minute walk in the middle of the day is particularly beneficial since it combines the benefits of physical activity with light exposure. Any activity that gets the body moving for thirty to forty-five minutes each day is effective in improving neurotrophic activity, however.

Nutritional supplementation is critically important. A comprehensive vitamin/mineral/amino acid supplement that delivers optimum levels of these basic nutrients is a must. Specific supports for neurotrophic activity are necessary to reverse depression, however.

While St. John’s Wort is the best known and widely promoted supplement for prevention and management of depression, I have not recommended it for many years. While safer than pharmaceutical antidepressants, it has similar limitations in effectiveness.

I have found two supplements to be highly effective in reversing depression quickly and consistently. These are N-N-dimethylglycine (DMG) and 5-hydroxytryptophan (5-HTP).

DMG is a rich source of methyl groups, a chemical entity required by cells for energy production and to sustain chemical reactions. Methyl groups are required by nerve cells to increase the action of key chemicals in the manufacture of BDNF. DMG is therefore a key ingredient in the restoration and maintenance of optimum neurotrophic levels.

5-HTP is the last building block needed by the body to manufacture serotonin. Unlike antidepressants, which simply hold more serotonin at nerve junctions, 5-HTP dramatically enhances the body’s ability to manufacture serotonin and compensate for genetically low levels of Seratonin Transporter.

Genetic predispositions need not, in most instances, dictate the state of one’s health. This is certainly true in the case of depression. Combining effective stress management, prudent diet, light exposure, physical activity, and nutritional supplementation can prevent and reverse depression regardless of an individual’s genetic makeup. Everyone may get the blues from time to time, but no one need remain in the grasp of depression. The sun can come out and tomorrow can be a brighter day.