Case Study 4 Hormones And Depression

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Before puberty, the rates of mood and anxiety disorders are similar in boys and girls. It’s only after females begin menstrual function that a gender differential in mood disorders manifests itself. This, coupled with the observation that women appear to be especially vulnerable to mood disturbances during times of hormonal flux, certainly confirms that a relationship exists between sex hormones and mood.

How Do Hormones Affect Mood?

Levels of hormones, such as those produced by the thyroid gland, can be factors in depression. In addition, some symptoms of depression are associated with thyroid conditions. The same is true about conditions related to the menstrual cycle, such as premenstrual syndrome (PMS), perimenopause, and menopause.

The process of menstruation involves fluctuations in the levels of estrogen and other hormones. Some women experience depression-related symptoms such as sadness, irritability, and fatigue prior to menstruation. These symptoms are part of the premenstrual syndrome, or PMS. A more severe case of emotional problems related to menstruation is known as premenstrual dysphoric disorder (PMDD).

When pregnant, women are subject to physical and emotional changes caused in part by changes in hormones. After pregnancy, women experience a huge shift in hormone levels. This shift is a likely cause of the “baby blues,” a mild type of depression that immediately follows childbirth and resolves quickly. A more severe form of depression — post-partum depression — could also result.

When women get older and move out of child-bearing years, they experience changes in hormone levels. These changes happen during perimenopause and menopause. Symptoms that occur during this time of life could include fatigue, sleep disturbances, weight gain, and skin changes.

Watch this video of Dr. Andrew Petersen from Holtorf Medical Group talking about the important link between hormones and depression:

The Role Of Hormones In Mood Behavior

Estrogen can help improve your mood via its effect on serotonin, a neurotransmitter that is active in the brain. Low levels of serotonin can lead to depression, anxiety and difficulty sleeping, as well as affecting how you experience pain. Estrogen, however, helps in the formation of this neurotransmitter, bringing it back to optimal levels.

Progesterone, on the other hand, has a very calming effect. Progesterone affects the GABA receptors in the brain, calming you and helping you to sleep. Natural progesterone, in general, can also help alleviate mood swings, irritability and depression.

Testosterone can have a significant impact on mood, as well. It helps with one’s sense of well-being and self-confidence, which are important aspects to a positive mood. In fact, depression and anxiety are well-known symptoms of low testosterone.

Consistently high levels of cortisol, the stress hormone, can deplete the adrenal glands. They don’t have a chance to recover, so your cortisol levels remain low even when stress is present. During this state, which is known as adrenal fatigue, you may experience many mood-related symptoms, including depression, anxiety, insomnia and difficulty handling stress.

Your thyroid hormones are also important to your mood. Depression is a well-known symptom of hypothyroidism.

Balancing your hormones requires comprehensive testing and careful observation.

An eye-opening discussion and review of mental health case histories with Alyssa Burns-Hill, PhD in the webinar Perspectives on Mental Health And Hormones takes practitioners through the hormone looking glass for a deeper understanding of depression and mental illness. 

From Burns-Hill's perspective, mental health is not just the preserve of mental health professionals, but a global health problem that all specialists – from family practitioners and psychiatrists, to neurologists and social workers – ought to be concerned about.

She points to the 2010 Global Burden Disease Study that identified the most predominant mental health problems as depression and anxiety, which are symptoms physicians see in practice every day. Yet many people remain untreated or locked into a standard medical approach that focuses on the illness rather than the individual.

As a practitioner of holistic medicine, Burns-Hill believes the conventional medical model has become so reliant on technology that diet, stress, lifestyle and relaxation are routinely ignored. When patients say they can't sleep, or are dealing with job stress, anxiety or depression, providers should be looking at the whole person, she says, including their physiology – and hormones in particular.

Following the strength of her convictions, she is a long-time proponent of salivary and blood spot testing to detect sex, adrenal and thyroid hormone imbalances. These three major hormone systems are absolutely vital to mental and emotional health and yet generally overlooked by mainstream medicine.

Burns-Hill advocates documenting lab levels in concert with patient symptoms to provide "both quantitative and qualitative test results" that help her tailor treatment to patient needs with impressive results.

The benefits of this approach are clearly in evidence in three compelling case histories drawn from her UK-based patient practice. Rejecting old-school approaches that isolate the disease from the patient actually living it, she presents her patient histories from within a framework of mind-body perspectives:

Body-Mind as defined by "alterations in endogenous hormone levels resulting in mental health issues."

Mind-Body as defined by "mental health issues caused by hormone- related illness."

Body-Mind as defined by "behavioral/mental health issues as a result of hormone therapy or treatment."

For example, in the first Body-Mind case history, we meet Rebecca, a 46 year-old IT manager with "really bad PMS," terrible mood swings, irritability, anxiety and severe sleep issues. She’s already got thyroid problems and a raft of symptoms like dry skin, water retention and allergies.

Burns-Hill lets us in on her intuitive thinking process around the patient herself, a consideration of needs and priorities, and which hormone tests to run on Rebecca. Test results are shown to reveal imbalances of all three major hormonal systems with estrogen dominant and progesterone low, adrenal stress hormones high, and thyroid levels down despite medication.  

Burns-Hill outlines her treatment approach in generous detail. In every case it is the holistic natural approach that looms large, specifically:

  • Stress reduction techniques like yoga and meditation
  • Improved diet bolstered by individualized vitamin, mineral and amino acid supplements
  • Lifestyle changes as fine-tuned as switching to toxin free laundry detergent and fluoride free toothpaste
  • Suggested use of bioidentical hormones as needed

Six weeks later Rebecca reports none of her usual symptoms: "mood perfect," just a tiny bit of water retention and no more dizziness. After changing her soap products, she has woken for the first time without dermatitis on her face. In addition, the 5HTP and meditation is helping her sleep, and she hasn't felt this good in ages!

The other two case studies presented here: a mid-life male who has been on antidepressants since he was seventeen, and a menopausal woman whose complete hysterectomy is shown to be a big contributor to her chronic depression, round out this essential tutorial on the hormonal links to mental health and wellness.

The not-to-be-missed recorded webinar conversation on Perspectives on Mental Health And Hormones challenges providers to consider mental health conditions from a fresh viewpoint – through the lens of hormone balance.

Watch the Webinar

When it comes to mental health, stress factors
cannot be emphasized enough…and a holistic approach can make a big impact.


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