From the book ” The Conprehensive Guide to Glutathione ” by Dr. Jimmy Gutman

MDD (major depressive disorder) is a serious debilitating illness that affects

persons of every age, sex, cultural/racial background and economic status. Everyone

can relate to “being depressed” but MDD is a severe condition with prolonged symptoms

that interferes with life’s daily functions. Symptoms of depression vary.

The NIMH (National Institute of Mental Health, USA) estimates that upward of 20

million adults have at least one bout of major depression per year. That’s about 7% of the

population experiencing depression in any one Year. But when looking at how many

adults will be affected by depression within their lifetime, the figure is a staggering 20%.

Just as concerning is that one fifth of these may develop psychotic symptoms including

hallucinations, delusions, or paranoia.

Moe recently recognized that 10 to 15% of women will develop postpartum depression. A shocking 15% of seriously depressed patients will die from suicide. This does not include those with suicidal thoughts and unsuccessful attempts, both of which are far more common.

The biological basis of depression is still being worked out. We can comfortably say that it includes neurotransmitter abnormalities, hormones, genetics and epigenetics, external stressors, environmental factors, and neurodegenerative disorders.

Also apparent in the past three decades is that oxidative stress, free radicals, antioxidant all play their parts in this disorder. A handful of articles linked antioxidant dysfunction with depression in the 1980s, but only in the 1990s was this connection established. Initially it was shown that patients with MDD had higher levels of both lipid peroxidation and breakdown products of oxidative stress and free radical damage.

This was followed by measurement of actual ntioxidant function-which naturally includes an examination of glutathione status. It was no surprise to find that glutathione abnormalities were abundant.

Many more nuances of antioxidant dysfunction in depression were uncovered as other researchers elaborated on this foundational work. It seems that the more depressed the patient, the greater the free radical damage and the lesser the antioxidant protection. As expected, this held true glutathione—the master antioxidant.

Conversely, as patients’ conditions improved,nts and GLUTATHIONE all their oxidative stress markers improved too.

 BY the turn of the millennium two groups-Bilici et al and Khanzode et al- showed that the use of SSRI/4 antidepressant

drugs improved measurements of oxidation. Lukash et al were eventually able to correlate improvement in oxidative stress with positive response to SSRI antidepressants. As mentioned earlier, post-mortem brain samples from psychiatric patients were found to be glutathione deficient. Today, scientists can measure glutathione levels in the brains of living patients with a specially tuned “magnetic resonance spectroscopy” brain scanner. With it, a 2017 study by Freed et al examined glutathione levels in subjects aged 12 to 21 and suffering from major depression. This study validated older biopsy studies showing a significant decrease in GLUTATHIONE in the brain of depressed patients.

Clearly, low GLUTATHIONE levels are correlated with major depression. This begs the question: can raising glutathione levels improve symptoms of depression? Australian Michael Berk has been at the forefront of investigating the use of the glutathione precursor NAC (N-acetyl-cysteine) in psychiatric illness. A 2014 study of over 250 patients by his group showed improvement in many symptoms using this drug. Patients continued their usual medications but were also given either NAC or a placebo. According to multiple scales of depression, results showed an improvement in symptoms. This will certainly lead to more investigation of this approach as a complementary therapy for major depression.