Depression is one of the psychiatric disorders, that is now very common in individuals of any age group. WHO estimates that globally 350 million people are affected with depression and this population is spread over various age groups.
Technology advances every day to make life more comfortable and to increase connectivity; but alarmingly the risk of mental disorders such as depression is increasing in leaps and bounds. There is not one factor that could be blamed entirely for development of depression.
Multiple factors like lifestyle choices, dietary choices, financial conditions, relationship issues, chronic diseases or even inherited conditions could be responsible for depression.
Depression presents with various symptoms and an effort is made to classify each type of depression.
One such type is atypical depression. Depression is identified as a state of persistent sadness involving anxiety, panic disorder, self rejection, social anxiety etc. However atypical depression differs in this aspect.
Atypical depression is a condition in which ‘mood brightens in response to positive events.’ This is different from depressive episodes or major depressive disorder where the persistent feeling of sadness makes it difficult to cope with life.
The word ‘atypical’ means rare but atypical depression is the most common form of depression identified by clinics. It is four times more common in women than men. Atypical depression has been linked with bipolar disorder.
Other symptoms of atypical depression included increased appetite, increased sleep and a heavy feeling in limbs and these symptoms are persistent for 2 weeks or more.
Symptoms of atypical depression has early age of onset compared to atypical depression and also the worst outcomes. Symptoms of atypical depression are prevalent at least two years prior to depressive episode or prior to occurrence of major depressive disorder.
As far as pharmacotherapy is concerned, SSRI (selective serotonin reuptake inhibitors- a type of antidepressant) is found to be a safe option for treatment of atypical depression. However it depends on each individual as to which antidepressant suits them.
A study soon to be published in Journal of Affective Disorders,2017 revealed that curcumin/saffron combination was effective in treating depression.
This study was carried out by Dr. Adrian Lopresti and Dr. Peter Drummond, two scientists who have been actively researching the anti-depressant properties of curcumin.
What happened in the study?
123 individuals with major depressive disorder were enrolled in the study. Four groups were made:
- Group 1: received low dose curcumin extract (250mg twice a day)
- Group 2: received high dose curcumin extract (500mg twice a day)
- Group 3: received low dose curcumin (250mg twice a day) and saffron(15mg twice a day)
- Group 4: received placebo
The curcumin extract used was BCM-95. BCM-95 is a formulation of turmeric supplement which contains curcumin and ar-tumerone, active ingredient of turmeric oil. It is developed by Arjuna Natural Extracts and Dolcas Biotech LLC.
BCM-95 contains 86% curcuminoids and 7-9% essential oils and it has better bioavailabilty than other formulations of curcumin. BCM-95 was chosen for this study on the premise that it had turmeric essential oils for increasing absorption of curcumin rather than artificial agents found in other formulations.
The study lasted for 12 weeks. Outcomes were measured based on self reported questionnaires: Inventory of Depressive Symptomatology and Spielberger State-Trait Anxiety Inventory (STAI).
What were the results?
The combination treatment resulted in significant improvement in depressive symptoms compared to placebo and significant improvement in scores of questionnaires was observed.
There was no significant difference in response in high dose and low dose curcumin or even curcumin/saffron combination.
This demonstrated that curcumin was the key ingredient in reducing depressive symptoms and BCM-95 formulation delivered results even at low doses.
The response rate was more pronounced in those with atypical depression; 65% response rate was observed compared to 35% in patients without atypical depression.
Reduction in anxiety symptoms was observed in curcumin treated groups. The effect of treatment was observed as early as 4 weeks and sustained over 12 weeks.
A few limitations of the study is small sample size, small population of individuals suffering from atypical depression involved in the study as noted by scientists.
Other factors that need to be considered is comparison with conventional treatment instead of placebo.
How did this occur?
Various studies have identified curcumin’s anti-depressant activity which involves :
- Reduction of inflammation
- Improving antioxidant defences
- Regulating neurotransmitters like serotonin, dopamine etc.
- Ameliorating gastric symptoms
- Reducing anxiety and insomnia
Atypical depression is found to be linked with inflammation of the brain and curcumin is one of the most potent natural anti-inflammatory agents. This could possibly explain why the response rate was higher in individuals suffering from atypical depression.
Earlier studies by the same group of researchers find that curcumin can serve as add-on therapy for depression delivering results by 4-8 weeks of treatment in major depressive disorder.
A study by the same researchers published in European Neuropsychopharmacology, 2015 shows that curcumin acts on various hormones and enzymes in the body in order to mediate anti-depressant action.
This indicates curcumin acts via various multiple pathways and has wholesome approach towards fighting depression.
Study has found curcumin to act better than anti-depressant fluoxetine and considering its good safety profile it can be considered as a viable treatment for depression.
Apart from curcumin, turmeric has other molecules that have anti-depressant action. A study published in BMC Complementary and Alternative Medicine, 2015 shows that turmerone, active ingredient of turmeric oil, has anti-depressant action which it mediates by regulating neurotransmitters. (Read Scientists Identify New Anti-depressant Compound In Turmeric Oil)
This explains why even low doses of curcumin extract, BCM-95 delivered results in this study. BCM-95, as mentioned previously, contains curcuminoids and turmeric essential oils for increasing absorption.
Lopresti et. al have also investigated the anti-depressant effect of saffron. Few of the mechanism identified are anti-inflammatory, antioxidant, brain protective and saffron may also boost serotonin levels.
A recent study published in Pharmacopsychiatry, 2016 demonstrates that saffron may be as effective as antidepressant fluoxetine(studied in relation to post partum depression) but this study has a couple of limitations.
Research till date shows that saffron may be of help in mild to moderate depression.
All in all based on current research, curcumin and turmeric can serve as an effective palliative therapy in depression and related disorders.
What does this mean?
Researchers concluded that treatments comprising curcumin and curcumin/saffron treatment are effective in reducing depressive and anxiety symptoms in major depressive disorder. As per the results a significant improvement with curcumin treatment was observed in atypical depression.
Curcumin, stand alone or with saffron, is effective in treating depression in major depressive disorder and atypical depression.
Read the paper here: https://www.ncbi.nlm.nih.gov/pubmed/27723543