DEPRESSION: A ROOT-CAUSE GUIDE
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Table of Contents
Depression at RootPsych: Looking Beyond “Chemical Imbalance”
Depression isn’t just simple sadness but rather it’s a whole-body condition involving energy, cognition, mood, sleep, appetite, and motivation.
At RootPsych we assume:
Your symptoms are real
There may be biological factors that standard care doesn’t check for
Addressing these factors can improve outcomes
What Is Depression?
Common symptoms:
Low mood
Loss of interest
Fatigue
Sleep problems
Appetite changes
Brain fog
Irritability
Feelings of guilt or hopelessness
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Brain chemistry shifts
Nutrient issues: B12, folate, zinc
Thyroid dysfunction, including reverse T3
Inflammation affecting neurotransmitters
Gut–brain disturbances
Chronic stress
What Is Treatment-Resistant Depression?
Usually defined as:
Trying two adequate antidepressant trials
Still experiencing significant symptoms
This doesn’t mean you’re untreatable — often something important has been missed.
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Subclinical B12 or folate issues
Low zinc impairing neuroplasticity
Suboptimal thyroid function
Inflammation biasing mood
Gut dysbiosis
Vitamin B12 & Depression
Low or borderline B12 is common in depression and especially in treatment-resistant depression.
What We Evaluate:
Serum B12
Methylmalonic acid
Homocysteine
Sometimes “active B12”
Zinc & Depression
Low zinc is associated with:
Worse depression symptoms
Lower antidepressant response
Reduced neuroplasticity
How We Approach Zinc:
Fasting serum zinc
Copper:zinc balance
Adjunctive zinc (~25 mg elemental) when appropriate
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Traditional ranges only screen for severe deficiency
Psychiatric symptoms can appear at low-normal levels
Functional markers (MMA, homocysteine) reveal early deficits
Thyroid (Including Reverse T3) & Mood
Even normal TSH can hide low T3 activity or high reverse T3.
Symptoms may include:
Fatigue
Low mood
Brain fog
Weight or temperature sensitivity
Slowed thinking
What We Test
TSH
Free T4
Free T3
Reverse T3
Antibodies (as needed)
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Chronic fatigue
Brain fog
Long-standing depression
Atypical depression symptoms
Inflammation: TNF-Alpha & CRP
Inflammation can directly affect mood and neurotransmitter signaling.
We often check:
High-sensitivity CRP
TNF-alpha
High levels may suggest an inflammatory subtype of depression, which responds to targeted treatment.
Gut Health & the Microbiome
Gut imbalance can increase stress, anxiety, and depression.
Psychobiotics (specific probiotics) show:
Modest mood improvements
Reduced anxiety
Better sleep and stress resilience
Especially helpful for those with GI symptoms.
What a RootPsych Work-Up Includes
Clinical history
Targeted labs:
B12 panel
Zinc
Thyroid with reverse T3
CRP, TNF-α
Optional gut-related markers
Tailored plan combining:
Current meds/therapy
Nutrients
Anti-inflammatory strategies
Gut–brain tools
Lifestyle & integrative care
Will This Replace My Meds or Therapy?
No — this approach is additive.
Many people feel better when root causes are addressed alongside their current treatments.
When to Get Evaluated
You should consider a deeper assessment if:
You’ve tried multiple treatments without relief
You’re fatigued or foggy without clear explanation
Symptoms fluctuate unpredictably
You feel like “something else is going on”
Clinically Reviewed By: