Depression: The 5 Biotypes

By Samantha Gilbert, FNC, CHNP, CNC     Last updated on October 30th, 2022

Depression: The 5 Biotypes

Born with epigenetic disorders, I struggled with depression for most of my life.

Over the years I’ve tried a variety of antidepressants such as Prozac and Zoloft, as well as amino acid therapy (5-HTP, etc.), and other herbal remedies such as St. John’s Wort.

Some helped a bit, which was a clue to my undermethylation status, but they had nasty side-effects and over time, actually made me feel worse.

Since most psychiatrists believe that depression is caused by low levels of the neurotransmitter serotonin, SSRI anti-depressants (Selective Serotonin Reuptake Inhibitors) tend to be the standard of care because they inhibit the removal of serotonin from synapses by transport proteins called serotonin transporters (SERT). Unfortunately, this is a very flawed approach because it doesn’t take into account the unique biochemical imbalances and symptoms of the individual.

Thanks to the amazing 40-year research by William J. Walsh, Ph.D., president of the Walsh Research Institute, and clinical applications by Drs. Albert Mensah and Judith Bowman of Mensah Medical, I was finally able to get to the root cause of my suffering and eliminate my depression for good. Today, I partner with them on nutritional therapy programs.

With a database of 300,000 blood and urine chemistry test results and 200,000 medical history factors from approximately 2,800 patients diagnosed with depression, Dr. Walsh and his team found that there are actually five major depression biotypes (I’ve added four additional types that can also create depressive symptoms).

What’s even more fascinating is that three of these forms of depression are not caused by fluctuating serotonin levels, which explains why some people experience relief with SSRI’s and others do not.

Keep in mind that each imbalance can produce a wide range of symptoms and outcomes. For example, copper overload and undermethylation are the factors that contributed to my depression, high anxiety, disordered eating, digestive, menstrual, and other health problems. This is why my work is based on biochemical individuality, meaning what’s good for your best friend, is often not good for you too.

The 5 Depression Biotypes


The most common biotype, these folks tends to see improvement with SSRI’s. The problem in these cases is low activity at serotonin receptors due to rapid reabsorption after serotonin is released into a synapse; as well as high blood levels of histamine, another neurotransmitter. It’s actually not so much a serotonin deficiency, but an inability to keep serotonin in the synapse long enough. For more detailed information, see this post.

Pyrrole Disorder

This biotype also tends to see improvement with SSRI’s. Pyrolurics exhibit a combination of impaired serotonin production and extreme oxidative stress. These individuals have elevated urine pyrroles coupled with severe zinc and vitamin B-6 deficiency. Omega 3 supplements create more inflammation for these folks. Sensitivity to noise and bright lights, poor short-term memory, no dream recall, frequent infections, extreme mood swings, high anxiety, alcoholism, tendency to skip breakfast, poor growth, an affinity for spicy food, fears, and dry skin are all symptoms. This type is the fastest to respond to treatment. For more detailed information, see this post.

Copper Overload

High copper folks cannot properly metabolize metals. Most of these people say that SSRI’s do not have much of an effect either way, but they report benefits from normalizing their copper levels through nutrient therapy. High copper affects women who are also estrogen intolerant. In copper overload, it’s not so much a serotonin issue, but extreme blood and brain levels of copper that result in dopamine deficiency and norepinephrine overload. High copper is indicated in cases of postpartum depression. Andrea Yates who drowned her five children in 2001 is an extreme example. For more detailed information, see this post.

Overmethylation (folate deficiency)

This biotype tends to get worse on SSRIs, while folic acid supplements help. A study of 50 school shootings over the past five decades showed that most shooters probably had this type of depression, as SSRI’s can cause suicidal or homicidal ideation in these people. For more detailed information, see this post.

Toxic Metal Overload

This type of depression is caused by toxic metals (not including copper), usually, lead poisoning. Over the years, this type accounted for 5 percent of depressed patients, but removing lead from gasoline and paint has lowered the frequency of these cases.

Other Clinical Factors that May Also Cause Depression

Food Intolerances (gluten, dairy, and naturally occurring plant-based chemicals such as salicylates and oxalates, to name a few)
Blood Sugar Dysregulation (hypo or hyperglycemia)
Gut pathogens (such as yeast and bacterial overgrowth)
Thyroid diseases and imbalances

If you know of someone who struggles with depression, please share this post. If you struggle with depression, please share your experience in the comments below. It is through sharing your story that we create community, eliminate guilt and shame, and bring about healing.


37 thoughts on “Depression: The 5 Biotypes”

  1. I was diagnosed over and under methylated which is rare. My copper is more than twice my zinc which makes my biochemistry very unusual. I am an angry and very anxious person. I would love to work this out!


    1. Hi Susan,
      Yes, an assessment and testing is what I use, but labs are determined post-assessment so I know what to order for you. Click here to schedule a complimentary session with me to see how I can help.

  2. Great website!!

    What type of multi b should folks with pyroluria take if they are also undermethylated? (I heard that taking b6 alone can cause deficiency in other bs.)


  3. Can antidepressants cause the conditions above? I was on them 17 yrs for anxiety low confidence but over the yrs would try yo stop and develop horrendous suicidal depression. I then had a severe reaction to another antidepressant last year and now suffering from among other things histamine intolerance.

    These antidepressants need to be investigated. The group that do poorly on them in my support group don’t just suffer while they are on them.. 8 yrs later after bad reaction a few people still suffering.

  4. Interested in getting help for an UM, pyrroluric, copper overload, toxic metal, and low cortisol. Will be doing repeat tests WBH, pyrrole, and 1st time hair test for Mensah but the individual is not interested in supplements and more interested in organic means. Looking forward to suggests. Thanks.

    1. Hi Denise,
      Honestly, with that kind of chemistry, diet alone will not suffice, but will provide some benefits. If you are a practitioner, you can email my assistant for further information on consulting with me.

  5. Thanks for sharing. I took SSRI for 3 years, and had to stop because of severe side effects. Currently I take no medication, just using Reliv nutrition for my nerve pain, ear and neck pain, and for depression. My depression got worse after work injury, and being in pain every day for six and half years. I never thought nutrition can help me this much. I hope more doctors will look into nutrition rather than medication. Keep up the good work.

  6. Are you asserting that all depression is biological and essentially a medical problem? What about early life trauma, later trauma, chronic stress, social isolation, cultural alienation, grief, spiritual and existential crises, family dysfunction, etc?

    I have been tested for some of the things you mention. Definitely relevant. But seems to me the roots are often deeper. And working only at the level of the physiology is maybe not gonna cut it for some.

    BTW, seems the reason the SSRI approach is flawed is because there has never been compelling evidence implicating serotonin deficiency in depression in the first place. According to my reading anyway.

    1. Doug, I think all of that affect depression. However, from what I have gone through, there is always ways to get over the past, and have a happier life. I still suffer with depression, I have to watch my thoughts, but I can definitely see that I can do something for my depression. I don’t want my past to control me. When I am thinking negatively, there are chemicals released in my brain to make it worse. When I try to think positive, and do things to make me feel better, then I can feel happier. Going through therapies helped me a lot along with nutritional approach. Trying to help other people also help me with my depression.

  7. So how do you get the blood tests for these diagnosis to be determined. Most regular doctors wouldn’t entertain the idea.

  8. Great article!

    I do disagree on one point about benzodiazepines. Those are not good long treatments because they downregulate the gaba receptor and other receptors in the brain. In the long run they aggravate anxietyamd depression. Not to mention they are associated with Benzo Withdrawal Syndrome and jave tolerance withdrawal effects.

    Thanks for the good read!

    1. Hi Amy,
      Thank you, I couldn’t agree with you more and wish benzos were never prescribed, but some patients in extreme pain do experience relief with them short-term while better options are explored. The key word here being “short-term.”

      1. Absolutely correct! As many side effects Diazepam and likes has there’s cases that they’re must for short term use.

  9. Hi Sami! Thanks so much for your valuable information. So, how do I know what type of issue I have, of those 6 types of causes? Blessings. Jose

  10. hey sam, doctor said that i got depression and i have bipolar diaorder, i read some articels and it is said that food can fix the mental illness. can you gimme some tips to ease me to go through this hard times. lately i feel so low. actually i dont feel like a have a manic part of bipolar all that i know i feel so week and anxious about a lot things even some bad thoughts sometime fly on to my mind i dont know what to do but in trying my best to find a way out. can you please suggest me avout what kinf of supplements or vitamina and also effort which is better to be done to make me feel better? thanks. i live far away from you that it may be hard for me to do lab test as there is no kind of medication which is familiar like that near here. thanks.

  11. Major depression is a day-to-day challenge; It takes hard work to defeat it however natural solutions are quite helpful. For anybody struggling from depressive disorders, I recommend the. Written by James Gordon, a depression & PTSD sufferer who struggled with major depression for thirty years, it teaches 7 natural steps that he implemented to treat his own depression and has helped 1000s.

  12. Can a person be a combination of several types (ie, copper toxic, pyroluria, and undermethylator)? If so, how would one approach treatment?

    Lastly, how would a person address the biochemical imbalances if also struggling with chronic in lyme?


    1. Hi Ann,
      Great question! Yes, multi-biotypes are very common. Treatment is based on a thorough assessment and lab work, so the approach will vary based on those outcomes, as well as the severity and symptoms of lyme disease.

  13. Hi Sami,

    I was wondering if you could help me. My 16 yr old son suffers from depression. He was always in gifted programs in school because of his intelligence. A few years ago he started underachieving in school mainly because of his lack of caring about grades or homework. This year he began dabbling in alcohol, marijuana, and just last week tried hydrocodone that he bought from someone at school. He is desperately trying to feel better. I have always found out, by the grace of God, right away when he has tried something. He has always been open and honest with me about it. This last time he started sobbing saying how much better he felt with the pain killer….more motivated, happy, etc. He has always been an extremely calm kid, never very excited or upset. He is polite and doesn’t get in any other trouble. He’s not a big sports kid(cross country), but is competitive when it comes to games or gaming. For the last year or so sleep has been a major problem for him.

    In light of the last incident, I was very close to putting him on an anti-depressant. A friend of mine gave me the book by Dr. Walsh, Nutrient Power and Heal with Amino Acids by Dr. Sahley. After reading those I decided he was most likely an undermethlylator. I started him on 5HTP and L-Tyrosine. My question is this…He’s only been taking for 2 days but says he’s having headaches. He experienced some anxiety the first day and some nausea the second morning. Do you think these are normal reactions?

    1. Hi Chris,
      Thanks for sharing about your son. 5-HTP and L-Tyrosine are powerful nutrients and I don’t recommend taking them without proper testing. Despite what’s online, they are not safe for everyone.

  14. That is interesting reading. I have schizophrenia, epilepsy and clinical depression. In 1998 I attempted suicide and in 2007 I contemplated suicide 3 times. I am psychologically improving thank goodness. Thank you for sharing that information.

  15. Keep up the good work Samantha. This message needs to get out more into the mainstream. I too suffered from depression when I was in my 40s and contemplated suicide. I feel your mission is to get this message out and I pray you are shown the path !!

    Love and Light


    1. great work Samantha, it is very helpful article to understand the biological depression.
      one my family member has been in depression. it is nicely informative article.

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