Depression: The 5 Biotypes

By Samantha Gilbert, FNC, CHNP, CNC     Last updated on August 17th, 2021

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

Over the years I’ve tried a variety of anti-depressants 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.


36 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.

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