DEPRESSION
Depression is a psychological mood state that may be mild or severe. Typical symptoms of depression include hopelessness, decreased interest in usual activities, insomnia or excessive sleep, significant loss of weight or appetite, lack of energy, feelings of guilt or worthlessness, agitation or slowing of movements, inability to think or concentrate and suicidal thoughts. Additional symptoms may include crying spells, decreased sex drive, irritability, impaired functioning in usual activities and isolation from others. This disorder is very common and may afflict 10-20% of the population over the course of a lifetime. Twice as many women are diagnosed with depression as men but this may reflect a greater willingness by women to seek help. Depression is a significant health risk. Depressed people die younger, get cancer more often and are more likely to have other serious illnesses.
The causes of depression are numerous and there is a genetic component. Half of depressed people have a family history of depression. Commonly overlooked physical disorders causing depression include candidiasis (yeast overgrowth), chronic fatigue syndrome, chemical hypersensitivity syndrome (often due to liver malfunction), vitamin deficiency, inhalant and food allergies and low thyroid function. Seasonal affective disorder is due to lack of sufficient sunlight in the wintertime. Many prescription drugs can cause depression, including Tagament, Inderal and other beta-blockers, narcotics, corticosteroids (prednisone), tranquilizers, sedatives and alcohol. Emotional and mental factors that can lead to depression may include distorted thinking, grief over loss, history of abuse and/or violence (as a child, in an adult relationship, crime victims, war or torture), divorce, retirement, and many more. Spiritual factors can include lack of purpose in life, feeling isolated, lack of connection to others and feeling disconnected from God.
Conventional medical treatment relies upon antidepressant medication and various types of psychotherapy. While prescription medications often are effective, they do not address the underlying cause(s). In severe cases, they can be used to stabilize the mood state and other approaches can then be safely pursued.
A holistic approach should include a thorough medical evaluation to rule out physical diseases that can cause depression. The diet needs to be of high quality and should include vegetables, legumes, whole grains and lean meats. Sugar, caffeine and alcohol are to be avoided. A food elimination diet may be helpful. Numerous supplements have been shown in studies to be helpful. B vitamins, phenylalanine, L-tyrosine, glutamine, taurine, 5-hydroxytryptophan, Vitamin C and E, zinc and magnesium and essential fatty acids all may help depression.
The primary herb with a good track record helping mild to moderate depression is St. John’s wort. It is as effective as medications and has far fewer side effects. The onset of action is slower however. This herb can interact with other medications so consult your physician before starting it.
Ginkgo biloba may be helpful as well by improving circulation to the brain.
Regular physical exercise has an outstanding record of helping depression with low cost and minimal risks. Joining an exercise class or group is often a good way to get motivated.
A host of other techniques may be helpful by themselves or used in conjunction with other therapies. Acupuncture, affirmations, meditation, visualization, prayer, energetic healing, breathing exercises, biofeedback, journaling, hypnosis and bodywork can all be of benefit for certain people.
Depression is not a moral failure and can always be helped in anyone willing to commit to changes in their life.
Daniel Blodgett MD